TRICARE Program Officially Transitioned to Health Net Federal Services

 

On January 1, 2018, Health Net Federal Services (HNFS) began providing managed care services to 2.9 million TRICARE beneficiaries in the 21 western states, including California. During the first month of the transition, there were few reports of issues with the new TRICARE West Region contractor. 

HNFS has advised that callers to its customer service call centers may experience longer than average hold times due to heavy call volumes. The HNFS provider site current has the following message "We are currently experiencing network issues and are unable to answer phone calls at this time."

The California Podiatric Medical Association (CPMA) has heard of reports of longs delays in the authorization approval process similar to those experienced during the prior TRICARE transition to UnitedHealthcare Military and Veterans Services (UMVS). During that transition, physicians reported significant delays in processing of authorizations and referral requests, long hold times, website problems and difficulty registering for secured access to the UMVS portal.

HNFS has advised that it will honor referrals and authorizations issued by UMVS through their 2018 expiration dates, even if the servicing provider is not a part of the HNFS West Region network. HNFS will issue authorization letters for services for dates of service on or after January 1, 2018. Providers seeking to determine whether a procedure or service requires prior authorization, referral or if a covered benefit can utilize the HNFS Prior Authorization, Referral & Benefit Tool, located on the HNFS website.

Physicians with questions regarding the TRICARE transition may contact HNFS at HNFSProvRel@healthnet.com.

CPMA had made available to members a TriCare transition guide to help understand the impact the transition will have on their practices. CPMA will continue to monitor the situation.