How to Initiate and Implement the VA IHS/THP Reimbursement Agreement
This page outlines the process for starting and implementing a VA IHS/THP reimbursement agreement. While working through the agreement process, the VA encourages IHS/THP facility staff to ensure Veterans are enrolled in the VA health care system.
STEP 1: Send an email to the VA IHS/THP Reimbursement Agreements Team
In order to begin the agreement process, please send an email to the VA IHS/THP Reimbursement Agreements Team (firstname.lastname@example.org). The email should include a short statement indicating interest in the agreement, the facility’s name, address and phone number, plus a point of contact. The VA IHS/THP Reimbursement Agreements Team will respond within two business days to confirm receipt and work with the facility point of contact to schedule a joint orientation call with the appropriate VA staff.
STEP 2: Schedule a joint orientation call
During the joint orientation call, the VA IHS/THP Reimbursement Agreements Team will present an overview of the program, go over needed paperwork and address the implementation of the program. The facility staff will also be put in touch with the corresponding Office of Tribal Government Relations (OTGR) representative and VA medical center (VAMC) staff for further assistance.
STEP 3: Submit required paperwork and information
Once the joint orientation call is completed, facility staff can submit the site readiness documentation and information listed below via email to the VA IHS/THP Reimbursement Agreements Team.
VA-THP Reimbursement Agreement Template
Please keep the VA-THP Reimbursement Agreement Template in MS Word format and use the “Track Changes” feature for all changes made to the template.
VA-THP Implementation Plan Template
The implementation plan is a communication tool used to exchange information such as health care services offered to Veterans and points of contact for both the tribal facility and the VA. The VA IHS/THP Reimbursement Agreements Team will take care of the site readiness checklist and the VA information; however, the tribal facility will need to provide page 5: A list of services the tribal facility provides (in-house and contracted), and page 6: A tribal facility point of contact.
NOTE: For IHS sites only, the implementation plan will be signed by the tribal and VA leadership.
OTHER ITEMS AND DOCUMENTS:
- Proof of accreditation/certification
See the IHS/THP Provider Guide, Appendix B for examples. This guide provides detail on the reimbursement agreement onboarding and implementation process.
- Whether or not claims will be submitted electronically (EDI) to the VA
See the IHS/THP–Information for Providers page, Submitting Claims section for details on how to sign up for electronic claims submission.
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 2‑3 p.m., EST. The VA IHS/THP Reimbursement Agreement Team will forward the invitation for the training to the email addresses provided. Facility staff need to attend the trafining only one time.
STEP 4: Implement the signed agreement
Once the agreement is signed by the VA contracting officer and the facility, the VA IHS/THP Reimbursement Agreements Team will email the final agreement, notice to proceed, 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 the notice to proceed.
IHS/THP Facility Quality Requirements
In order to receive reimbursement, each facility of the IHS or THP must meet conditions and 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 Heath Care (AAAHC).
- IHS/THP Provider Guide
This guide provides the Continental U.S. IHS and THP providers with instructions on how to complete the sharing agreement process and seek reimbursement from VA.
- IHS/THP Eligibility and Enrollment Verification
Information on ways IHS/THP facilities can verify American Indian/Alaska Native Veteran eligibility.
- IHS National Reimbursement Agreement