Provider Resources Toolkit
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.
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. 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. Please review the provider frequently asked questions for more information.
CHAMPVA Mental Health Preauthorization Request form
The CHAMPVA Mental Health Preauthorization Request form is a tool to simplify the mental health preauthorization process for CHAMPVA and the Spina Bifida Health Care Benefits Program.
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.
Emergency Medical Care
Emergency Medical Care for Veterans, filing claims for services, and receiving payment from VA fall under legal authorities Title 38 US.C. Sections 1728, 28 CFT Section 17.120 and 17.132. VA has an Emergency Medical Care web page dedicated to explaining the rules which contains an Emergency Medical Care Video that provides an overview.
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 for Updates
Stay up to date with VA Community Care by subscribing to our email distribution list. Send an email to LISTSERV@LISTSERV.VA.GOV with the subject line "SUBSCRIBE COMMUNITYPROVIDERS-L” along with your name in the body of the email.
VA Public ListServ
Visit the VA Public ListServ for more information about electronic newsletters, discussion groups and direct email lists.
VA Facility Locator
Use the VA Facility Locator if you need assistance in determining your local office, key staff, or for immediate general information.