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Welcome to the East

TRICARE is now managed in two separate regions, with two new regional contractors. Humana Military manages the new East Region, while Health Net Federal Services, LLC manages the West Region. The East Region contract covers approximately 6 million TRICARE beneficiaries in a 32-state region (including D.C.).

The team of experienced administrators for the East Region includes Humana Military as the managed care support contractor and Wisconsin Physicians Service (WPS), conducting claims processing. Learn more about being a part of the TRICARE East network.


Changes in TRICARE

  • WPS is the TRICARE East Region claims processor. Any existing claims can be mailed to: TRICARE East Region Claims, PO Box 7981, Madison, WI 53707-7981.
  • WPS requires all electronic providers/groups sign, and have on file, a Trading Partner Claims Agreement prior to submission of electronic claims. Providers who will submit EDI claims directly to WPS must complete the self-registration process.
  • EMC applications are available electronically for self-registration.
  • ERA and EFT options are available.
  • TRICARE Select replaced TRICARE Standard and TRICARE Extra. Learn more at TRICARE.mil/changes or visit Health.mil to find information you can share with your patients.
  • If your current contract is with Humana Military, you do not need to execute a new provider agreement.
  • Beneficiaries in the Lubbock and Amarillo, TX areas are now a part of the TRICARE West Region. The new regional contractor for the West Region is Health Net Federal Services, the same contractor that supports Cannon Air Force Base in Clovis, New Mexico.
  • Any carry-over referrals and authorizations, approved prior to December 31, 2017, are still good in 2018.
    • Routine care is any regular visit to a Primary Care Manager (PCM), or care received by another doctor that a beneficiary’s PCM has sent him or her to see. Routine care can be check-ups, physicals, health screenings or care for health problems such as diabetes, hypertension and asthma.
    • Urgent referral is a medically necessary treatment, required for illness or injury that would not result in further disability or death if not treated immediately. The illness or injury does require professional attention, and should be treated within 24 hours to avoid a situation in which further complications could result without treatment.
  • Prior authorization from Humana Military is required for procedures and services found on the prior authorization list.

Former TRICARE North providers:

Health Net Federal Services referrals are not viewable on Humana Military’s web portal.
Humana Military will honor all referrals and authorizations from Health Net Federal Services until
they expire. If you have a copy of the referral, Humana Military will honor it. No action is required on
your end. Beneficiaries should have received a copy of the approval letter from Health Net Federal Services.

To view or obtain a copy of your referral, log into Health Net Federal Services’ web portal and view approved
referrals and authorizations. This access is available through the end of June 2018. Visit now

If you need to change the rendering provider, add a visit(s), add a CPT code(s), or extend the expiration date
30 days on a referral or an authorization created by Health Net, you can submit a new request on the provider
self-service portal. Self-service is the easiest way to request a change; most referrals are approved immediately
upon submission. If you need additional help, please call us at 1.800.444.5445.

Self-service log in

REGISTER

Claims and other self-service features
are now available on Humana Military's self-service portal.

Log in or register

DISCOVER

We offer a variety of provider education
materials including the provider
handbook, orientation presentations
and more.

Learn more

INQUIRE

If you are not already a network
provider and are interested in
joining the network, you can learn
more about how to submit an inquiry.

Get started

Connect with us

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Live chat

Chat is available during business hours through provider self-service. Customer service representatives are standing by to assist TRICARE providers with questions and concerns.

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Provider self-service

Provider self-service is available 24/7 and offers many features that will save time, ensure patient privacy and help manage your office more efficiently.

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Call 1.800.444.5445

Our knowledgeable customer service representatives are available during business hours to answer questions and direct TRICARE providers to subject matter experts.

Electronic Media Claims (EMC):
Provider claims & East Region phase in


The new East Region TRICARE contract begins January 1, 2018 with a new fiscal intermediary.
The first phase for provider claims is transition of your EDI processes for EMC, EFT and ERA.


Learn more