Request and Coordinate Care - Community Care
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Request and Coordinate Care

Strong care care coordination between VA and community providers ensures Veterans receive timely, high-quality care. VA’s care coordination model is a Veteran-centered, team-based approach involving five steps:

  1. Receive request for community care: Several events can trigger the receipt of a request for community care, such as:
    • A new Veteran visit
    • Receipt of a referral from a VA or community provider
    • A hospital notification
    • An inpatient admission or emergency department visit.

It is the responsibility of the community care team to receive these requests, assign staff to manage them, and to confirm eligibility and authorize services indicated in the consult. Referrals and authorizations for community care are managed through the HealthShare Referral Manager (HSRM) system. See below for more information about HSRM.

  1. Assess Veteran needs: The VA facility community care staff determines the appropriate level of care coordination for each Veteran through the use of the Screening Triage Tool combined with clinical judgement.
  2. Develop care coordination plan: Community providers and the VA facility community care integrated team will develop an individualized care coordination plan to include: scheduling, navigation and other follow-up activities. Care coordination involves determining the complexity of care needs of the Veteran who receives care in the community followed by coordination of care delivery and transition back to the VA.
  3. Implement care coordination plan: The VA facility community care integrated team will facilitate a collaborative relationship regarding all aspects of the care coordination process. This helps streamline the flow of information between Veterans, the VA community care integrated team, VA providers, and the community provider.
  4. Follow-up and complete episode: The VA facility community care team will follow-up with the Veteran to ensure all services were performed appropriately, perform any necessary handoff and close the consult. Throughout the episode of care, the facility community care staff should be monitoring and tracking the Veteran.

Facility Contact Numbers for Care Coordination
Use this list of VA medical facility contacts to locate and contact the nearest VA medical facility community care office in order to coordinate care for a Veteran.

VA has several tools available for community providers that help support the continuity of care Veterans receive, including HealthShare Referral Manager, Community Viewer, and Azure RMS.

Request for Service (RFS) Requirements

VHA has implemented a standardized form for Community Providers to request additional or continued care or services for Veterans. The purpose of the Community Care Provider-Request for Service, VA Form 10-10172, is to manage requests from community providers and to allow for placement, tracking, managing, and reporting of those requests. Approved care may be performed within VA or at community facilities. The location is dependent on the service availability within VA as well as the Veteran’s community care eligibility and preferences.

The use of the RFS form is recommended for clinical requests from a community provider to facilitate review and authorization. All supporting medical documentation must accompany the completed form, this may include laboratory and radiology reports or provider progress notes. If additional information is needed to authorize the request, the community provider will be contacted and will have three business days to provide the necessary requested documentation or the request will be denied.

The VA Medical Center staff will process all requests within three business days and the community provider will be notified of the decision or outcome via their preferred method of communication. The notification will also indicate if the care will be provided within VA or in the community. If the care is denied, it is the responsibility of the requesting community provider to contact the Veteran and discuss alternate treatment plans.

A blank RFS Form will be sent with all referral packets and is also available online. To complete VA Form 10-10172, fill-out the required fields and indicate the type of service being requested.

Please note: A separate form is required for each service requested.

Community Care Provider-Request for Service (RFS), VA Form 10-10172

HealthShare Referral Manager

HealthShare Referral Manager (HSRM) is a secure, web-based system VA uses to generate and submit referrals and authorizations to community providers. HSRM allows community providers and VA to better manage community care for Veterans. The system’s robust functionality facilitates reduced turnaround time for processing referrals, providing care, submitting claims, and receiving payment. Registration, training, and technical support for HSRM are available to community providers at no cost!

Benefits

  • Fosters health information exchange (HIE) between VA and community providers through one unified platform
  • Promotes reduced turnaround time for authorizations and reimbursement
  • Provides easy access to bundled care/standardized episode of care (SEOC) details
  • Indicates which services are required and how to acquire precertification when necessary
  • Reduces time spent waiting for fax, phone, or email contact prior to serving a Veteran

How to Access HSRM

If you are interested in using HSRM, confirm your facility meets the following criteria:

  1. Your facility has an active network agreement (i.e. Community Care Network (CCN), TriWest) or Veterans Care Agreement (VCA) with VA.
  2. A point of contact from your facility has reached out to the Community Care Point of Contact at the VA Medical Center(s) you partner with to:
    • Confirm that your facility’s specialty can be processed in HSRM
    • Request the exact facility name/location on the Provider Profile Management System (PPMS) record for your National Provider Identifier (NPI) numbers
    • Obtain concurrence to move forward with HSRM at this time

HSRM Community Care Points of Contact List

Follow the steps below to obtain access to HSRM. Resources mentioned in the following steps are available in the HSRM Training and HSRM Resources sections below.

  1. Attend the training webinar on VHA TRAIN or access the eLearning lessons listed in the HSRM Training section below, or review the HSRM Community Provider User Guide to learn how to use HSRM.

NOTE: It is highly recommended that the training webinar hosted on VHA TRAIN is attended prior to obtaining access to HSRM. The training sessions include an overview of HSRM, an in-depth walkthrough of the system, and additional time for questions.

  1. All users sign up for an ID.me account using the steps outlined in the HSRM Single Sign-On External (SSOe) Quick Reference fact sheet.
  2. One facility point of contact from your organization fills out the End User Tracker Template with all the names and emails of end users requiring HSRM access.

NOTE: Please ensure the email addresses listed match those used for each respective user’s ID.me account.

  1. The facility point of contact submits the End User Tracker to the HSRM Help Desk.
  2. The HSRM Help Desk will provide the facility point of contact with confirmation that staff access has been granted.
Screenshot of registration steps to obtain access to HSRM.

Figure 1: Sign Up Steps for Community Provider Referral Processing Staff

HSRM System Training

For interested community providers, HSRM trainings are offered weekly through the Veterans Health Administration (VHA) Training Finder Real-time Affiliate Integrated Network (TRAIN) website. The HSRMregistration information sessions will provide an in-depth walkthrough of the process to obtain access to HSRM (i.e. creating an ID.me account and completing the End User Tracker). Please check VHA TRAIN for available dates and register in advance. A free account in VHA TRAIN is required in order to register for the webinar.

Register for a virtual Community Provider HSRM Training

HSRM Registration Information Session

For interested community providers, HSRM registration information sessions are now offered weekly through the VHA TRAIN website. The HSRM registration information sessions will provide an in-depth walkthrough of the process to obtain access to HSRM (i.e. creating an ID.me account and completing the End User Tracker). Please check VHA TRAIN for available dates and register in advance. A free account in VHA TRAIN is required in order to register for the webinar.

Register for a virtual Community Provider HSRM Registration Information Session

HSRM eLearning

Community providers can also learn about HSRM system functionality through self-paced eLearning, available 24/7 through VHA TRAIN. A free account in VHA TRAIN is required in order to access the eLearning.

Access all Community Provider HSRM eLearning Lessons

Frequently Asked Questions about HSRM

Is training and deployment information available for community providers?

To receive training and deployment updates, please sign up for VHA Office of Community Care (VHA OCC) Provider Updates Newsletter.

Do community providers have to pay to use HSRM?

No, there is no cost to community providers to use HSRM. It is a web-based application that simply requires internet access.

Do community providers need to be part of the Community Care Network to use HSRM?

No, community providers do not need to be part of the Community Care Network (CCN) to use HSRM. VA encourages all community providers who serve Veterans to use HSRM for all episodes of care.

Can a VA medical facility refer a Veteran to a community provider who is not using HSRM?

Yes, VA can refer a patient to a community provider who is listed in VA’s Provider Profile Management System (PPMS) by using the offline referral form in HSRM. VA facility community care staff create the referral in HSRM, print, and then manually send it to the provider. The provider’s preferred method of communication (e.g., fax, email) is logged into HSRM under the notes field for reference.

 

Community Viewer (CV)

CV is a web-based application that enables community providers to view the full, VA electronic health record of each Veteran assigned to them in CV.

Community providers in an "Active" status will be eligible for access to CV as one of the following:

  • Community Care Network (CCN)
  • Provider Agreement (PA)
  • Local Contract

Request Access to Community Viewer

To request access to CV, email the Community Provider Technical Service Desk, or the VA staff resource who assigns patients to you. When requesting access, please provide your Community Provider NPI number and email address. You will use your NPI number as your user name and receive a password from VA staff which will allow you to log into CV to view the Veteran’s VA health history.

Frequently Asked Questions about Community Viewer

How do I get access to CV?

Community providers have multiple means to request access to CV:

  1. Contact the VA staff located at the VA facility that referred the Veteran for care.
  2. Contact the Community Provider Technical Service Desk at 844-788-6161 or via email.
  3. Request access through the CV Community Care Provider website.

A valid NPI number with a status of ‘Active’ is required as a login ID to CV. Password and link to the application can be provided by the VA staff that refer the Veteran for care. Please note, that the VA staff at the local VA Medical Center or local Community Care facility must assign a Veteran record to a Community Provider in CV for the health record to be available for viewing.

What is the link to access CV?

Once you have been provided access credentials from a VA staff member, you can access CV via the Community Care Provider Login page.

Community Viewer Provider Login

Why am I having trouble logging into CV with my email address and password?

Community Providers will now use their NPI number as the user ID and your password should still be valid. As a reminder, Community Providers can reset their own passwords if needed.

What if I forget my CV password?

Community Providers that are authorized users can change their password using the forgot password link on the CV login page.

Is there print capability within CV?

Only Community Providers can print when viewing a patient record.

Can I upload my patient notes/findings into CV?

CV is a view-only application and cannot be used for uploading records.

Is support available?

For access issues contact your local VA medical center for assistance. For technical issues, contact the Community Provider Technical Service Desk

 

Azure Rights Management Services (Azure RMS )

As of August 24, 2019, VA has transitioned from Virtru Pro to Azure RMS for encrypted email. Azure RMS allows VA to securely exchange information with community providers using encrypted email. With Azure RMS, community providers no longer have to wait for a Veteran’s information via fax or mail. Azure RMS enables safe communication about Veterans’ health information through email.

How Azure RMS Works

When a community provider receives an email from VA encrypted through Azure RMS, they will be able to seamlessly read and respond to the email through the existing email provider or open the email in a web browser and read and respond securely.

Access to Azure RMS

To access Azure RMS, you do not need to install any software to receive and reply to secure messages from VA. Azure RMS is accessed directly through email in the same way you receive other emails.

If you, as a provider, want to reply to an older message that was encrypted with Virtru Pro (the previous encryption software), you will continue to have the ability to do so. On the VA side, the VA user will still get notice of the email response and can open the email in the Virtru Pro Secure Reader via a web browser.

Frequently Asked Questions about Azure RMS

Should I use Azure RMS or Community Viewer?

You can use both! To access Community Viewer (CV), you must have a user name and password. You can use Azure RMS to transmit this information securely. More information about CV can be found above.

Can prescriptions be sent via Azure RMS?

No. At this time Azure RMS should not to be used to submit prescriptions to a pharmacy.

Can community providers initiate a secure email to VA using Azure RMS?

No. You can only securely reply to VA-initiated emails, including the ability to add attachments. Other software may need to be installed, and licenses may be required for recipients to send unsolicited emails to VA. If you have questions about Azure RMS, please contact Azure RMS Project Team.

Azure RMS Project Team: VHARMSTeam@va.gov

Where can I get more information about opening an encrypted email sent using Azure RMS?

Please see the information protection website for more information on using Azure RMS.
*NOTE: This website is external to the VA network. VA is not responsible for the privacy practices or the content of non-VA websites.

If you need assistance, email the VA Azure RMS Project Team and include your contact information.
**Please do not include any personally-identifiable patient information in your message.**

 

Azure RMS Resources

Azure RMS Contacts

VHARMSTeam@va.gov
For technical support questions about Azure RMS.

VA Facility Locator
Contact your local facility which you can find using the VA Facility Locator.

Veterans Health Information Exchange (VHIE)

Many Veterans see providers from the Department of Veterans Affairs (VA) as well as providers in the community outside of the VA. This can make it difficult for providers to access the records they need to manage a Veteran’s care. By sharing a Veteran’s health information electronically, VA and participating community care providers are better able to coordinate and improve the overall quality of care for our Veterans.

VA Exchange enables bi-directional sharing of Veteran Health Information between the VA and participating community providers. The Information is exchanged over a secure network and includes medical history, allergies, medications, immunizations, problems and more.

For more information on how to participate, please see our VA Exchange Onboarding Flyer and contact VA Exchange Team to get started.

VA Exchange

Allows providers in the community to exchange Veteran health information with the VA

Health information is exchanged over a secure network and accessible through your Electronic Medical Record (EMR)

Partners include other federal agencies, health care organizations, and health information exchange networks

VA Exchange Team: VAExchangeInformation@va.gov