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IHS/THP Reimbursement Agreements Program–Information for Providers

icon medical cross, indian feathers, and dollar signThe VA Indian Health Services/Tribal Health Programs (IHS/THP) Reimbursement Agreements Program provides a means for IHS and THP health facilities to receive reimbursement from the VA for direct care services provided to eligible American Indian/Alaska Native (AI/AN) Veterans. This program is part of a larger effort set forth in the VA and IHS Memorandum of Understanding signed in October 2010 to improve care coordination and access to care for our nation’s Native Veterans. Listed below are several resources for initiating agreements and implementing the reimbursement agreement.

Initiation and Implementation

This page outlines the process for starting and implementing the 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 system.

IHS/THP Initiation and Implementation

Eligibility and Enrollment Verification

The Eligibility and Enrollment Verification page explains ways in which IHS/THP facilities can verify AI/AN Veteran eligibility.

Eligibility and Enrollment Verification

Submitting Claims

Tribal facility staff may submit claims electronically or on paper:

Electronic billing (Electronic Data Interchange)

Facilities submitting electronic/Electronic Data Interchange (EDI) claims will need to register with Change Healthcare (formerly Emdeon) by phone or web:

800-845-6592

Change Healthcare website at http://www.emdeon.com/payerlists/


Once registered, billing staff should ensure that “THP” is added to the SBR03 segment of the 837 for proper routing through the VA. The VA payer IDs are:

  • 12115 for medical claim submissions
  • 12116 for dental claims
  • 00231 for any inquiry transaction

Paper Claims

VA has a centralized claims processing center for paper claims. Send paper claims to:

VA Portland Health Care System
10N20NPC
ATTN: IHS/THP
1601 E Fourth Plain Blvd.
Vancouver, WA 98661


Claim Questions

IHS/THP Claims Payment Processing Center: (855) 331-5560

IHS/THP Reimbursement Agreements Team: tribal.agreements@va.gov

Contacts

For additional questions or information, please email the VA IHS/THP Reimbursement Agreements Team
tribal.agreements@va.gov