TRICARE deﬁnes a provider as a person, business or organization that provides healthcare. Certain provider types are recognized as TRICARE-authorized providers, meaning they are eligible to provide services and submit claims for TRICARE beneficiaries. All TRICARE-authorized providers must be certiﬁed under TRICARE regulation and must have that certiﬁed status veriﬁed in the East Region.
After TRICARE-authorized providers have completed the TRICARE certification process, they can choose to become a non-network participating provider, a non-network non-participating provider or a TRICARE network provider. A TRICARE network provider has been certiﬁed for TRICARE and has a contract with Humana Military, following speciﬁc compliance rules deﬁned for network providers. Providers can request to join the network once they are certiﬁed.
Providers must be TRICARE-certified in order to ﬁle claims and receive payment for TRICARE services. TRICARE-certified providers must meet the licensing and certiﬁcation requirements of TRICARE regulations and practice for that area of healthcare.
Fill out and submit certiﬁcation application
Receive approval notiﬁcation
Submit claims for beneﬁciaries and receive payment from TRICARE