VHA Office of Community Care
IHS/THP Reimbursement Agreements Program–Information for Providers
The 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.
For additional questions or information, please send an email to the VA IHS/THP Reimbursement Agreements Team at firstname.lastname@example.org.
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. Visit IHS/THP Initiation and Implementation.
More detail is provided in the IHS/THP Provider Guide.
Eligibility and Enrollment Verification
Eligibility and Enrollment Verification explains ways in which IHS/THP facilities can verify AI/AN Veteran eligibility.
Tribal facility staff may submit claims electronically (EDI) or on paper:
Electronic billing (Electronic Data Interchange)
Facilities submitting electronic/EDI claims will need to register with Change Healthcare (formerly Emdeon) by calling 1-800-845-6592 or visit the 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
VA has a centralized claims processing center for paper claims. Send paper claims to:
VA Portland Health Care System
1601 E Fourth Plain Blvd.
Vancouver, WA 98661
For claims related questions, please call the VA-IHS/THP Claims Payment Processing Center at (855) 331-5560 or email email@example.com