Prior Authorization, Referral & Benefit Tool

Prior Authorization, Referral and Benefit Tool

The Prior Authorization, Referral and Benefit Tool allows you to easily determine:

  • approval requirements from Health Net Federal Services, LLC (Health Net),
  • benefit limitations and
  • copayments or cost-shares when applicable.

While provider office staff do not need to log in at www.hnfs.com to access the Prior Authorization, Referral and Benefit Tool, those who do log in can take advantage of the following key features: 

  • Enter the sponsor Social Security number or beneficiary DoD Benefit Number to pre-populate information, or elect to not search by specific beneficiary and manually select the beneficiary's plan type and service member status.
  • View copayment/cost-share information within the result, without the need to visit another page or site.
  • Print results with the patient’s information for your records.

Those not logged in will simply select the beneficiary's plan type and service member status.

Providers should verify eligibility prior to using the Prior Authorization, Referral and Benefit Tool, either online through Health Net's Patient Eligibility tool or through the interactive voice response (IVR) by calling 1-877-TRICARE (1-877-874-2273). Verify patient eligibility on the date of service and use that date for the effective date.

Please note: This tool only identifies whether a Health Net approval is needed. It does not provide the approval.

If the service or supply you are requesting requires an approval from Health net, visit our How to Submit page to learn more on how to submit that request.