Provider Resources Toolkit
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 Ending
The VA contract with Health Net Federal Services (HNFS), a third party administrator for the Veterans Choice Program (VCP) and Patient-Centered Community Care (PC3) networks, is ending and will expire on September 30, 2018. HNFS currently administers the eastern region of VA’s contracted network and performs certain administrative tasks on behalf of VA. The end of the VA-HNFS contract does not affect VA’s contract with TriWest Healthcare Alliance who administers the western region of the VCP and PC3 networks.
When the contract with HNFS ends, VA will take over all activity previously performed by HNFS. VA will work with Veterans, community providers, and VA staff to transition care coordination from HNFS to your local VA medical facility as seamlessly as possible. Please review the announcement for more information and frequently asked questions.
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.
View the Veterans Choice Program–Information for Providers website for information on the requirements and process for establishing a contract with one of the Choice contractors, Health Net Federal Services (HNFS) or TriWest Healthcare Alliance.
Choice Contractor Resources for Providers
The provider guides and handbooks listed below are published by each contractor and provide valuable information on their processes and requirements. The TriWest and Health Net websites contain information on how to join their network and how to register for Veteran selection as well as providing contact numbers, fact sheets, and training.
VA Guides for Providers
Fact Sheet: How to become a Veterans Choice Program and/or PC3 Provider
This fact sheet details what providers should expect in terms of authorizations and referrals, claims payment, and the return of medical documentation to the VA medical center (VAMC).
VA Community Care Provider Toolkit
Community providers play a key role in ensuring Veterans have access to care. The purpose of this toolkit is to connect community providers with information and resources they need to successfully collaborate with VA.
Working With the Veterans Health Administration: A Guide for Providers
The Working With the Veterans Health Administration: A Guide for Providers is targeted to providers who work directly with VA (as a community care provider)—not under the PC3/Choice network—but has helpful information that can benefit those providers, too.
Instructions and helpful information for developing, submitting and checking claims status including for the PC3/Choice programs administered by VA contractors (Health Net and 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.