TriWest Credentialing: Authorized vs. Network

TRICARE-authorized and in-network are different statuses. TriWest’s provider handbook requires network providers to be certified and credentialed, with a network contract. An Availity user account does not grant any of those approvals.

Last checked: October 10, 2026.

Certification establishes provider authorization

TriWest’s certification and credentialing page explains that certification establishes whether a provider meets TRICARE requirements. The provider’s credentials and provider type determine the applicable application; the same form is not appropriate for every therapist.

If you have not signed a network agreement with TriWest, that page directs you to the applicable TRICARE Non-Network Provider Application and its instructions. The official list includes Clinical Psychologist, Clinical Social Worker, Certified Marriage and Family Therapist, and Mental Health Counselor applications. Use the current form for the provider category rather than assuming a state license title alone determines TRICARE authorization.

A network contract and credentialing are separate

The Join Our Network page routes a Provider Contract Request to JoinOurNetwork.TriWest.com and asks for the Federal Tax ID. The provider handbook says a TRICARE-authorized provider joining the network must complete credentialing, if not already credentialed with TriWest, and sign a contract. A certification result is not a network effective date.

Participating is not another name for in-network

TriWest’s handbook distinguishes network status from accepting assignment. Network providers must participate. A non-network provider who accepts assignment for a claim is a participating non-network provider: they accept the TRICARE-allowable charge as full payment for covered services, file the claim, and collect the applicable beneficiary cost-share.

For a non-participating non-network professional claim, the handbook describes different payment and billing rules, including a statutory ceiling of 115% of the allowable charge. Do not use that distinction to promise coverage; eligibility, the covered service and the patient’s referral or authorization rules still matter. See the official provider-information section for the applicable conditions.

Portal access and care authorization are different tasks

Use our TRICARE West provider login guide to reach TriWest through Availity and give your biller their own account access. That guide routes eligibility, claims and referral tools; it does not replace certification or a contract.

“TRICARE-authorized provider” also differs from authorization for a particular patient’s care. If you are unsure whether the planned service requires approval, use the Referral and Authorization Decision Support tool in the TRICARE West payer space, following TriWest’s referral guidance. Avoid a blanket assumption that every behavioral-health service has the same requirements.

Keep the approval records distinct

• Provider certification: the applicable TRICARE provider-type approval.

• Network participation: the TriWest contract and required credentialing.

• Account access: each user’s Availity login and assigned practice permissions.

• Patient-specific care: eligibility and any required referral or authorization.

For the related contracting discussion, see TriWest certification and contracting tracks. For payment setup after the provider and claims route are ready, see TriWest EFT and remittance validation.

Frequently Asked Questions

Is TRICARE-authorized the same as in-network with TriWest?

No. TRICARE certification establishes provider authorization. Joining the TriWest network additionally requires the applicable credentialing and a network contract.

Does going non-network mean I skip TRICARE certification?

No. TriWest directs providers without a signed network agreement to the applicable TRICARE Non-Network Provider Application. Follow the current form’s provider-type requirements and submission instructions.

Does an Availity login make me a TRICARE-authorized provider?

No. Availity user access, TRICARE certification, network contracting and patient-specific referral or authorization requirements are separate tasks.

Is a participating non-network provider in the TriWest network?

No. Participating means accepting assignment on the claim. A participating non-network provider remains outside the network and accepts the TRICARE-allowable charge as full payment for covered services, subject to the beneficiary’s applicable cost-share.