Provider Reference Library
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The fact sheets listed below provide specific information that providers and office managers need to know in order to participate in Community Care programs.
You can view fact sheets for Veterans and beneficiaries on Community Care Fact Sheets.
Below are forms frequently used by our providers. Forms for other Community Care programs can be found on our Forms page.
- VA-FSC Vendor File Request Form, VA Form 10091
This form enables all vendors to apply for payment via Electronic Funds Transfer, or to submit changes/updates to their Financial Management System (FMS) Vendor Record in order to receive VA payments that comply with the 1996 Debt Collection Improvement Act.
VA Form 10091–Fillable PDF
For questions regarding VA Form 10091, please contact the Nationwide Vendor File Division to VAFSCCSHD@VA.GOV or call 1-877-353-9791.
- CMS-1500 (OMB NO. 0938-0999), Health Insurance Claim Form
- UB-04 CMS-1450 (OMB NO. 0938-0997), Medical Billing Claim Form
Visit the Centers for Medicare & Medicaid Services (CMS), Institutional Paper Claim Form (CMS-1450) for information on obtaining the CMS-1450.
Institutional Paper Claim Form (CMS-1450)
You can download a sample CMS Form 1450 from the CMS.gov website. However, copies of the form should not be downloaded for submission of claims, since they may not accurately replicate colors included in the form. These colors are needed to enable automated reading of information on the form.
- UB-92 HCFA-1450 (OMB NO. 0938-0279), Medical Billing Claim Form
As of May 23, 2007, the use of Form UB-92 HCFA-1450 has been discontinued; only the new UB-04 billing form is to be used. All rebilling of claims should use the UB-04 billing form, even though earlier submissions may have been on the UB-92.
For more information the use of Form UB-92 HCFA-1450, visit the National Uniform Billing Committee website at www.nubc.org.
- Refusal of Transfer to VA Health Care Facility, VA Form 10-8001
VA Form 10-8001–Fillable PDF
- CHAMPVA Mental Health Preauthorization Request form
This form is for mental health preauthorization for Veterans Affairs family member programs.
CHAMPVA Mental Health Preauthorization Request form–Fillable PDF
Training and Presentations
- VHA TrainingFinder Real-time Affiliate-Integrated Network (TRAIN)
VHA TRAIN is an external learning management system that provides valuable, Veteran-focused, accredited, continuing medical education at no cost to community health care providers. Access and log into the VHA TRAIN website to get started. Information on how to enroll, a list of available courses and additional instructions can be found in the VHA TRAIN Fact Sheet.
VHA TRAIN website VHA TRAIN Fact Sheet
VHA TRAIN delivers free, VA-approved training on Veteran-specific health topics. Published on Nov 22, 2017.
- Veterans Choice Program Resources for Outreach Partners
A compilation of materials designed to make it easy to share information and spread awareness about the Veterans Choice Program. It includes customizable communications and templates.
Veterans Choice Program Resources for Outreach Partners
- Learn About Military Culture
A training course for community providers on treating the unique Veteran patient community.
- PTSD Consultation Program
Post-traumatic stress disorder training offered for health care professionals who treat Veterans.
PTSD Consultation Program
- Fraud, Waste and Abuse Prevention
VHA Office of Community Care Department of Program Integrity provides news and information on fraud, waste and abuse – including a robust suite of resources and training – to guide your understanding of these issues and how you can help prevent them.
Fraud, Waste and Abuse Prevention
- How to Read a Preliminary Fee Remittance Advice Report (PFRAR)
This document will help providers understand the format of the PFRAR, a customized, vendor-specific document that supplies data to identify claim dates and services, reasons for disapproval and/or payment amounts. An interactive training module is being developed that will familiarize providers with the PFRAR including what individual fields mean, how to find outstanding balances and how to use the report to reconcile bills with outstanding claims.
How to Read a PFRAR
- ICD-10 Resources
- Centers for Medicare and Medicaid Services
Official CMS Industry Resources for the ICD-10 Transition Medicare ICD 9 – ICD 10 Crosswalk Basics
- American Medical Association (AMA)
Solutions for Managing Your Practice: ICD-10 Code Set
- American Health Information Management Association (AHIMA)
- VA Talent Management System
Training modules for VA Stakeholders
- Pregnancy Management: Clinical Practice Guidelines
A detailed, VA/DoD reference guide of current industry best practices for symptoms and diagnoses related to the management of pregnancy.
Pregnancy Management: Clinical Practice Guidelines
- Clinical Education Products
Free clinical education products on a range of mental health and substance use topics developed by the VA are available to our VA Community Care partners on the Mental Illness Research, Education and Clinical Centers (MIRECC) website.
Below is a sample of the products that are available:
- A Therapist's Guide to Brief Cognitive Behavioral Therapy
- Get Moving and Get Well Manual
- Multi-Setting Peaceful Mind: A Manual to Aid in the Management of Anxiety in Veterans with Memory Impairment
- A Veteran’s Guide to Talking With Kids About PTSD
- Collaborative Safety Planning for Older Adults
The Monthly Provider Webinar Series is one facet of a prioritized, proactive provider outreach effort focused on building stronger and more sustainable working relationships with our community providers. Two monthly provider webinars are hosted on the third and fourth Thursdays of each month by the VHA Office of Community Care (OCC). Webinars run for two hours, from 1 p.m. to 3 p.m. Eastern Standard Time with some date changes during holiday weeks.
Providers must register in the VHA TrainingFinder Real-time Affiliate-Integrated Network (TRAIN) for all webinars as a login account is required.
The VHA Office of Community Care Overview webinar is offered on the third Thursday of each month and facilitated by VHA OCC Provider Regional Experience Managers. This webinar gives an overview of Community Care programs and policies, focuses on how to file clean claims, and goes into other topics such as eligibility, referral, top rejection reasons and other provider issues.
Accredited webinars on clinical topics such as suicide prevention, understanding military culture, smoking cessation, opioid safety use, post traumatic stress disorder (PTST), military sexual trauma and much more are offered on the fourth Thursdays of each month beginning October 2018. Highly regarded VA subject matter experts present this webinar sequence.
|VHA Office of Community Care Monthly Provider Webinar Series|
FY 2018–FY 2019
September 2018–September 2019
|Office of Community Care Overview
Register for the VHA Office of Community Care Overview webinar
|27 September 2018||HealthShare Referral Manager (HSRM)
Register for the HealthShare Referral Manager (HSRM) webinar
|25 October 2018||VA’s Suicide Prevention Strategy|
|29 November 2018||Military Culture|
|20 December 2018||Opioid Safety Initiative|
|31 January 2019||Telemental Health in the VA|
|28 February 2019||Treating PTSD|
|28 March 2019||Military Sexual Trauma|
|18 April 2019||Treating LGBT Veterans|
|23 May 2019||VA’s Suicide Prevention Strategy|
|27 June 2019||Smoking Cessation|
|25 July 2019||Military Culture|
|22 August 2019||Opioid Safety Initiative|
|26 September 2019||Alternative Treatments|