 Dear VA Community Providers,
On behalf of VA, I would like to thank you
for all that you do each and every day to care for our nation’s Veterans. You
are part of a critical network of over half a million community providers who
have chosen to work with VA to care for Veterans across the country. Thank you
so much for this partnership and your service!
As part of our efforts to make community care work better
for Veterans, community providers, and VA staff, we are working hard to improve
our outreach and communications to you, which is why I am pleased to announce
the first issue of the new VHA Office of Community Care Provider Updates
monthly newsletter!
The newsletter replaces our previous Community Care
Providers ListServe, and will be delivered to you via the GovDelivery platform.
The newsletter will contain announcements, updates, program changes and
upcoming events relevant to VA’s community providers.
Please note: All subscribers of the previous
Community Care Providers ListServ were transferred to the VHA Office of
Community Care Provider Updates newsletter. You can manage your
subscription here. In addition, if you have a question or
comment about this newsletter, please send it to VHA10DCommunityProviderCommunications@va.gov.
Again, I want to thank you for partnering with us here at
VA to care for Veterans who have served and sacrificed for our country.
Sincerely,
SreyRam Kuy, MD, MHS, FACS
Deputy Under Secretary for Health for Community
Care
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 As part of VA’s goal to improve our claims processing systems and payment timeliness and accuracy, VA is implementing a new paper claims intake process to convert the majority* of Veteran paper claims submitted by community providers to an electronic format known as Electronic Data Interchange (EDI) transactions.to edit this placeholder text.
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VA is currently in a transition phase
where its VA Medical Centers (VAMCs) are sending paper claims from community
providers to a centralized location for scanning and conversion to EDI. However,
beginning fall 2018, community providers will mail paper claim submissions
for Veterans directly to the new address, which will be shared when the initiative launches nationally.
There, paper claims will be scanned automatically for non-compliant form fields
based on national standards, which should reduce the need to correct
non-compliant fields throughout claims processing.
Please be aware that this intake scan may cause an
increase in rejections at the beginning of claims processing.
Community providers who submit non-compliant claims will receive a letter from
VA that includes the rejection code and reason for the claim rejection. The
most common rejection reason for paper claims is an incorrect or insufficient
number in the “Insured’s Unique ID” field, which is the Veteran’s social
security number (SSN). To prevent your claim from being rejected for this
reason, please be sure to input an exact total of nine (9) numerical digits in
this field.
Guidance on how to prevent the
most common paper claims rejections, as well as details about the new paper
claims submission process, is available online here. Please
continue to check this site for updates in the coming months, including the new
mailing address for paper claims when it becomes available. We will also send
updates via this newsletter when new information is available.
To expedite claim submission, VA encourages
community providers to submit claims electronically by working with VA’s
clearinghouse, Change Healthcare, to submit electronic claims to VA by
contacting 1-877-363-3666. You may
contact P2EInquiries@va.gov with questions.
The
VA contract with Health Net Federal Services (HNFS), Third Party Administrator
(TPA) for the Veterans Choice Program (VCP) and Patient-Centered Community Care
(PC3) networks, is expiring and will end on September 30, 2018. HNFS currently
administers the eastern region of VA’s VCP/PC3 networks and performs certain
administrative tasks on behalf of VA.
When
the contract ends, VA will take over all activity previously performed by HNFS.
VA is working 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 VA’s VCP/PC3
networks.
The
end of VA’s contract with Health Net does not affect VA’s contract with TriWest
Healthcare Alliance, which administers the western region of the Veterans
Choice Program and Patient-Centered Community Care networks
See
Health Net Federal
Services FAQs
for more information.
 On
June 6, 2018 the President signed into law the John S. McCain III, Daniel K.
Akaka, and Samuel R. Johnson VA Maintaining Internal Systems and Strengthening
Integrated Outside Networks Act of 2018, or the 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.
See VA Mission Act and New
Veterans Community Care Program fact sheet for more information.
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VA’s new Community
Care Provider Webinar Series is part of our efforts to build stronger
working relationships with community providers. Two monthly provider webinars will
be hosted each month on the third and fourth Thursdays of the month
by the VHA Office of Community Care (OCC). The webinars run for two hours,
from 1:00PM to 3:00PM ET, with some date changes during holiday weeks.
The “Office of
Community Care Overview” webinar provides an overview of community
care programs, will be recurring and offered on the third Thursday of each
month. Offered to all community providers, the webinar focuses on
providers who deliver care through the Veterans Choice program (VCP), VCP
Provider Agreements, Patient-Centered Community Care (PC3), and traditional VA community
care. Register here to attend this webinar; creation of an account in TRAIN is required first.
In
addition, accredited webinars on clinical topics such
as suicide prevention, understanding military culture, smoking cessation,
opioid safety use, PTSD, military sexual trauma and much more will be offered
on the fourth Thursdays of each month. Subject matter experts from
throughout VA will present on their respective topics.
To access
the webinars, providers will log into VHA TrainingFinder Real-time
Affiliate Integrated Network (TRAIN) to register. Creation of an account in TRAIN is required. Registration links for the accredited webinar series will be provided soon.
The Community
Care Provider Webinar Series is hosting “An Introduction to HealthShare Referral Manager (HSRM)” webinar on
September 27, 2018, at 1 pm – 3
pm EST.
HSRM is VA’s new IT solution
that will speed and streamline the referral and authorization process for
community providers and significantly improve Veterans’ access to community
care. Attendees will learn about how HSRM functions, which will improve providers’
referral experience as they work with VA to care for Veterans.
The webinar includes a
demonstration of HSRM and review how it will positively impact the business
processes used for referral and authorization management. Following the
demonstration, there will be ample time for questions and answers. Register for
the HSRM webinar through VHA TRAIN at https://www.train.org/vha/course/1079801/live_event.
VA is
grateful for the assistance of community providers in caring for our Veterans.
To that end, we are always looking for better ways to support you and would
like to point out a resource website, “Have you Ever Served?”* from the American
Academy of Nursing.
Many
women Veterans, or those that served in the Reserves or National Guard may not
self-identify during their appointments which can lead to incomplete medical
histories. The website above offers pocket guides and posters aimed at starting
a conversation with Veterans about their service and how that may impact their
health.
VA is grateful for the assistance of community providers in caring for our Veterans. To that end, we are always looking for better ways to support you and would like to point out a resource website, “Have you Ever Served?”* from the American Academy of Nursing.
Many women Veterans, or those that served in the Reserves or National Guard may not self-identify during their appointments which can lead to incomplete medical histories. The website above offers pocket guides and posters aimed at starting a conversation with Veterans about their service and how that may impact their health.
*Note: The link above is provided for informational purposes only and VA does not endorse and is not responsible for the content of the linked website.
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