Provider Resources Toolkit
HealthShare Referral Manager (HSRM) is a commercial off-the-shelf solution that VA has selected to accelerate and better manage community care referrals and authorizations. HSRM streamlines referral and authorization management, and improves information-sharing between VA and community providers.
These improvements allow more timely access to care for Veterans and greater coordination between community providers and VA. The information sheet, accessed through the link above, provides the key benefits community providers will see with the use of HealthShare Referral Manager.
Community Care Network
To streamline VA’s community care programs, VA is establishing a new Community Care Network (CCN). To establish the new CCN, VA released a Request for Proposal (RFP) for Third Party Administrators (TPAs) to develop and administer regional networks of high-performing licensed health care providers who will work together with VA providers and practitioners to provide medical, dental and pharmacy services to eligible Veterans who are unable to receive care at local VA medical centers.
The CCN contracts were developed with a focus on transparency, accountability, quality and increased communications between VA and Veterans. More information, including a video that describes the features and benefits of the VA Community Care Network, can be viewed on the Community Care Network page.
Health Net Federal Services Contract Close Out – Filing Deadline Extended
VA has reached an agreement with Health Net Federal Services (Health Net) to extend the final date for filing claims to March 26, 2019. Originally, community providers were required to file claims within 180 days of health care delivery.
To meet the extended deadline, community providers must file initial claims for Health Net-authorized services with Health Net by March 26, 2019.
Health Net was a Third-Party Administrator for the VA Patient-Centered Community Care (PC3) and the Veterans Choice Program (VCP) community provider networks. Health care provided to Veterans through Health Net ceased in June 2018 and VA’s contract with Health Net ended on September 30, 2018.
For more information about the Health Net close out, please see HNFS Contract Closeout–Provider Frequently Asked Questions. If you have questions and would like more information, please call the Health Net provider service line at 844-728-1914 or visit the Health Net website.HNFS Contract Close Out–Provider FAQs Health Net website
VA Mission Act of 2018
The VA Mission Act of 2018 will consolidate VA’s community care programs into a New Veterans Community Program. This new program will strengthen VA by merging the Department’s tangled web of competing and confusing community care programs, including the Choice Program, into one system that is easier to navigate for Veterans, VA employees, and VA community providers.
Opioid Safety Initiative
VHA appreciates community provider partnerships in the care of our Nation’s Veterans and especially the continuity of effort for improving how community-based health services are provided for our Veterans. This correspondence serves to educate and ensure a greater awareness of the first evidence-based guideline to be shared with our community partners – the VHA Opioid Safety Initiative (OSI) – and to provide a registration link to VHA-developed online training for providers.
Veterans Choice Program–Information for Providers
View the Veterans Choice Program–Information for Providers website for information on the requirements and process for establishing a contract with the Choice contractor, TriWest Healthcare Alliance.
Choice Contractor Resources for Providers
The provider guides and handbooks listed below are published by TriWest and provide valuable information on their processes and requirements. The TriWest website contains information on how to join their network and how to register for Veteran selection as well as providing contact numbers, fact sheets, and training.
Instructions and helpful information for developing, submitting and checking claims status including for the PC3/Choice programs administered by the VA contractor, TriWest, and for programs that file claims directly with VA.
Claims Process Video
This video explains the VA community care claims process, including authorizations, types of community care programs, ways to avoid rejected and denied claims, and how to check the status of a claim.
Community Viewer is a secure, web-based application which allows community providers to view the electronic health record (EHR) of a Veteran assigned to them as authorized by the VA. This resource includes information on the features and benefits of Community Viewer and its impact on community providers.
This is a tool to help community providers learn more about Virtru Pro, a secure email technology VA is using to more easily exchange information. The resource includes information on how Virtru Pro will impact community providers, and how VA is using the technology to communicate more seamlessly with those providers who have Veterans Choice Program (VCP) Provider Agreements.
Connect with Us
This page contains addresses and phone numbers for the VHA Office of Community Care (VHA OCC) health care benefits programs.
Providers may send questions and feedback to HACProviderFeedback@va.gov
Subscribe to the Provider Updates Newsletter
Stay up to date with VA Community Care announcements, updates about news, policies, program changes and more by subscribing to the GovDelivery VHA Office of Community Care Provider Updates newsletter. Click on the link above to become a subscriber.
VA Facility Locator
Use the VA Facility Locator if you need assistance in determining your local office, key staff, or for immediate general information.