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Community Care

VA provides care to Veterans through community providers when VA cannot provide the care needed. Community care is based on specific eligibility requirements, availability of VA care, and the needs and circumstances of individual Veterans.

Your provider has entered your referral, now what?

The specialty care service will review your referral to determine if the service is available in the VA or if it needs to be referred to the community.

What happens if my referral is kept in VA?

If the VA offers the requested services, expect a call from a VA staff member within 3 business days.

After one unsuccessful telephone contact attempt, you will receive a letter via email or mail to help you schedule your appointment.

Your referral may be canceled after 14 days of unsuccessful contact.

Please have your voicemail turned on and do not block calls from the VA. Read the letters the VA sends to you. If you have questions, please call us at 307-778-7550, select option 2.

What if my referral goes to Community Care?

Contact Community Care to see if your referral is approved. After 7 business days, you may contact Community Care to complete the intake process. You can do this either via Secure Message, or in person with a Community Care customer service representative.

Contact the Community Care Office with secure messaging by signing in to My HealtheVet.

Community Care Office will:

  1. Assist you in choosing a network-preferred community provider. You can also start looking for a provider with the VA Locator Tool.
  2. Send your preferred community provider your referral and medical documentation.
  3. Send you a letter with your referral information via email, MyHealtheVet (MHV) Secure Message, or mail.
  4. Schedule your appointment for you, unless you have chosen to self-schedule.

You are responsible for

  1. Watching your email, secure messaging, or mail for the authorization letter. This letter will contain important information about your approved authorization.
  2. Schedule your appointment with the community provider if you choose to self-schedule.
  3. To prevent cancellation, notify the Community Care Office of your appointment within 14 days of receipt of the self-scheduling letter by calling 307-778-7550, selecting option 6, then option 3 to leave a message, or use My HealtheVet.

What do I do once I obtain my authorization letter?

Keep the letter for your records and take it to your first appointment.

You are responsible for

  1. Attending your appointments within the dates of authorization.
  2. Ensuring your community provider submits a Request For Services (RFS) form to VA if additional services are needed 60 days before the authorization expiration date.
  3. The community provider addresses the codes and reasons you're authorized for as sent by the VHA to your community provider.

How can my VA provider review my community records?

Ask the community provider to fax the results of your visit directly to 307-778-7360. These records will then be added to your medical record for your VA provider to review. Alternatively, you can obtain the community records yourself and bring them to the VA. The records will be entered into your medical chart for your provider's review.

What is the fastest way to contact the VA medical teams?

Create an account online with My HealtheVet.

Or you can call the My HealtheVet help desk at 877-327-0022.

What should I do if I receive a bill for care that has been authorized?

If you disagree with the balance on your bill, call the phone number listed on the bill to ensure the community provider has a copy of your referral authorization and correct sponsor/guarantor information. If they have your referral/authorization correct but are still unable to resolve the issue, call the Office of Community Care National Contact Center at 1-877-881-7618 for claims and billing assistance.

You can see your approved Community Care authorizations by signing up with the Tri-West Veteran Portal.

To hear updates on your Authorization, please contact the National VHA Community Care Office Contact Center:
1-877-881-7618
Monday – Friday, 6:00 a.m. to 7:00 p.m.

Other Important Referral Information

Seeking care from a community provider without valid authorization can result in significant out-of-pocket costs to you. Please make sure you have the preauthorization before seeking community non-emergent care. Understand that appointment types may vary. Many providers may conduct appointments by telephone, telehealth (virtual), record reviews, or in-person.

If you are eligible for beneficiary travel, please contact the travel office for the requirements of reimbursement for VA and community appointments by calling 307-778-7550, ext. 17224.

How to prevent billing challenges

  1. Never go to a community provider without an authorization or go outside of your authorization dates. If you need an authorization number or service dates, consider calling 307-778-7550, select option 6.
  2. If you go to the Emergency Room in the community, call 844-724-7842 within 72 hours.

What To Do if Contacted by a Provider for Bills/Payment

If you have a bill or questions about a claims payment

Contact the VA Community Care Contact Center - Includes U.S. Pacific Territories.
Phone: 877-881-7618.
Hours of Operation: 5:45 a.m. to 6:15 p.m.

If you are contacted by a community provider regarding a bill or unpaid claim

Refer the community provider to the TriWest Claims Call Center at 877-226-8749 (This phone line is only for TriWest Network Providers).

The TriWest Claims Call Center will assist providers with how to submit claims, claims status updates, and claims denials.

If you have adverse credit reporting and debt collection issues as a result of using community care

Contact the VA Adverse Credit Helpline at 877-881-7618.

Additional Information

TriWest
Current authorizations, complaints regarding community providers.
877-226-8749

Local VAMC Pharmacy
307-778-7550, option 1

Patient Advocate
307-778-7573
Secure Messaging
Email: CheyennePatientAdvocate@va.gov

Urgent Care

To verify your eligibility for VA urgent care, call 800-MyVA411 (800-698-2411) and select option 1, then option 3. 

To locate in-network urgent care providers and pharmacies, use the VA Locator Tool.

Learn more about getting urgent care at VA or in-network community providers.

Emergency Care

VA must be notified within 72 hours of your hospital visit, at 844-72HRVHA (844-724-7842).

Learn more about getting emergency care at non-VA facilities.

Community Care Frequently Asked Questions

Access the TriWest Website, sign up and then see all your authorizations.

Ask your community provider to send a fax for continued services to the Cheyenne VA Community Care office at: .

Call 844-724-7842 within 72 hours of going to the Emergency Room.

No. If they have an authorization from the VA for the care, their insurance has no influence on their care. They should take a copy of their authorization letter with them to the appointment and present it if the office asks for insurance information.

Veterans have multiple options.

  1. They can call 877-226-8479 which is the TriWest customer line and follow the prompts to speak with a Customer Service Rep who will take their information and forward it to our Claims office to follow-up with the provider.
  2. They can report the bill to the local Community Care Office at the VAMC who will refer the case to TriWest who will educate the provider as to how to handle these issues without billing the veteran.
  3. They can report the issue to the Patient Advocate at the VAMC who will forward the information to the Community Care Office.

Community Providers have multiple options.

  1. They can call the 877 number above and follow the prompts to the Claims Dept.
  2. They can email ProviderServices@triwest.com
  3. They can contact PGBA (Palmetto Government Benefits Administrators) who pay the claims. Contact information is in their Provider Handbook.
  4. They can check the status of their claims using their provider portal account with TriWest.
  5. They can use their provider portal to send an email to TriWest Claims Dept. to obtain a status.
  6. They can contact the state Provider Relations Representative who can check on the status of their claims.

  • Find a VA location or in-network community care provider. For same-day care for minor illnesses or injuries, select Urgent care for facility type.

  • You can now manage your VA health care in the same place you manage your other VA benefits and services. Sign in to start using the new My HealtheVet experience on VA.gov.

  • VA has partnered with TriWest in administering Community Care programs for eligible Veterans.

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