TRICARE Provider Credentialing: How to Become a TRICARE-Authorized and Network Provider (2026 Guide)

TRICARE is not a commercial plan with a federal logo on it. It is a Department of Defense health program run by the Defense Health Agency, and the work of certifying providers, building networks, issuing referrals and paying claims is outsourced to two regional contractors. Treat it like one more payer on the CAQH attestation and you will spend months wondering why claims deny for a provider you thought was "in." This guide walks through the actual sequence: get certified as a TRICARE-authorized provider first, then decide whether to contract with the network, then set up referrals and claims correctly for your region.

Fast Track Credentialing is an independent credentialing service and is not affiliated with, or endorsed by, the Department of Defense, the Defense Health Agency, or any TRICARE contractor. Everything below is drawn from the public pages of tricare.mil, health.mil, Humana Military and TriWest; where a rule could not be confirmed on an official page, we say so and tell you to confirm with your regional contractor.

Start here: authorized, network, participating

Three words drive every TRICARE credentialing conversation, and they mean different things.

TRICARE-authorized (also called TRICARE-certified). An authorized provider is "any individual, institution/organization, or supplier that is licensed by a state, accredited by national organization, or meets other standards of the medical community, and is certified to provide benefits under TRICARE" (All Provider Directories, tricare.mil). Certification is the gate. Without it, TRICARE pays nothing for your services, network or not. Humana Military states it plainly for the East Region: providers must be TRICARE-certified in order to file claims and receive payment for TRICARE services (TRICARE Certification and Network Information, Humana Military).

Network provider. "Any TRICARE-authorized provider that has signed a contract with your regional contractor is a network provider" (Network Providers, tricare.mil). Network status is a contract layered on top of certification. It comes with a credentialing review, a fee arrangement, and obligations such as filing claims for the beneficiary and honoring referrals.

Non-network provider, participating or non-participating. Any TRICARE-authorized provider who has not joined the network is a non-network provider (Network Providers, tricare.mil). Non-network providers choose, claim by claim, whether to participate. Participating providers accept the TRICARE allowable charge as payment in full and file the claim. Non-participating providers may bill the beneficiary and can balance bill up to 115 percent of what TRICARE allows, which is the 15 percent above the allowable charge that TRICARE permits; network and participating providers may not balance bill at all (Balance Billing, tricare.mil West Region; TRICARE-allowable charges and balance billing, TRICARE Newsroom).

The last row is where new practices get hurt. Humana Military's certification FAQ states that if a provider is not TRICARE-authorized or certified on the date services are rendered, the claim will deny, and if the provider never completes certification paperwork the beneficiary becomes responsible for all charges (Provider Certification FAQ, Humana Military). Certification is date-of-service driven. Seeing TRICARE patients "while the paperwork is in" is a plan to write off visits.

How TRICARE is structured in 2026

The Defense Health Agency runs TRICARE. It sets policy through the TRICARE Policy Manual and TRICARE Operations Manual, and it awards regional managed care support contracts. TRICARE is managed in three separate regions: the East Region, the West Region, and the Overseas Region (Regions, tricare.mil). This guide covers the two stateside regions.

The current contract generation, referred to as T-5, took effect on January 1, 2025. The contractor for the East Region is Humana Military. The contractor for the West Region is TriWest Healthcare Alliance (Who are the East and West Regions (T-5) contractors?, tricare.mil). The transition also moved six states. Starting January 1, 2025, Arkansas, Illinois, Louisiana, Oklahoma, Texas and Wisconsin moved from the East Region to the West Region, with TriWest replacing Health Net Federal Services as the West contractor, while Humana Military remained the East contractor (Understanding the New TRICARE Contract Region Changes Starting on Jan. 1, 2025, health.mil; Reminder: TRICARE Regions Are Changing Jan. 1, 2025, TRICARE Newsroom).

TriWest publishes the resulting West Region map: 26 states, namely Alaska, Arizona, Arkansas, California, Colorado, Hawaii, Idaho, Illinois, Iowa, Kansas, Louisiana, Minnesota, Missouri, Montana, Nebraska, Nevada, New Mexico, North Dakota, Oklahoma, Oregon, South Dakota, Texas, Utah, Washington, Wisconsin and Wyoming (TriWest TRICARE West Region Provider Handbook, Intro to TRICARE). Everything else stateside is East.

Two practical consequences follow from the map. First, your region is determined by where you render care, not by where the beneficiary is enrolled, so a group with sites on both sides of a regional line certifies and contracts with both contractors. Under the pre-2025 map, parts of Iowa and Missouri were split between regions; TriWest's current list places both states entirely in the West Region. If your practice sits near a former boundary, confirm with your regional contractor. Second, if you were an East Region provider in one of the six moved states, your Humana Military certification and contract did not carry over to TriWest automatically. If your office is still billing the East payer ID for a Texas or Illinois location, that alone explains a run of rejections.

There is one more contractor you will meet: the claims processor. Both regional contractors now use PGBA, LLC. Humana Military's claims processor switched from Wisconsin Physicians Service to PGBA effective January 1, 2025 (Provider Updates, Humana Military), and TriWest describes PGBA as its claims processing partner (Claims Clearinghouses, TRICARE West).

Provider types TRICARE authorizes, and the ones with extra rules

TRICARE authorizes individual professional providers, institutional providers and corporate services providers. The certification application is provider-type specific. TriWest, for example, publishes separate certification applications for physicians (MD, DO), certified physician assistants, certified nurse practitioners, clinical social workers and mental health counselors, each listing its own required documentation (TRICARE West Region Provider Forms, TriWest). Humana Military maintains an equivalent library of practitioner, institutional and corporate certification applications (TRICARE Certification and Network Information, Humana Military).

Licensure is non-negotiable and TRICARE reads it strictly. TriWest's certification page notes that if state licensure is available, it is required even if the state offers licensure on a voluntary basis (Provider Certification and Credentialing, TRICARE West). A provider type that is unlicensed in your state but licensed in others will be measured against your state's rules.

Provider types that require supervision or a physician referral

TRICARE covers several behavioral health provider types only under supervision or with a physician referral, and this is where practices most often misjudge eligibility.

• Mental health counselors. A TRICARE Certified Mental Health Counselor (TCMHC) practices independently. The counselor must be licensed for independent practice in mental health counseling by the jurisdiction where practicing and must meet the post-master's supervised practice thresholds in the TRICARE Policy Manual, Chapter 11, Section 3.11. A counselor who does not meet all TCMHC requirements may qualify as a Supervised Mental Health Counselor (SMHC), a category that requires physician supervision and referral (TRICARE Provider Handbook East Region 2026, Humana Military; TRICARE Certification and Network Information, Humana Military). The two categories are certified differently and paid differently, so the application must match the counselor's actual qualifications.
• Pastoral counselors. TRICARE covers pastoral counselors supervised by a physician, and a physician referral is always required for visits to a pastoral counselor (Types of Mental Health Providers, tricare.mil).
• Applied behavior analysis. ABA is delivered under TRICARE's Autism Care Demonstration. An autism center, autism clinic, or a sole ABA supervisor without a tiered delivery model must complete the Autism Corporate Services Provider (ACSP) certification application rather than an individual practitioner application (Childbirth and Breastfeeding Support Demonstration and ABA provider pages, Humana Military). Behavior technicians are certified under the corporate entity, not on their own.

Provider types that must sign a participation agreement

Some provider types cannot be non-participating even outside the network. Certified marriage and family therapists, autism corporate services providers and most institutions such as hospitals, skilled nursing facilities and home health agencies are required to have a participation agreement with TRICARE whether they are network or non-network (TRICARE Certification and Network Information, Humana Military). All institutional providers must be participating providers (Non-network provider FAQs, Humana Military). If you fall in one of these groups, treat the participation agreement as part of the certification packet, because certification will not finalize without it.

Demonstration-specific certifications

TRICARE runs demonstration programs with their own certification tracks. Under the Childbirth and Breastfeeding Support Demonstration, certified labor doulas, lactation consultants and lactation counselors complete a program-specific application, and Humana Military requires current certificates and signed participation agreements (Childbirth and Breastfeeding Support Demonstration, Humana Military). Virtual-health-only practices have their own application in the East Region (Provider certification virtual health only application, Humana Military). Use the demonstration application; the standard practitioner form will be returned.

Step by step: certification first, then the network

Here is the sequence that works, in order. Do not run steps 3 and 6 in parallel unless the contractor has told you it accepts both packets at once.

1. Confirm the rendering provider's Medicare position. Institutional providers are generally expected to hold Medicare certification, and any provider who will see TRICARE For Life patients must be able to bill Medicare (see the Medicare section below). Resolve PECOS enrollment or an opt-out decision first, because the TRICARE application asks.
2. Identify the region for each practice location. Use the state table above. Multi-state groups certify with each contractor separately.
3. Select the correct certification application. Pull the application for your exact provider type from the contractor's forms library. In the West Region the packet consists of the certification application, the required documentation listed on the application, and TriWest's roster template (Provider Certification and Credentialing, TRICARE West). In the East Region, Humana Military accepts certification applications and supporting documents through its provider certification submission page and provider self-service portal (Provider Certification submissions, Humana Military).
4. Submit the certification packet and calendar the follow-up. TriWest directs complete certification packets to the provider certification mailbox published on its certification page. Humana Military states that properly completed requests are processed within 30 days based on the information submitted (Provider Certification FAQ, Humana Military). Incomplete packets restart the clock, so run the documents checklist below before you send.
5. Verify the certification and its effective date. Ask for written confirmation. Because claims deny for dates of service before certification, the effective date, not the approval letter date, is what your billing team needs. Hold TRICARE claims until you have it, then release them in one batch.
6. Decide on network participation, and check whether the network is open. Openings vary by specialty and region. Humana Military's certification page has, for extended periods, stated that it is not accepting requests to join the medical, surgical or ancillary networks while it continues to take requests for autism, psychiatry, mental health, substance use disorder, doula and lactation networks (TRICARE Certification and Network Information, Humana Military). TriWest continues to accept interest forms through its online Join Our Network form (Join Our Network, TRICARE West). Check the current statement on the day you apply.
7. Complete credentialing for the network. In the West Region, a TRICARE-authorized provider not already credentialed with TriWest must complete credentialing and sign a contract. TriWest follows URAC credentialing standards and verifies education, board certification, license, professional background, malpractice history and related data. CAQH is used here: individual providers who participate in CAQH populate the CAQH ID field on the roster template and keep the profile updated and complete; those who do not use CAQH complete the TriWest Individual Provider Credentialing Application. Ancillary and facility providers complete the TriWest Ancillary/Facility Credentialing Application (Provider Certification and Credentialing, TRICARE West). In the East Region, Humana Military's handbook states that credentialing may take up to 30 days and that recredentialing is required every three years (TRICARE Provider Handbook East Region 2026, Humana Military). Whether Humana Military pulls from CAQH is not stated on its public certification page; confirm with your regional contractor and keep the profile current regardless.
8. Execute the contract and confirm the network effective date. TriWest is explicit that a provider must have a signed contract and credentialing approval to be a network provider (Provider Information, TriWest TRICARE West Region Provider Handbook). One without the other is still non-network.
9. Register on the portals and complete EDI enrollment. West Region providers work through Availity; East Region providers register for Humana Military provider self-service. Enroll with PGBA for electronic claims and remittances using the regional payer ID.
10. Load the provider correctly in your practice management system. Enter the certification effective date, the network effective date if any, the regional payer ID and the participation election, then test with a small claim batch before releasing the backlog.

Documents checklist

Each application lists its own attachments. Across both regions the packet generally includes the items below. Assemble them first, because the 30-day clocks only start on a complete submission.

• Completed, signed certification application for the exact provider type
• Current state license, and any state certification or registration the provider type requires
• DEA registration where the provider prescribes controlled substances
• Board certification or eligibility documentation where applicable
• Individual NPI and, for groups and facilities, the organizational NPI
• Tax identification information and a current W-9 for the billing entity
• Practice location addresses, service addresses and the remit-to address exactly as they appear on the W-9
• Professional liability insurance face sheet showing limits and dates
• Medicare enrollment status, including PECOS enrollment confirmation or an opt-out affidavit where relevant
• Education, training and work history in the format the credentialing application requests, or a current, attested CAQH profile with the CAQH ID on the roster template
• Signed participation agreement for provider types that require one
• Supervision documentation for supervised provider types, including the supervising physician's information
• Completed roster template with every rendering provider, location and TIN combination

Timeline: what to expect and where it slips

Treat every number here as a range. Contractor turnaround depends on packet completeness, provider type, and whether a participation agreement or supervision arrangement has to be reviewed.

Common stalls before approval

• Wrong application for the provider type. A supervised counselor filed on the independent counselor form, or an ABA group filed as individual practitioners, is returned rather than corrected.
• Network application submitted before certification is final. In both regions the network step presumes an authorized provider. Submitting the contracting packet first produces a queue entry that goes nowhere.
• Applying to a closed network. If the contractor is not accepting your specialty, the application does not sit in a waiting list; it is declined. Certify anyway so you can be paid as a participating non-network provider and reapply when the network opens.
• CAQH profile not attested or missing the practice location. An expired attestation stops TriWest's primary-source verification.
• Roster template mismatch. A TIN, NPI or address on the roster that differs from the W-9 or the application must be resolved manually.
• Wrong region. Six states changed regions on January 1, 2025. Packets sent to the former contractor are not forwarded.

Medicare enrollment and TRICARE For Life

Medicare and TRICARE are entangled for two groups of providers: institutional providers, and anyone who will treat beneficiaries who have both Medicare and TRICARE.

TRICARE For Life (TFL) is Medicare-wraparound coverage for TRICARE beneficiaries who have Medicare Part A and Part B. Beneficiaries pay no TFL enrollment fee but must pay their Medicare Part B premiums (TRICARE For Life, tricare.mil). The claim flow is the part your billers need to memorize: if the beneficiary has no other health insurance, the provider files the claim with Medicare, Medicare processes it and pays its portion first, and then Medicare automatically forwards the claim to the TFL claims processor, which pays second (TRICARE For Life; Q&A: How Does TRICARE For Life Work With Medicare?, TRICARE Newsroom). In the United States and U.S. territories the TFL contractor is WPS Government Services (TRICARE For Life, tricare.mil). If the beneficiary has other health insurance, the crossover does not happen automatically; after the other insurance adjudicates, a paper claim goes to the TFL contractor (Using TRICARE For Life with Other Health Insurance, tricare.mil).

Three implications for credentialing:

• You do not certify separately for TFL. TFL claims never touch Humana Military or TriWest. A provider who bills Medicare receives the TFL secondary payment through the Medicare crossover. What you need is an active Medicare enrollment and a correct crossover setup, not a regional contractor application.
• A Medicare opt-out changes the math. TFL beneficiaries in Original Medicare may see Medicare participating, non-participating or opt-out providers (Medicare Providers, tricare.mil). When the provider has opted out, Medicare pays nothing and there is no crossover, so the TFL portion is limited and handled differently. If you have opted out of Medicare and expect to see TFL patients, confirm the reimbursement rules with the TFL contractor before you build a schedule around it.
• Institutional providers are expected to hold Medicare certification. Most facilities, including hospitals and nursing homes, must have a participation agreement with TRICARE, accept the TRICARE-approved amount as full payment, and file claims for the beneficiary (What Are My TRICARE Health Care Provider Options?, TRICARE Newsroom). The institutional certification application asks for Medicare certification status; facilities without it should confirm eligibility with your regional contractor before investing in the packet.

The same ordering applies to beneficiaries under 65 who have Medicare due to disability: Medicare pays first and TRICARE second unless there is other health insurance (Beneficiaries Eligible for TRICARE and Medicare, tricare.mil). Capture Medicare status on every TRICARE eligibility check, not just for patients over 65.

Referrals and authorizations for a new network provider

TRICARE has two managed care plans that behave differently at the front desk. TRICARE Prime enrollees have a primary care manager (PCM), and TRICARE Select enrollees do not.

The rules that follow are from the Referrals and Pre-Authorizations page on tricare.mil. A referral is when a PCM or provider sends the beneficiary to another provider for care they do not provide. A pre-authorization is when the regional contractor approves care before the appointment. Prime enrollees must have a referral from their PCM for any routine or specialty care the PCM cannot provide. If a Prime enrollee sees a provider other than the PCM for non-emergency care without a referral, they pay more. Care from a non-network provider, or from a network provider outside the enrollee's region, without a PCM referral is the point-of-service option and carries higher out-of-pocket cost. Certain services, including inpatient admissions, some behavioral health services, adjunctive dental care and home health services, require pre-authorization regardless (Referrals and Pre-Authorizations, tricare.mil).

For a newly contracted specialist this means:

• Your first Prime patients arrive on a referral you did not write. The PCM submits it, the contractor approves it and assigns it to a network provider, and the beneficiary can view it in the contractor's secure portal (Referrals and Pre-Authorizations, tricare.mil). Until your network load is complete you will not be selectable, so hold Prime scheduling until the contractor confirms your directory listing.
• Verify the referral number, the approved provider and the visit count before the visit. A referral addressed to a different provider or specialty does not cover you. West Region providers view and submit referrals and authorizations through the online referral management tool under the TRICARE West payer space on Availity (Referral and Authorization Guidelines, TRICARE West); East Region providers use Humana Military provider self-service.
• Know the processing windows. TriWest states that routine referral requests are processed within one to two business days of receipt, routine authorization requests within two to five business days of receipt with all required clinical documentation, and urgent authorization requests on an accelerated basis for care needed within 72 hours; attaching clinical documentation reduces processing time (Referral and Authorization Guidelines, TRICARE West). Confirm the equivalent East Region windows with Humana Military; do not promise a patient a date the contractor has not committed to.
• Some Prime referrals route through a military hospital or clinic first. In the West Region a specialty referral may go through MTF optimization processing before it is released to a civilian network provider (Referral and Authorization Guidelines, TRICARE West). If a referral seems to vanish, that is usually where it is.

Select enrollees generally do not need referrals for outpatient specialty care but still need pre-authorization for the listed services. Active duty service members have their own rules, so confirm the plan type on every eligibility check.

Claims submission by region

Both regions moved to PGBA for claims processing on January 1, 2025, but each region has its own payer ID and its own portal, and claims must go to the region where care was rendered. For all plans other than TRICARE For Life, claims go to the region where the beneficiary receives care (Filing Claims, tricare.mil).

A few setup details that prevent front-end rejections:

• Humana Military specifies that payer ID 99727 belongs in ISA-08, GS-03 and NM1-09 with the 40 qualifier in the 837 file (Claims, Humana Military). A clearinghouse still carrying a pre-2025 East configuration will bounce claims.
• The rendering NPI on the claim must be the NPI that was certified. For a supervised provider, bill the way the certification letter and contractor handbook instruct, not the way you bill commercial payers.
• TriWest recommends submitting within 30 days of service (Claims Processing and Billing Information, TRICARE West). One year is the deadline, not the target.
• Enroll for electronic remittance at the same time as claims; reconciling allowable amounts against contracted rates is where network underpayments hide.

What goes wrong after approval: post-approval denials and fixes

The approval letter is not the finish line. These are the recurring failures in the first six months after a provider is certified or contracted, with the fix for each.

Claim reconsiderations and allowable-charge reviews in the East Region go through Humana Military's appeals and reconsideration submission process (Appeals, allowable charge review and claims reconsideration, Humana Military). In the West Region, beneficiaries who believe they have been balance billed can submit a claims correspondence form to TriWest (Balance Billing, tricare.mil West Region), one more reason to get the participating election right on every claim.

Most TRICARE rework traces back to one of three root causes: a wrong effective date, a wrong region, or a network status the office believed but never confirmed. Fast Track Credentialing's credentialing service tracks those dates and statuses per provider and per region so billing does not have to guess.

Maintenance, recredentialing and roster upkeep

Certification and network status are not permanent, and the two are maintained on different cycles.

Recredentialing

Network providers in both regions are recredentialed on a three-year cycle. TriWest states that after initial credentialing, providers are scheduled for recredentialing every three years, and that it proactively contacts providers or their designated credentialing contact several months before credentialing expires (Provider Certification and Credentialing, TRICARE West). Humana Military's handbook likewise requires recredentialing every three years (TRICARE Provider Handbook East Region 2026, Humana Military). The most common way to fall out of network without noticing is an outreach email sent to a staff member who left. Give the contractor a role-based credentialing contact and keep it current.

Recertification

Certification itself can require updating. Humana Military publishes a Provider Recertification Requirements attachment for the East Region (Provider Recertification Requirements, Humana Military). Typical triggers include license renewals, a change of supervising physician for supervised provider types, and changes in the entity that holds the certification. Confirm the schedule for your provider type with your regional contractor and diary it alongside the license expiration.

Roster and demographic changes

Changes that must reach the contractor promptly:

• New rendering providers joining the group, and providers leaving
• New, closed or relocated practice locations
• TIN changes, which Humana Military handles through a dedicated TIN change form
• Changes to the billing or remit-to address
• Changes in supervision arrangements for supervised provider types
• Panel status changes, such as closing to new Prime patients

In the East Region, practice demographics are updated in provider self-service by opening the roster, choosing View/Update Details on the practitioner's line and selecting Edit Information (Provider self-service tip sheet, Humana Military). In the West Region, TriWest recommends its Provider Roster Template for additions, changes and terminations, and organizations operating under a delegation agreement must submit updates at least monthly (Provider Certification and Credentialing, TRICARE West).

Ongoing maintenance checklist

• License, DEA and malpractice expirations diaried at least 90 days out, with copies sent to the contractor on renewal
• CAQH profile attested on schedule, with every TRICARE practice location listed
• Role-based email address on file with each contractor as the credentialing contact
• Roster reconciled against the contractor directory quarterly
• Medicare revalidation dates tracked for providers who see TFL patients
• Payer ID and EDI configuration re-verified after any clearinghouse or practice management change
• Contractor provider updates reviewed monthly for network openings and processor changes

Frequently asked questions

Do I have to be a network provider to bill TRICARE?

No. You must be TRICARE-authorized, which means certified with your regional contractor. Once certified you can bill as a non-network provider, either participating (accepting the allowable charge and filing the claim) or non-participating. Network status is a separate contract on top of certification (Network Providers, tricare.mil).

Can I get certified if the network is closed for my specialty?

Yes. Certification and network participation are separate decisions. Humana Military has at times listed the medical, surgical and ancillary networks as closed to new requests while still certifying providers and accepting network requests for behavioral health, autism, doula and lactation providers (TRICARE Certification and Network Information, Humana Military). Certify now, bill as participating non-network, and reapply when the network opens.

Does TRICARE use CAQH?

The West Region does for individual network credentialing: TriWest asks CAQH participants to enter their CAQH ID on the roster template and keep the profile complete, and offers its own application to those who do not use CAQH (Provider Certification and Credentialing, TRICARE West). Humana Military's public certification page does not spell out CAQH use, so confirm with your regional contractor. In both regions, certification itself is a contractor application, not a CAQH pull.

Is TRICARE certification retroactive?

Plan as if it is not. Humana Military states that claims deny when the provider is not certified on the date of service (Provider Certification FAQ, Humana Military). If you believe you qualify for an earlier effective date, ask the contractor in writing when you submit; do not bill in anticipation.

Which contractor do I apply to if I have offices in two states?

The one for each state where care is rendered. A group with locations in Tennessee and Arkansas certifies with Humana Military for Tennessee and with TriWest for Arkansas, because Arkansas moved to the West Region on January 1, 2025 (Reminder: TRICARE Regions Are Changing Jan. 1, 2025, TRICARE Newsroom).

Do I need Medicare enrollment to be a TRICARE provider?

Not for every provider type, but you need it to be paid for TRICARE For Life patients, because those claims are filed with Medicare and crossed over to the TFL contractor (TRICARE For Life, tricare.mil). Institutional providers are generally expected to hold Medicare certification. Confirm your provider type's requirement with your regional contractor before submitting.

How long does it take to become a TRICARE network provider?

Certification alone often lands in roughly four to eight weeks with a complete packet; Humana Military cites about 30 days for a properly completed certification request and up to 30 days for credentialing (Provider Certification FAQ; TRICARE Provider Handbook East Region 2026, Humana Military). Certification plus credentialing, contracting and system load commonly runs two to four months. These are ranges, not commitments; ask the contractor for its current turnaround.

What does a TRICARE Prime referral mean for my scheduling?

Prime enrollees need a referral from their PCM for specialty care, and the regional contractor approves and directs that referral to a network provider (Referrals and Pre-Authorizations, tricare.mil). Confirm the referral number, the approved provider and the visit count before booking, and treat services on the pre-authorization list as separate approvals.

Which payer ID do I use?

99727 for the East Region and 99726 for the West Region, both processed by PGBA (Claims, Humana Military; Claims Clearinghouses, TRICARE West). Use the region where the care was rendered.

Can Fast Track Credentialing submit the applications for us?

Yes. We prepare and submit certification packets, network credentialing and contracting requests for both regions, track effective dates, and handle recredentialing and roster maintenance. Start at Get Credentialed or contact us with the provider types and states involved; we will tell you which networks are currently open before you commit to anything.

Sources and verification

Official pages consulted for this guide. Checked 2026-09-13.

• Regions | TRICARE — https://tricare.mil/About/Regions
• Who are the East and West Regions (T-5) contractors? | TRICARE — https://tricare.mil/FAQs/General/T5_Who
• Understanding the New TRICARE Contract Region Changes Starting on Jan. 1, 2025 | health.mil — https://health.mil/MHSHome/Reference-Center/Technical-Documents/2024/10/10/TRICARE-T5-Regional-Map
• Reminder: TRICARE Regions Are Changing Jan. 1, 2025 | TRICARE Newsroom — https://newsroom.tricare.mil/News/TRICARE-News/Article/3983190/reminder-tricare-regions-are-changing-jan-1-2025
• All Provider Directories | TRICARE — https://tricare.mil/GettingCare/FindDoctor/AllProviderDirectories
• Network Providers | TRICARE — https://tricare.mil/networkproviders
• What Are My TRICARE Health Care Provider Options? | TRICARE Newsroom — https://newsroom.tricare.mil/News/TRICARE-News/Article/3624922/what-are-my-tricare-health-care-provider-options
• Balance Billing | TRICARE (West Region) — https://www.tricare.mil/About/Regions/West-Region/Claims/Balance-Billing
• TRICARE-allowable charges and balance billing: What you need to know | TRICARE Newsroom — https://newsroom.tricare.mil/News/TRICARE-News/Article/4371752/tricare-allowable-charges-and-balance-billing-what-you-need-to-know
• How do I become a TRICARE provider? | TRICARE — https://tricare.mil/FAQs/General/GEN_Become_Provider
• Types of Mental Health Providers | TRICARE — https://tricare.mil/CoveredServices/Mental/MentalHealthAppts/Types-of-Providers
• Referrals and Pre-Authorizations | TRICARE — https://tricare.mil/GettingCare/ReferralsPreAuth
• Filing Claims | TRICARE — https://tricare.mil/PatientResources/Claims
• TRICARE For Life | TRICARE — https://tricare.mil/tfl
• Using TRICARE For Life with Other Health Insurance | TRICARE — https://tricare.mil/Plans/HealthPlans/TFL/TFL_OHI
• Beneficiaries Eligible for TRICARE and Medicare | TRICARE — https://tricare.mil/Plans/Eligibility/MedicareEligible
• Medicare Providers | TRICARE — https://tricare.mil/GettingCare/FindDoctor/AllProviderDirectories/Medicare
• Q&A: How Does TRICARE For Life Work With Medicare? | TRICARE Newsroom — https://newsroom.tricare.mil/News/TRICARE-News/Article/3617884/qa-how-does-tricare-for-life-work-with-medicare
• TRICARE Certification and Network Information | Humana Military — https://www.humanamilitary.com/provider/resources/tricarecertapps
• Provider Certification FAQ | Humana Military — https://www.humanamilitary.com/content/dam/sites/humana-military-com/provider/faqs/provider-certification-faq.pdf
• Provider Recertification Requirements | Humana Military — https://www.humanamilitary.com/content/dam/sites/humana-military-com/provider/forms/provider_certifications/recertification-requirements-attachment.pdf
• TRICARE Provider Handbook East Region 2026 | Humana Military — https://www.humanamilitary.com/content/dam/sites/humana-military-com/provider/tricare-provider-handbook.pdf
• Non-network provider FAQs | Humana Military — https://www.humanamilitary.com/content/dam/sites/humana-military-com/provider/faqs/non-network-provider-faq.pdf
• Childbirth and Breastfeeding Support Demonstration (CBSD) | Humana Military — https://www.humanamilitary.com/provider/resources/cbsd
• Provider certification virtual health only application | Humana Military — https://www.humanamilitary.com/content/dam/sites/humana-military-com/provider/forms/provider_certifications/provider-certification-telemedicine-only-application.pdf
• Claims | Humana Military — https://www.humanamilitary.com/provider/claims
• Provider Updates | Humana Military — https://www.humanamilitary.com/provupdates
• Provider self-service tip sheet | Humana Military — https://www.humanamilitary.com/content/dam/sites/humana-military-com/provider/tipsheets/provider-self-service.pdf
• Appeals, allowable charge review and claims reconsideration | Humana Military — https://www.humanamilitary.com/content/humana-military-com/us/en/contact/submissions/appeals-and-reconsideration.html
• Provider Certification and Credentialing | TRICARE West (TriWest) — https://tricare.triwest.com/en/provider/intro-to-tricare/certification-and-credentialing/
• Join Our Network | TRICARE West (TriWest) — https://tricare.triwest.com/en/provider/join-our-network/
• Provider Information | TriWest TRICARE West Region Provider Handbook — https://tricare.triwest.com/en/provider/tricare-provider-handbook/provider-information/
• Intro to TRICARE | TRICARE West (TriWest) — https://tricare.triwest.com/en/provider/intro-to-tricare/
• Referral and Authorization Guidelines | TRICARE West (TriWest) — https://tricare.triwest.com/en/provider/referral-and-authorization-guidelines/
• Claims Clearinghouses | TRICARE West (TriWest) — https://tricare.triwest.com/en/provider/claims-guidelines/claims-clearinghouses/
• Claims Processing and Billing Information | TriWest TRICARE West Region Provider Handbook — https://tricare.triwest.com/en/provider/tricare-provider-handbook/claims-processing-and-billing-information/