Doctor and female patient meeting at the hospital and shaking hands, healthcare and medicine banner

Become a TRICARE provider

As the healthcare program for uniformed service members, retirees, and their families, TRICARE supplements military healthcare resources with civilian providers to offer quick access and high-quality services.

What does it mean to be a TRICARE provider?

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.

TYPES OF TRICARE PROVIDERS

TRICARE-certified providers

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.

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Fill out and submit certification application

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Receive approval notification

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Submit claims for beneficiaries and receive payment from TRICARE

Once you are TRICARE-certified, you are considered a non-network provider until you request and are approved to be a network provider.

Non-network providers

Participating providers:

  • Must be TRICARE-certified
  • Agrees to accept the TRICARE Maximum Allowable Charge (TMAC) as payment in full for services

Non-participating providers:

  • Must be TRICARE-certified
  • Does not agree to accept the TMAC as payment in full for services, but can elect to accept TMAC on a claim-by-claim basis

Network providers

  • Must be TRICARE-certified
  • Accepts the TMAC minus an agreed-upon discount as payment in full
  • Agrees to submit claims electronically for TRICARE beneficiaries
  • Agrees to a discount off the 100 percent TMAC or billed charges if no TMAC exists


Join the TRICARE East network