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Community Care

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Provider Resources & Reference Library

Welcome to the Community Care Provider Reference Library! Here you will find key information and links to other information to make it easier for you to do business with VA.

Fact sheets, program guides and forms located throughout the Community Care provider website are housed on this page and cross linked with the topic.

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On this page:

Support Resources

There are a number of resources readily available to Veterans listed below. We encourage you to share them with the Veterans and their beneficiaries that you serve.

VA Resources

  • Veterans Crisis Line: If you are having thoughts of suicide, the Veterans Crisis Line can help even if you’re not enrolled in VA benefits or health care. Free, 24/7, confidential support is a click away.

800-273-8255, then PRESS 1
or Text 838255

  • Find a VA location: for emergency mental health care, you can go directly to your local VA medical center 24/7 regardless of your discharge status or enrollment in other VA health care.
  • Vet Centers: Discuss how you feel with other Veterans in these community-based counseling centers. 70% of Vet Center staff are Veterans.
  • VA Mental Health Services Guide: This guide will help you sign up and access mental health services.
  • MakeTheConnection.net: Information, resources and Veteran to Veteran videos for challenging life events and experiences with mental health issues.
  • Center for Minority Veterans: Serves as an advocate for minority Veterans by conducting outreach activities to promote the awareness and use of VA benefits and services.
  • VA Self-Help Apps: Download tools to help deal with common reactions like stress, sadness and anxiety. You can also track your symptoms over time.
  • VA Women Veterans Call Center: Health care and benefits services, and programs for women Veterans
  • VA Caregiver Support Line: A toll-free number for caregivers, family members, friends, Veterans, and community partners to contact for information related to caregiving and available supports and services.

Find a VA medical center or Vet Center location

Vet Center Call Center:
877-WAR-VETS (800-733-8387)

VA Mental Health Services Guide

MakeTheConnection.net

Center for Minority Veterans

VA Self-Help Apps

VA Women Veterans Call Center:
Call/Text 855-829-6636 (M-F, 8:00 a.m.–10:00 p.m. & Sat., 8:00 a.m.–6:30 p.m. ET)

VA Caregiver Support Line:
855-260-3274 (M-F, 8:00 a.m.–10:00 p.m. & Sat., 8:00 a.m.–5:00 p.m. ET)

Other Resources

American Red Cross Military Veteran Caregiver Network: Connect online, find mentoring and join a peer support group.

Elizabeth Dole Foundation Hidden Heroes: Sign up on the National Caregiver Registry for access to local events and resources.

George W. Bush Institute Veteran Wellness Alliance: Connecting veterans with the support and services they need.


Student Veterans of America: Use our directory to find an SVA Chapter on a campus near you.

Team Red, White & Blue: Find a chapter for local and virtual opportunities for Veterans and the community to connect through physical and social activity.

Team Rubicon: Serves communities by mobilizing veterans to continue their service, leveraging their skills and experience to help people affected by disaster.

Together We Served: A secure platform for all Veterans to engage with other Veterans. Find your battle buddies. Honor military service.

Tragedy Assistance Program for Survivors (TAPS): Compassionate care to all those grieving the death of a military loved one. Programs include seminars, youth events, peer mentors, an online community and more.

VA News: Four-part series–How Afghanistan Veterans can get help through VA.

VAntage Point blog: Official blog of the U.S. Department of Veterans Affairs. Find stories from around VA and the Veteran community.

VetResources newsletter: A weekly newsletter for Veterans, their families, caregivers and survivors.

Resources for Veteran Care Programs

The resources listed below provide specific information that may help providers and office staff who have questions about participating in Community Care Network programs.

General Information

Resources for Veteran care programs–General Information
Program Resource Title / Type Associated Page
Community
Care Network
Community Care Network
Fact Sheet
Community Care Network
Community Care Network–Regions 1-5
Fact Sheet
How to Become a VA Community Provider
Fact Sheet
How to Become a VA CCN Dental Community Provider
Fact Sheet
Utilizing VHA TRAIN MISSION Act training
Fact Sheet
Veteran Care Program In Vitro Fertilization (IVF)
Web Page
Other Types of Care–IVF
Indian Health Services/Tribal Health Programs (IHS/THP) Reimbursement Agreement Program (RAP)
Fact Sheet
IHS/THP/UIO RAP–Information for Providers

Eligibility

Resources for Veteran care programs–Eligibility
Program Resource Title / Type Associated Page
Community
Care Network
Veteran Community Care–Eligibility
Fact Sheet
General Community Care

Appointments and Care

Resources for Veteran care programs–Appointments and Care
Program Resource Title / Type Associated Page
Community
Care Network
Veterans Community Care–Appointments and Getting Care
Fact Sheet
General Community Care

Care Coordination

Resources for Veteran care programs–Care Coordination
Program Resource Title / Type Associated Page
Community
Care Network
Azure RMS Encryption Software
Fact Sheet
Azure Rights
Management Services
HSRM Community Provider
Information Sheet
HealthShare Referral Manager (HSRM)
HSRM Account Creation and Single Sign-On External (SSOE) Quick Reference Guide
HSRM Community Provider Quick Reference Guide
HSRM Community Provider User Guide
HSRM Desk Support Information
Fact Sheet

Emergency Care

Resources for Veteran care programs–Emergency Care
Program Resource Title / Type Associated Page
Veteran Care Program VA Community Emergency Care–Information for Veterans
Fact Sheet
Emergency Medical Care–Information for Providers
Centralized Community Emergency Treatment Reporting and Care Coordination
Fact Sheet
VHA IVC Ambulance Transportation
Fact Sheet

Urgent Care

Resources for Veteran care programs–Urgent Care
Program Resource Title / Type Associated Page
Veteran Care Program Veteran Community Care–Urgent Care
Fact Sheet
Urgent Care–Information
for Providers
Infographic: How to Access Urgent Care
How to Sheet
Infografía: Cómo acceder a la atención de urgencia
Como Acceder

Billing and Claims

Resources for Veteran care programs–Billing and Claims
Program Resource Title / Type Associated Page
Community
Care Network
Billing and Payments
Fact Sheet
File a Claim for
Veteran Care
ADA Dental Claim Form and Completion Instructions
Fact Sheet
Preventing Paper Claims Rejections
Fact Sheet
Medical Document Submission Requirements for Care Coordination
Fact Sheet
Veteran Care Program Geriatrics and Extended Care (GEC) Fee Schedule
Fact Sheet
VA Fee Schedule
Indian Health Services/Tribal Health Programs/Urban Indian Organization (I/T/U) Reimbursement Agreements Program (RAP)
Fact Sheet
IHS/THP/UIO RAP–
Information for Providers
Indian Health Services/Tribal Health Programs/Urban Indian Organization (I/T/U) Reimbursement Agreements Program (RAP) Provider Guide IHS/THP/UIO RAP–
Information for Providers
Foreign Medical Program (FMP)–Information for Outpatient Providers and Office Managers
Fact Sheet
Other Types of Care–
Foreign Medical Care
Dialysis Provider Portal User Guide Claims Status

VA Manuals

Resources for Veteran care programs–VA Manuals
Program Resource Title / Type Associated Page
Pharmacy VHA Directive 1108.08, VHA Formulary Management Process DME Requirements /
Pharmacy Requirements
Support HIPAA Transaction Standard Companion Guide (275 TR3) File a Veteran Care Claim

Resources for Family Member Care Programs

Family Member care programs–Resources for providers
Program Resource Title / Type Associated Page
Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA) About / Apply / File a Claim / Explanation of Benefits
Brochures
Publications of VHA
Office of IVC
Information for Outpatient Providers and Office Managers
Fact Sheet
File a Claim for Family
Member Care
Deductibles and Copays
Fact Sheet
File a Claim for Family
Member Care
CHAMPVA In-House Treatment Initiative (CITI)
Fact Sheet
CHAMPVA In-House Treatment Initiative (CITI)
Pharmacy Benefits
Fact Sheet
Pharmacy Benefits
CHAMPVA Guide
Guide
File a Claim for FamilyMember Care
Camp LeJeune Family Member Program (CLFMP) CLFMP–Information for Providers
Fact Sheet
CLFMP–Information for Providers
Spina Bifida Health Care Benefits Program (SBHCBP) SBHCBP–Program and Payment Methodology
Fact Sheet
SBHCBP–Information for Providers
SBHCBP–Information for Providers and Office Managers
Fact Sheet
SBHCBP–Information for Providers

Forms

Specific forms are used to request information or provide information as requested.

Fillable PDF Forms

Fillable PDF forms for community providers
Item Title / Description Associated Page / Website
Community Care Provider Request for Service (RFS), VA Form 10-10172 Request and Coordinate Care–Request for Service (RFS) Requirements
FMP Claim Cover Sheet, VA Form 10-7959f-2 Other Types of Care–FMP
HSRM End User Tracker Template
(Excel download)
Request and Coordinate Care–HSRM
P2E Documentation Cover Sheet, VA Form 10-10143f File a Veteran Claim–Supporting Documentation
Refusal of Transfer to VA Health Care Facility, VA Form 10-8001
VA Form 10-8001 is used when a Veteran refuses to transfer to a VA health care facility.
Emergency Medical Care–Information for Providers
Third Party Payer Precertification Form Precertification Requirements
VA Financial Services Center (VA-FSC) Vendor File Request Form, VA Form 10091

To apply for payment via Electronic Funds Transfer (EFT), complete the "PAYEE/VENDOR INFORMATION" and "EFT/ACH" sections of VA Form 10091 via the VA-FSC Customer Engagement Portal.

VA-FSC Customer Engagement Portal

Vendor Web Form User Guide

Please contact the FSC Customer Support Help Desk via email or phone listed below for questions regarding VA Form 10091.

877-353-9791
Monday–Friday,
7:15 a.m.–4:15 p.m. CT

Provider Payments

Claims Status
Veterans Care Agreement Form, VA Form 10-10171 Veteran Care Agreements

Print-Only Forms

Print-only forms for community providers
Item Title / Description Associated Page / Website
Medical Billing Claim Form, UB-04 (CMS‑1450) Institutional Paper Claim Form

The CMS-1450 form can be used by an institutional provider to bill a Medicare fiscal intermediary when a provider qualifies for a waiver from the Administrative Simplification Compliance Act requirement for electronic submission of claims. It is also used for billing of institutional charges to most Medicaid State Agencies.

PLEASE NOTE: You can download a sample CMS-1450 from the Centers for Medicare & Medicaid Services (CMS) 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.

CMS-1450 on CMS.gov
Health Insurance Claim Form (CMS-1500)

The CMS-1500 Claim Form is the basic paper claim form prescribed by many health care payers for claims submitted by physicians, other providers, and suppliers, and in some cases, for ambulance services.

CMS 1500 on CMS.gov

Contact Lists and Locator Links

The following contact lists, customer call center phone numbers and locator links are valuable tools for providers when looking for additional information or answers to questions.

CCN contact lists and locator links
Item Type Contact Information
Contact Lists Office of Integrated Veteran Care Support page
Facility Contact Numbers for Care Coordination
Customer Service
Call Centers
VA Claims: 877-881-7618
Monday–Friday, 8:00 a.m.–9:00 p.m. ET
Region 1, Optum Claims: 888-901-7407
Monday–Friday, 8:00 a.m.–6:00 p.m. local time
Region 2, Optum Claims: 844-839-6108
Monday–Friday, 8:00 a.m.–6:00 p.m. local time
Region 3, Optum Claims: 888-901-6613
Monday–Friday, 8:00 a.m.–6:00 p.m. local time
Regions 4 and 5, TriWest Claims: 877-226-8749
Monday–Friday, 8:00 a.m.–6:00 p.m. local time
Locator Links VA Facility Locator
CVS Caremark Pharmacy Locator
Third Party Administrator (TPA) websites Optum–CCN Regions 1, 2, and 3
TriWest Health Care Alliance–CCN Regions 4 and 5