Tricare Participating Provider Agreement

(iv) surveying the facilities. The investigation of new institutional suppliers and the regular re-consultation of all authorized institutional suppliers is an ongoing process conducted by OCHAMPUS. (B) In order to cover the benefits of a psychiatric hospital, the hospital must comply with the provisions of paragraph b) paragraph 4, paragraph 4, paragraph (i), of this section. All psychiatric hospitals must be accredited by an accreditation body accredited by the Director so that their services can be distributed free of charge between CHAMPUS. In the case of psychiatric hospitals that are not accredited because they were not operational enough to request an accreditation investigation, the director or construction manager may grant temporary authorization if the hospital is certified and participates in Title XVIII of the Social Security Act (Medicare, Part A). This temporary authorization expires 12 months from the date on which the psychiatric hospital has the right to request accreditation by an accreditation body approved by the director. HNFS recognizes that many supplier groups have a separate registration service to verify individual provider requirements, such as licensing, training, professional liability insurance, negative penalties, etc. If you are a group of suppliers with your own connection information department, you should speed up the information process on the TRICARE West network by allowing you to delegate login information to HNFS. In this way, HNFS can use the credentials already collected, which can be transmitted to HNFS in an electronic format. (1) General. Institutional providers are providers who charge for services on behalf of an organizational unit (for example. B hospital and skilled care facility) and not on behalf of a person.

The concept of « institutional provider » does not cover professional companies or associations that comply with the rules of internal management of financial services. 301.7701-5 of the Internal Income Service Regulation, and other companies that primarily provide professional services. Institutional providers can provide medical services and supplies, either in hospital or outpatient. If your group has delegated registration information, visit our Delegate Suppliers page. It can take up to 30 days for an application without a network provider to process. (A) An institutional supplier covered by Section 199.6 point b) must, in order to be a TRICARE approved supplier, be a participating supplier for all claims.