What’s the Difference Between Enrollment Billing and Claims Billing? (West Region)

3/1/2022

This article contains information specific to beneficiaries living in the West RegionAlaska, Arizona, California, Colorado, Hawaii, Idaho, Iowa (excludes Rock Island arsenal area), Kansas, Minnesota, Missouri (except St. Louis area), Montana, Nebraska, Nevada, New Mexico, North Dakota, Oregon, South Dakota, Texas (southwestern corner including El Paso), Utah, Washington and Wyoming.. Check the map to find your region.

If you received a TRICARE billing notice and have questions, Health Net Federal Services, LLC (HNFS) wants to help. Log in on the HNFS website for enrollment billing history and to view explanations of benefits for processed claims. If you need further help, call HNFS’ customer service line and follow the phone tree prompts to direct your call.

Keep in mind, HNFS is seeing an increase in callers choosing the enrollment billing option for questions about claims. Choosing the right choice helps route your call correctly, so you can get quicker service.

Not sure about the difference between enrollment billing and claims billing? Let’s review the differences.

What is enrollment billing?

Enrollment fees or premiums are what you pay to be enrolled in a TRICARE plan. This doesn’t apply to active duty service members or active duty family members. In general, you’ll pay these costs monthly or annually. These costs are for TRICARE coverage, and have nothing to do with health care services received from your doctor.

What is claims billing?

Claims billing is for costs you must pay when using your TRICARE plan. These can be copayments, cost-shares, or deductibles, and are paid to your provider. Your costs vary based on the health care service received, your military status, your TRICARE plan, whether you saw a network or non-network provider, and if you had a referral and/or pre-authorization when required.

If you have billing questions, reach out to HNFS. To review current TRICARE costs and fees, check out the TRICARE Compare Cost Tool.

At the time of posting, this information is current. For the most recent information, contact your TRICARE contractor or local military hospital or clinic.

Last Updated 11/22/2022