Most of the providers in our group are approved non-network provider with TRICARE. This means that we submit claims on your behalf, and we accept the fee that TRICARE allows, based on the terms of your benefits plan. You are not balance-billed for the difference between our usual fee, and the fee allowed by TRICARE. You are financially responsible for any co-payments/co-insurance, deductibles, and non-covered services.
Please note: although we submit claims to TRICARE on your behalf, as non-participating providers we do not accept assignment of benefits. This means that your therapist will be asking for payment at the time of service, and that TRICARE will send you the benefit check after they process the claims that we send to them.
Please note that providers electing not to accept assignment of benefits are permitted by TRICARE to charge a fee that is 15% higher than TRICARE’s usual reduced fee. You can find more information about this at the TRICARE website.
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Referrals and Authorizations: TRICARE North Region benefits are administered by Health Net Federal Services (HNFS). Depending on your plan (Prime versus Standard), you will need to take certain steps prior to your initial appointment to make full use of your benefits:
TRICARE Prime subscribers cannot self-refer, but need to get both 1) a referral from their Primary Care Manager (PCM) to a specific therapist prior to initiating treatment, and 2) an authorization for services from HNFS (Call HNFS at 877 874-2273 to request an authorization).
TRICARE Standard allows subscribers to self-refer to a provider of their choosing without a referral from their PCM. However, an authorization from HNFS is still required (Call HNFS at 877 874-2273 to request an authorization)
Active Duty military can request a referral from their PCM to receive services from any provider in our group.