VHA Office of Community Care
HOT TOPICS!Community Viewer
Community Viewer is a secure, web-based application which allows community providers to view the electronic health record (EHR) of a Veteran assigned to them as authorized by the VA. This resource includes information on the features and benefits of Community Viewer and its impact on community providers. View more information about the Community Viewer application. Virtru Pro
This is a tool to help community providers learn more about Virtru Pro, a secure email technology VA is using to more easily exchange information. The resource includes information on how Virtru Pro will impact community providers, and how VA is using the technology to communicate more seamlessly with those providers who have Veterans Choice Program (VCP) Provider Agreements. View the Virtru Pro Community Provider Resource for more information. VA Community Care Provider Toolkit
Community providers play a key role in ensuring Veterans have access to care. The purpose of this toolkit is to connect community providers with information and resources they need to successfully collaborate with VA. View the VA Community Care Provider Toolkit for details.
Connect with Us
- Our Contact Us page contains addresses and phone numbers for the VHA Office of Community Care (VHA CC) health care benefits programs.
- Providers may send questions and feedback to HACProviderFeedback@va.gov
- For information on authorization/claims paid by VA, contact your local VA Office. If you need assistance in determining your local office, or for immediate general information, use the VA Facility Locator.
- Stay up to date with VA Community Care by subscribing to our email distribution list. At least once per month, helpful information about doing business with the VA is provided to those on our Community Provider Listserv. Send an email to LISTSERV@LISTSERV.VA.GOV and include the words “SUBSCRIBE COMMUNITYPROVIDERS-L” along with your name in the body of the email.
- You can also visit the VA Public ListServ for more information about electronic newsletters, discussion groups and direct email lists.
How to Become a Provider
- View the TriWest Healthcare Alliance and Health Net Federal Services websites for information on how to join their network or to register for Veteran selection as well as for contact numbers, fact sheets and training. The provider guides and handbooks listed below are published by each contractor and provide valuable information on their processes and requirements.
- View the Veterans Choice Program For Providers website for information on the requirements and process for establishing a contract with one of the Choice contractors, Health Net Federal Services or TriWest Healthcare Alliance.
- Fact Sheet: How to become a Veterans Choice Program and/or PC3 Provider
- Working With the Veterans Health Administration: A Guide for Providers
This guide details what providers should expect in terms of authorizations and referrals, claims payment, and the return of medical documentation to the VA Medical Center (VAMC). The guide is targeted for providers who work directly with VA (as a non-VA medical care provider), not under the PC3/Choice network, but has helpful information that can benefit those providers, too.
Developing, Submitting and Checking Claims Status
For the PC3/Choice programs administered by VA contractors (Health Net and TriWest), claims are submitted to and paid by the contactors. You can find specific instructions and contact information on their websites:
For programs that file claims directly with VA, instructions and helpful information are listed below:
- Billing Fact Sheet for VA Community Care Programs
A tool to help community providers deliver care through the Veterans Choice Program (VCP), VCP Provider Agreements, Patient-Centered Community Care (PC3), or traditional VA Community Care to submit claims and get paid faster.
- How to File a Claim–Instructions for Providers
Details about the information and documentation needed when filing paper claims, including helpful claim-filing hints. You will also find information for CHAMPVA claims filing and authorization requirements.
- Electronic Claims Information
Contains information about ICD-10, VHA Office of Community Care's National Provider Identifier (NPI) requirements, electronic pharmacy claims and how to register and/or submit an EDI claim to your local VA health care facility.
- Claims Payment Information
Instructions for customers who would like to apply for payment via Electronic Funds Transfer (EFT), information on file changes and updates for current EFT vendors as well as requirements for electronic payments for non-VA community providers.
- Rejected Claims–Explanation of Codes
A list of the top 10 reasons claims are rejected/denied along with additional explanations for the rejections and what a beneficiary/provider needs to do to get the claim processed correctly.
Provider Reference Library
In the News
View VHA CC news articles and VA press releases with information and helpful advice about or relating to VHA Office of Community Care programs, or read and comment on stories posted by VA employees on VAntage Point, the official VA blog.
Prevent Fraud, Waste and Abuse
View our Program Integrity pages for information and training on fraud, waste and abuse prevention.