Tricare Participating Provider Agreement

(D) The above additional information applies to each of the aforementioned categories of extramedical individual suppliers: To add to your network practice a provider that has been certified by Health Net Federal Services, LLC (HNFS) over the past three years: (5) Medical Equipment Companies, Medical Services and Long-Life Medical Equipment, Prosthetic, Orthotics, Suppliers/Suppliers. Any company, supplier or supplier that is a Medicare-approved supplier or is designated by the Director, TRICARE Management Activity, as an approved supplier. (A) a TRICARE-approved service provider within the meaning of this section; or (B) types of suppliers. Below is a list of entities specifically designated as institutional providers. 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. (i) Prior authorization of all authorizations for specific institutional suppliers. (3) Exclusion or suspension of ECHO suppliers.

A provider of ECHO services or objects may be excluded or suspended because of discrimination on the basis of a disability. Such an exclusion or suspension must be achieved in accordance with the provisions of p. 199.9. (A) related services and supplies provided by individual field suppliers or technical diagnostic services and related deliveries of a species requiring direct contact with the patient and a state-approved technologist in which the procedure is performed or certified by a qualified accreditation body pursuant to Section 199.2; and (C) The determining factor in determining whether a recipient`s stay in a LTCH can be covered by TRICARE is the level of professional care, supervision and skilled care that the recipient requires in addition to the diagnosis, the nature of the condition or the degree of functional employment. The nature and extent of medical services required or provided are monitored for the purpose of extending TRICARE benefits; not the type of supplier or the status of the recipient. (12) Medical records. Organizations of licensed providers and those providing clinical services must maintain appropriate clinical records to prove that specific care has been actually provided, that it has been medically necessary and appropriate, and to identify the person or persons who provided the care.

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