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How to Initiate and Implement the VA I/T/U Reimbursement Agreement

This page outlines the process for starting and implementing a VA Indian Health Service (IHS), Tribal Health Program (THP) and Urban Indian Organization (UIO) (I/T/U) reimbursement agreement. While working through the agreement process, VA encourages I/T/U facility staff to enroll Veterans in the VA health care system.

STEP 1: Send an Email or Contact the VA I/T/U Reimbursement Agreements Program Team

To begin the agreement process, send an email to the VA I/T/U Reimbursement Agreements Program Team (RAP). The email should include a short statement indicating interest in the agreement, the facility’s name, address, phone number and a point of contact. The VA I/T/U RAP Team will respond to schedule an onboarding meeting with the tribal staff.

Email: I/T/U Reimbursement Agreements Program Team

STEP 2: Schedule an Onboarding Meeting

During the onboarding call, the VA I/T/U Reimbursement Agreements Program Team will present an overview of the program, go over the needed paperwork, and address the implementation of the program.

STEP 3: Submit Required Paperwork and Information

Once the onboarding call is complete, facility staff can submit the site readiness documentation and information listed below via email to the VA I/T/U Reimbursement Agreements Program Team.


VA-THP Reimbursement Agreements Program Template

VA-UIO Reimbursement Agreements Program Template

Please keep the VA-THP and UIO Reimbursement Agreements Program Template in MS Word format and use the “Track Changes” feature for all changes made to the template.

NOTE: This document is for THP/UIO facilities only. IHS facilities do not need an individual agreement as they are under the National Agreement.

VA Implementation Plan Template (sample)

The implementation plan (sample) is a communication tool used to exchange information such as health care services offered to Veterans and points of contact for both the UIO facility and the VA. The VA I/T/U Reimbursement Agreements Program Team will take care of the site readiness checklist and the VA information; however, the I/T/U facility will need to provide page 5: List of Services the I/T/U Facility Provides (In-house and Contracted), and page 6: I/T/U Facility Point of Contact.

NOTE: The VA-IHS and THP implementation plan template has the same content as the above UIO template. For IHS sites only, the implementation plan will be signed by the IHS and VA Medical Center (VAMC) Director.


  • Proof of accreditation/certification: See the I/T/U Provider Guide, Appendix B for examples. This guide provides detail on the reimbursement agreement onboarding and implementation process.

    I/T/U Provider Guide

  • Whether or not claims will be submitted electronically (EDI) to the VA: See the I/T/U–Information for Providers page, Submitting Claims section for details on how to sign up for electronic claims submission.

    I/T/U–Information for Providers

  • Approximate number of Veterans the tribal facility serves
  • Email addresses for attendees to the Eligibility and Enrollment Training
    At least one tribal facility staff member is required to attend the training hosted by the VA Health Eligibility Center. The training is offered once a month on every third Tuesday from 2:00–3:00 p.m., ET. The VA I/T/U Reimbursement Agreements Program Team will forward the invitation for the training to the email addresses provided. Facility staff need only attend a one-time training.
  • Electronic payments request
    I/T/U facilities must complete the online VA-FSC Vendor File Request Form, VA Form 10091, to the VA Financial Services Center (FSC) via the VA-FSC Customer Engagement Portal. To apply for payment via Electronic Funds Transfer (EFT), complete the "PAYEE/VENDOR INFORMATION" and "EFT/ACH" sections of VA Form 10091.

STEP 4: Implement the signed agreement

Once the agreement is signed by the VA contracting officer and the facility, the VA I/T/U Reimbursement Agreements Program Team will email the final agreement and the completed implementation plan to the facility point of contact. The facility will be able to submit claims for reimbursement on and after the date notated on agreement.

To receive reimbursement, each facility of the IHS, THP or UIO must meet conditions and facility quality requirements for participation in Medicare or Medicaid, as demonstrated by enrollment or certification in Medicaid or Medicare, or by maintaining accreditation with an organization recognized by the Centers for Medicare and Medicaid Services (CMS), such as the Joint Commission or Accreditation Association for Ambulatory Health Care (AAAHC).

STEP 5: Joint Orientation Call

Schedule and hold a joint orientation call between tribe and VAMC, the VA I/T/U Reimbursement Agreements Program Team will provide program information, detailed requirement for operations and billing the program. The I/T/U facility staff will also be put in touch with the corresponding staff for further assistance.