Provider Certification and Credentialing

This page provides you with information about TRICARE certification and TriWest credentialing for the TRICARE West Region.

Provider Certification

Certified TRICARE-authorized providers are eligible to render services to and submit claims for TRICARE beneficiaries. To meet TRICARE requirements, TriWest Healthcare Alliance must ensure that all providers are TRICARE certified according to regulations found in 32 CFR 199.6 and the TRICARE Policy Manual, Chapter 11.

Network Providers

You can download the certification application and other necessary documents for your provider type.

Applied Behavior Analyst (ABA) Certification Applications and Documents

Individual Provider/Practitioner Certification Applications and Documents

More certification applications coming soon!

Submit your completed certification application and roster template to provcerts@triwest.com.

Non-Network Providers

If you have not signed a network agreement with TriWest, please complete the applicable TRICARE Non-Network Provider Application. Follow the instructions listed on the application to receive payment for claims.

Provider Credentialing

TriWest follows URAC credentialing standards, in addition to all applicable federal regulations and TRICARE requirements.

TriWest Delegated Providers

If you have signed a credentialing delegation agreement with TriWest, you have agreed to manage the initial credentialing and re-credentialing processes for your individual providers and/or ancillaries/facilities. As part of your delegation agreement, you will submit additions, changes/updates, and terminations to TriWest at least monthly. TriWest strongly recommends that you utilize the TriWest Provider Roster Template to ensure accurate and efficient processing of your data. Submit rosters to delegatedcred@triwest.com.

TriWest Credentialed Providers

If TriWest will complete the initial credentialing and re-credentialing processes for your individual providers and/or ancillaries/facilities, the TriWest Provider Roster Template may be used to submit additions, changes/updates, and terminations to ensure accurate and efficient processing of your data. Submit rosters to credentialing@triwest.com.

If you are an individual provider and participate in the Coalition for Affordable Quality Healthcare (CAQH), be sure to populate the CAQH ID field on the roster template. Also, ensure that your CAQH profile is updated and complete.

Individual providers that do not participate in CAQH need to complete the TriWest Individual Provider Credentialing Application and submit it along with required documentation to credentialing@triwest.com.

Ancillary and facility providers need to complete the TriWest Ancillary/Facility Credentialing Application and submit it along with required documentation to credentialing@triwest.com.

An updated W-9 form must be submitted when requesting a tax identification number (TIN), billing address, or organization or practice name change.