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2021 TRICARE Provider Handbook Now Online to Preview

Tuesday, December 1, 2020

The 2021 TRICARE West Region Provider Handbook, effective Jan. 1, 2021, is available to preview. The handbook is updated annually and contains important information about TRICARE contract requirements along with the most recent updates. Providers are required to review the handbook in its entirety as a component of their TRICARE Provider Agreement.

As a reminder, network providers agree to (list is not all inclusive): 

  • Submit TRICARE claims electronically (except for providers who are in Alaska).
  • Comply with prior authorization and referral requirements.
  • Not accept reimbursement in excess of the TRICARE/CHAMPUS Maximum Allowable Charge.
  • Maintain credentialing requirements for all providers within the group.
  • Provide patient encounter reports (also known as clear and legible reports or CLRs) to referring providers in a timely manner.
  • Inform Health Net Federal Services, LLC (HNFS) of demographic updates in a timely manner.

Changes to TRICARE programs are continually made as public law, federal regulation, and HNFS’ managed care support contract are amended. Please continue to visit www.tricare-west.com for the most up-to-date information.

HNFS greatly values your commitment to the health and well-­being of our uniformed service members and their families. Your participation in the TRICARE provider network is essential to the success of the program.