Earlier this year, we wrote about the announced Tricare merger, in which we explained that effective January 1, 2018 Tricare is merging the three current regions of coverage of Tricare North, Tricare South, and Tricare West into two regions: Tricare East and Tricare West. Along with the merger of the regions, new contracts were awarded to manage the regions.
For currently contracted Tricare provider, it is important to keep in mind that in order to continue seeing clients as an in-network Tricare provider, it is required to contract with one of the two new regional contractors who were awarded the contracts in 2016. For the last nine months of 2017, the transition process has been in process. For providers in the Tricare West region, Health Net Federal Services (MHN) will be the contractor, and for the new Tricare East region, Humana Military will be the contractor providers will need to contract with.
For providers who are not yet contracted with the new Tricare contractor in their region, they should expect a lapse in contracting status, as it is a fairly lengthy and complex credentialing and contracting process to begin accepting Tricare members.
KASA Solutions offers credentialing and contracting as an add-on service and we have worked with many providers through the Tricare merger process. You can reach out to us for more information to begin the process today.
Due to these upcoming changes, it is possible that a member’s doctor, physician, therapist, or primary care manager (PCM) will no longer be in network. The 2018 Tricare Network Provider Directories are now available when using the online Find a Doctor provider search tool. You can also follow instructions on Tricare’s website in order to request that your doctor be added to the Tricare network.
The new Tricare contracts are valued at over $57 billion, and throughout this year, the new managed care support contracts have been contacting current Tricare providers and updating processes in order to provide a seamless transition for both providers and members.
As part of the transition, goals have been to improve the delivery, quality, and cost of health care services, establish shorter wait times for specialty care appointments, improved communication between military and civilian providers, and set up an easier referral process.
Rachel Brookens, Billing Team Lead at KASA Solutions, contributed to this post.