If you provide care to TRICARE beneficiaries in the East Region, you must be TRICARE-certified before you can file TRICARE claims or receive payment for TRICARE services. Certification verifies that you meet the licensing and credential requirements for your provider type.
Certification does not make you a TRICARE East network provider. Network enrollment is a separate process with Humana Military.
Choose the right certification application
- Go to Humana Military’s TRICARE certification applications.
- Select the application for your provider type. For example, marriage and family therapists should use the Certified Marriage and Family Therapist application.
- Complete the application for every state where you provide TRICARE services. One application can include multiple locations that use the same TIN.
- Submit the application and keep the confirmation details.
The application asks for your NPI, practice and location information, license or certification information, and supporting documents. Your provider type can require additional documentation. Follow the application’s requirements rather than assuming the same documents apply to every specialty.
Participation agreements
Some TRICARE-certified provider types must sign a participation agreement, whether they are network or non-network. This includes certified marriage and family therapists, Autism Corporate Service Providers, and many facility types.
If your application includes a participation agreement, read its payment and billing terms before you sign. For certified marriage and family therapists, the agreement requires accepting the TRICARE allowable charge as payment in full, filing claims for the beneficiary, and collecting only applicable deductibles and cost-shares.
See Humana Military’s current list of provider types that require participation agreements to confirm whether your provider type is included.
Check your certification status
Processing can take up to 90 days after Humana Military receives the application. If you submitted online, use the Provider Certification Status Portal with the NPI associated with the application. For a facility or Autism Corporate Service Provider application, you will also need the location ZIP code.
After 90 days, if certification is still unresolved, use Humana Military provider self-service to send a secure message under Certification. Include the practitioner, facility, or ACSP NPI and ZIP code.
Network enrollment is separate
Certification establishes your authorization to provide TRICARE services. It does not enroll you in the TRICARE East network. Humana Military’s current network availability varies by provider category; use its network information to see whether it is accepting requests for your specialty.
What this means for Thrizer
This guide covers the payer’s certification process. It does not determine whether a specific client’s services are covered, whether a claim will be approved, or the reimbursement amount. Those decisions remain with TRICARE.
If you receive approval or a payer request that affects a claim through Thrizer, submit a support request through your Thrizer account and include the approval or correspondence. 
