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Health Net Federal Services

Details: Health Net Federal Services Launches Pilot Program Aimed to Improve Patient Outcomes While Maintaining Budget Certainty Through High-Value Care. Health Net Federal Services Earns URAC Accreditations in Health Utilization, Case and Disease Management. Vaccine Guidelines and …

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Check the Status or Make Changes

Details: Health Net Federal Services, LLC (HNFS) is unable to access referrals within the military health system. Routine requests are processed within 2–5 business days of receiving the complete request from the provider. Urgent requests are processed in an expedited manner for care that needs to be delivered within 72 hours.

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Home Health Care Details

Details: Home health care is covered for skilled nursing care and physical, speech and occupational therapy. Providers following the prospective payment system (PPS) may be authorized for a maximum of 28 hours per week part time or 35 hours per week intermittent.

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Telemedicine Billing

Details: Providers must bill using CPT® or HCPCS codes with a GT or 95 modifier for distant site and Q3014 for an applicable originating site to distinguish telemedicine services. Payment for Q3014 will not be made when a patient's home is the originating site. The distant site and originating site cannot be billed by the same provider.

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Check Credentialing Status

Details: Check Credentialing Status. This tool is to check credentialing status of a facility or an individual provider and not an entire group or clinic. Do not use this tool as confirmation of network status; rather, refer to your Provider Participation Agreement or contact your practice administrator.*. Per the terms of the Provider Participation

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How TRICARE Works with Other Health Insurance

Details: Health coverage through an employer, association, private insurer, school health care coverage for students, or Medicare is always primary to TRICARE. Exceptions are: Medicaid, State Victims of Crime Compensation Programs, Department of Veterans Affairs (DVA)/Veterans Health Administration (VHA), the Maternal and Child Program, the Indian

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What is Fraud and Abuse

Details: Health Net Federal Services, LLC (HNFS) has an entire department dedicated to combating health care fraud and abuse committed against the TRICARE program. This department is called Program Integrity, and like the name, the mission is to ensure the integrity of the TRICARE Program. Health Net Federal Services embraces a team approach in all areas.

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TRICARE West For Providers

Details: TRICARE's Childbirth and Breastfeeding Support Demonstration to start Jan. 1. Updated process for letting us know if you are accepting new patients. Autism Care Demonstration: Understanding outcome measures and clinical necessity reviews. Preview the …

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Company Information

Details: Health Net Federal Services, LLC. For more than three decades, Health Net Federal Services (HNFS) has partnered with the Department of Defense to provide health care services to those who serve and their family members. HNFS currently assists nearly 2.9 million beneficiaries in the TRICARE West Region, including active duty and retired service

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What Is Fraud and Abuse

Details: Health Net Federal Services, LLC (HNFS) has an entire department dedicated to combating health care fraud and abuse committed against the TRICARE program. This department is called Program Integrity, and like the name, the mission is to ensure the integrity of the TRICARE Program. Health Net Federal Services embraces a team approach in all areas.

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MHC Provider Requirements

Details: An individual must meet the following requirements to become an SMHC: 1. Possess a minimum of a master’s degree in mental health counseling or allied mental health field from a regionally accredited institution; and. 2. Have two years of post-master’s experience which includes 3,000 hours of clinical work and 100 hours of face-to-face

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Preventive Services Details

Details: Health promotion and disease prevention exam claims usually include a general medical examination diagnosis (V70 or V70.0). A separate diagnosis code for an immunization, screening Pap test, breast cancer screening, colorectal cancer screening, or prostate cancer screening is required for claims payment.

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Out of Network Requests for Prime Beneficiaries

Details: TRICARE Prime beneficiaries (excluding active duty service members) who receive care from a non-network provider without a prior authorization or referral from Health Net Federal Services, LLC (HNFS) will be subject to paying Point of Service charges. If a non-network provider is requested for a TRICARE Prime beneficiary and there are network

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Network Providers

Details: Health Net Federal Services, LLC (HNFS) offers a Network TRICARE Provider Roster for network provider groups to use when adding new providers who need to be credentialed (or certified for behavior technicians), and to submit demographic updates. See tip below for opening/saving the Excel file.

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Log In or Register

Details: Providers registered at www.tricare-west.com can access all the tools on our secure portal: submit claims and referrals and check status, verify patient eligibility, view provider remits, and more. Register today to get started. PROVIDER REGISTRATION. For support with login issues please call 1-800-440-3114. Support hours are Monday - Friday 6

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TRICARE and Other Health Insurance

Details: Health coverage through an employer, association, private insurer, school health care coverage for students, or Medicare is always primary to TRICARE. Exceptions are: Medicaid, State Victims of Crime Compensation Programs, Department of Veterans Affairs (DVA)/Veterans Health Administration (VHA), the Maternal and Child Program, the Indian

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Online Provider Education

Details: HNFS recognizes mental health care providers who have earned the Department of Defense’s (DoD) provider readiness designation by displaying a medicine bag icon next to their listing in the Network Provider Directory. The following four courses, offered by the Center for Deployment Psychology (CDP) of the Uniformed Services University of the

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Provider Directory

Details: Connect with a Telemedicine Provider. Now, more than ever, it’s important for beneficiaries to be able to easily connect with providers who can see them via virtual appointments. Select "Telemedicine" in our online directory to filter your search results, or beneficiaries can connect with a mental health provider through Telemynd.

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Orthotics Details

Details: Orthotics. Orthotic devices are a covered benefit and must be medically necessary to diagnose or treat a covered condition, approved by the U.S. Food and Drug Administration (FDA) and provided by a TRICARE-authorized provider. Coverage includes, but is not limited to: spinal (thoracic, cervical, lumbar, sacral), lower limb (hip, knee, angle

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Become a Non-Network Provider

Details: ABA Provider Certification Applications. All non-network provider certification applications should be sent via mail or fax to: TRICARE West – Provider Data Management. PO Box 202106. Florence, SC 29502-2106. Fax: 1-844-730-1373. Once all information is received, processing time can take up to 30 days.

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Stay Healthy with HNFS

Details: Diabetes is a common, yet serious disease affecting millions of Americans. If you have diabetes, visit our Diabetes Care page to learn about tests you need to help you manage your diabetes and get you started on the path to improved health and well-being.

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Maternity Care Details

Details: The Newborn's and Mothers' Health Protection Act of 1196 (NMHPA) is a federal law that affects the length of time a mother and newborn child are covered for a hospital stay in connection with childbirth. Health plans are prohibited from restricting benefits to stays less than 48 hours after a vaginal delivery or 96 hours following delivery by

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Non-Network Applications

Details: Non-Network Certification Applications. All non-network provider applications should be sent via mail or fax to: TRICARE West – Provider Data Management. PO Box 202106. Florence, SC 29502-2106. Fax: 1-844-730-1373.

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Mental Health Details

Details: Mental Health Benefits. Anger Management Treatment. Eating Disorder Treatment. Electroconvulsive Therapy (ECT) Family Therapy. Gender Dysphoria Treatment. Hospitalization for Mental Health. Intensive Outpatient Program for Mental Health and/or Substance Use Disorder. Marriage Counseling (Marital Therapy)

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Home Infusion Therapy Details

Details: Health Net Federal Services will generate authorizations as appropriate if the drug is a covered benefit. If covered under the medical benefit, the provider should submit the claim to PGBA. If covered under the TRICARE pharmacy benefit, HNFS will fax an authorization to the TRICARE pharmacy and the provider should submit the claim to the

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Military Children, Deployment and Mental Health Care

Details: Two childhood mental health conditions that are especially problematic to military families are obsessive-compulsive disorder and oppositional defiant disorder. The latter condition is a significant problem when military families want to relocate overseas because this disorder in a child can disqualify them from an overseas assignment.

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Claims Submission

Details: Health Net Federal Services offers payments and remittances by National Provider Identifier (NPI) number. The NPI billed on the claim will determine where payment and remittance will be sent. Visit our NPI forms page to print and complete …

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