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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 to assess and meet the needs of Veterans. The goal is to provide Veterans with seamless care either at a VA facility or a community provider.

The VA care coordination model with community providers involves five steps:

  1. Receive request for community care: The VA facility community care office or staff receives a request for community care from a VA provider or community provider. This request may be triggered from a new Veteran visit, receipt of a referral, or an inpatient admission/readmission. Referrals and authorizations for community care are managed through the HealthShare Referral Manager.
  2. Assess Veteran needs: The VA facility community care office or staff determines the appropriate level of care coordination for each Veteran using clinical judgment and by assessing the Veteran’s needs and preferences.
  3. Develop care coordination plan: Community providers and the VA facility community care office or staff develop a care coordination plan including scheduling, navigation, and other follow-up activities.
  4. Implement care coordination plan: VA’s integrated care team shares necessary documents and information regarding the Veteran’s care through Community Viewer or Virtru Pro.
  5. Follow-up and complete episode: The VA facility community care office or staff will follow up with the Veteran to ensure all services were performed appropriately, perform any necessary handoff, and close the consult.

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


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 transfer referrals and authorizations to community providers. HSRM allows community providers and VA to better manage community care referrals and authorizations using a standardized process based on clinical and business rules.

In addition, HSRM reduces turnaround time for processing referrals, providing care, submitting claims, and receiving payment. Community providers can access HSRM to manage referrals assigned to their facility, thus improving information sharing.

Benefits

  • Facilitates health information exchanges between VA and community providers through one unified platform
  • Reduces turnaround time for authorizations and reimbursement
  • Provides easy access to bundled care/standard episode of care (SEOC) information
  • Indicates which services are required, and how to acquire precertification
  • Allows community providers to submit Request for Services (RFS)
  • Reduces time wasted waiting for fax, phone, or email contact prior to serving a Veteran

How to Access HSRM

HSRM is being deployed across the country to all VA medical centers (VAMCs) in 2019. The system will be implemented at each VAMC on a phased deployment schedule. Local VAMCs will coordinate with their community provider partners to deliver details about the implementation timeline, instructions for how to sign up, training opportunities, and other relevant information.

PLEASE NOTE: HSRM is available to community providers at no cost, and technical support is available to help implement the system.

HSRM Training

For interested community providers, HSRM trainings are offered every Tuesday from 1:00 – 2:00 p.m. EST. You can sign up and view the webinar through the VHA TRAIN website. Please register in advance. An account in VHA TRAIN is required before registering for the webinar.

Register for the Community Provider HSRM Webinar Series

Frequently Asked Questions about HSRM

Is training and deployment information available for community providers?

eLearning courses and training documentation will be available for community providers on VHA TRAIN, VA’s learning management system available for community providers.

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

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

Community Viewer (CV) is a web-based application that allows VA staff and community providers to view a Veteran's electronic health record using a web browser. CV allows users to easily view existing VA consults, orders, progress reports, and other relevant health information when providing care to an assigned Veteran. It does not require any software installation and is accessed with a user name and password provided by VA.


Access to Community Viewer

To request access to Community Viewer, email the Community Provider Technical Service Desk. When requesting access, please have the following information available:

  • Provider first and last name
  • Provider email address
  • Provider phone number
  • State in which provider practices
  • Group/Practice name
  • Group/Practice address
  • Provider network affiliation (TriWest, PC3, etc.)

Once you have been approved for CV access, you will receive a user name and password which will allow you to log into CV to view the Veteran’s VA health history. VA staff provides these credentials the first time a Veteran is assigned to a community provider.

Frequently Asked Questions about Community Viewer

Who can demo CV capabilities to community providers?

The Community Viewer Project Team is available to conduct demonstrations for community providers. Email the Community Provider Technical Service Desk to request a demo.

Community_Provider_Technical_Service_Desk@va.gov

How do I get training on CV?

A link to training for community providers is located in the Resources section below along with links to other product-related information such as a user guide, fact sheet, etc.

Is support available?

Yes, there are multiple avenues of support available to community providers. You can email or call the Community Provider Technical Service Desk for support.

Who assigns and maintains community provider access to Community Viewer?

Local VA facility community care offices and staff use the Community Care Provider Management (CCPM) menu to manage community provider access.

I'm a community provider associated with multiple groups. Do I need a separate email address/user ID for each group?

Yes, CV requires you to create a separate email address/user ID for each group or organization with which you are affiliated.

Can I print from CV?

No, neither VA staff nor the community providers can print patient records due to HIPAA concerns and compliance.



Community Viewer Contacts

VA Facility Points of Contact for Community Viewer

844-788-6161
Community Provider Technical Service Desk

Virtru Pro

Virtru Pro allows VA to securely exchange information with community providers using encrypted email. With Virtru Pro, community providers no longer have to wait for a Veteran’s information via fax or mail. Virtru Pro enables safe communication about Veterans’ health information through email.

How Virtru Pro Works

Virtru Pro allows community providers to access Veteran information directly through email. Only the intended recipient of the email can decrypt and respond to secure messages. This allows community providers to use their existing email account without installing software, using portals, or creating accounts.


Access to Virtru Pro

To access Virtru Pro, you do not need to install any software to be able to receive and reply to secure messages from VA. Virtru Pro is accessed directly through email in the same way you receive other emails. Within your email account, a Virtru-secured email will appear in the same format as a regular email. Only the intended recipient of the email is able to decrypt and respond to the message. To reply, you just have to follow a couple of steps to authenticate that you are the correct recipient.


Frequently Asked Questions about Virtru Pro

Which do I use, Virtru Pro or Community Viewer?

You can use both! To access CV, you must have a user name and password. You can use Virtru Pro to provide this information securely. More information about Community Viewer can be found above.

Can prescriptions be sent via Virtu Pro?

No, at this time Virtru Pro should not to be used to submit prescriptions to a pharmacy.

Can community providers initiate a secure email to VA?

No, you will only be able to securely reply to VA-initiated emails, including the ability to add attachments. Virtru Pro offers several free email extensions and apps for encrypting an email. 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 obtaining Virtru Pro, please contact Virtru Pro Support.

Virtru Pro Support: support@virtru.com

Why do responses not include the initial conversation (message history)?

This is by design to protect the security of your message. When the replies are sent using the Secure Reader only the response will be provided. If the response is sent using one of the free email extensions or apps to reply to a message, the full message thread will be provided.

I am unable to open an encrypted email sent using Virtru Pro.

First, please try to resolve this problem by reviewing the Reading and Responding to a Message Protected by Virtru instructions on the Virtru website.

Reading and Responding to a Virtru Secure Email

If this does not resolve the issue, please email the VA Virtru Project Team and include your contact information. Please do not include any personally-identifiable patient information in your message.

VA Virtru Project Team: VA.Virtru@va.gov

I received a message stating that I was using a non-HIPPA compliant version of Virtru Pro.

No one at VA or whomever VA contacts using Virtru Pro should ever receive this type of message. Please report this issue to the VA Virtru Project Team.

Virtru Project Team: VA.Virtru@va.gov



Virtru Pro Contacts

VA Facility Locator
For questions about interacting with VA through Virtru Pro, contact your local facility which you can find using the VA Facility Locator.

VA.Virtru@va.gov
For technical support questions about Virtru Pro, please contact the VA Virtru Project Team.