TriWest TRICARE West Region Provider Handbook
Effective for Dates of Service Starting January 1, 2025
TRICARE Managed Care Support Contract (T-5 West) | Contract Number: HT940223C0002
Introduction to TriWest and TRICARE West Region
Welcome
Every day, health care providers in our communities are stepping up to care for military families. We thank these medical professionals for improving the lives of those we call heroes! On behalf of a grateful nation, we want every provider who has rendered care to the military or Veteran community to know – we are thankful for YOU.
This TRICARE Provider Handbook applies to the Department of Defense (DOD) TRICARE program for TriWest Healthcare Alliance (TriWest) network providers in the new 26-state TRICARE West Region. The West Region consists of the following states: Alaska, Arizona, Arkansas, California, Colorado, Hawaii, Idaho, Illinois, Iowa, Kansas, Louisiana, Minnesota, Missouri, Montana, Nebraska, New Mexico, Nevada, North Dakota, Oklahoma, Oregon, South Dakota, Texas, Utah, Washington, Wisconsin, and Wyoming. Note: For T-5, six states moved from the TRICARE East Region to the West Region – Wisconsin, Illinois, Arkansas, Louisiana, Oklahoma, and Texas. See Exhibit 2‑1.
Health care delivery in the new West Region began January 1, 2025.
TriWest continues to accept interest forms from providers who wish to join the TriWest network.
TriWest is looking for providers who are motivated by our mission to provide quality health care to active duty military, their families, and Veterans. By joining our network, you can help make a difference in the lives of our nation’s heroes, doing Whatever It Takes!® to increase access to care for those who deserve it most. Visit our TRICARE Provider Contracting Q&A page for more details or read on and then submit the online Join Our Network form. TriWest’s provider contracting team looks forward to working with you.
About TriWest Healthcare Alliance
Since our founding in 1996, TriWest has been On a Mission to Serve® our nation’s military and Veteran communities. TriWest previously administered the Department of Defense (DOD) TRICARE program in the West Region from 1996 to 2013.
TriWest has also been the Department of Veterans Affairs (VA) third-party administrator for VA’s Community Care Network (CCN) in Regions 4 and 5 since 2014. These regions include the following 14 states: Alaska, Arizona, California, Colorado, Hawaii, Idaho, Montana, Nevada, New Mexico, Oregon, Texas, Utah, Washington, and Wyoming, along with the U.S. Territories in the Pacific Islands to include Guam, American Samoa, and Northern Mariana Islands. If you are not currently a CCN network provider and are interested in joining TriWest’s network to care for Veterans, visit JoinOurNetwork.TriWest.com. More details about CCN can be found in the online CCN Provider Handbook.
TriWest has a long history of superior customer service and dedication to doing what is right for our nation’s heroes and those who care for them. Doing Whatever It Takes!® not only is our corporate motto, but it is also a deep-rooted desire to go above and beyond for our customers, because we understand and honor them. We respect the military culture, we honor the sacrifices made, and we are committed to providing the service our customers deserve.
Our network health care providers and our business partners strive to continually support the military and Veteran communities and exceed customer expectations. Together, we are one team making a difference in the lives of our nation’s heroes!
TRICARE West Region for Next Generation of TRICARE
TRICARE is the Department of Defense’s (DOD) uniformed services health care program for active duty service members (ADSM), active duty family members (ADFM), National Guard and Reserve members and their families, retired Service members and their families, survivors, and certain former spouses. The Defense Health Agency (DHA) oversees the TRICARE program. TRICARE is managed by support contractors in two continental United States (CONUS) regions: TRICARE East and TRICARE West. DHA has contracted with TriWest as the support contractor for the new West Region.
This contract’s purpose is to provide Managed Care Support (MCS) to the DOD TRICARE program. For the West Region, TriWest assists the Military Health System (MHS) in operating an integrated health care delivery system combining resources of the military’s direct medical care system and our managed care support to provide health, medical, and administrative support services to TRICARE-eligible beneficiaries.
Exhibit 2‑1: T-5 West Region Map
TRICARE Policy Resources
DHA provides TriWest with guidance as issued by the DOD for administering TRICARE-related services. DOD issues this direction through modifications to Title 32 of the Code of Federal Regulations (CFR), and TRICARE Manuals: TRICARE Operations Manual (TOM), TRICARE Reimbursement Manual (TRM), and TRICARE Policy Manual (TPM).
This TriWest TRICARE Provider Handbook provides an overview of the TRICARE program regulations and requirements. These manuals are regularly updated to reflect changes made to the TRICARE Program.
For current information about policy changes, timelines, and implementation guidance, refer to: