TRICARE authorizations and certification

TRICARE only reimburses appropriate covered services for eligible beneficiaries provided by TRICARE-authorized providers. TRICARE-authorized providers must meet TRICARE licensing and certification standards and must comply with regulations specific to their healthcare areas.

Authorized providers are considered non-network TRICARE-authorized providers. Non-network providers may also choose to “accept assignment” (i.e., participate) on a case-by-case basis. If a non-network provider accepts assignment, he or she is considered a participating non-network provider and agrees to accept the TRICARE allowable charge as payment in full for covered services.

Nonparticipating non-network providers do not have to accept the TRICARE allowable charge or file claims for beneficiaries.

All providers must submit certification forms to WPS to become a TRICARE-authorized provider. Complete the applicable form below and submit it to the address or fax number on the form: