The Department of Veterans Affairs (VA) is continuing its commitment to make timely and accurate payments to community health care providers. To further this goal, VA is modernizing its claims submission process by introducing the ability to attach supporting documentation, known as 275 transactions, with Electronic Data Interchange (EDI) claims submissions, known as 837 transactions.  

VA strongly encourages community providers to take advantage of EDI and to transition fully to electronic submissions as soon as possible. Doing so streamlines the manual processing of paper-based claims submission and improves overall efficiency and turnaround time for claims processing and payment.  

For Veteran care, the 275 transaction process for supporting documentation is used to accompany unauthorized emergency care claims; therefore, supporting documentation may include:

• Emergency Room Notes
• Transfer Notes and Discharge Summaries
• Operative Reports
• Other Health Insurance (OHI) Explanation of Benefits (EOBs)
• Any other document type normally sent via paper in support of a Veteran unauthorized emergency claim

Note:  Community providers treating Veterans under one of VA’s Third Party Administrators (TPAs) should submit their claims directly to the authorizing TPA for processing. Medical documentation for care referred and authorized by VA or by VA’s TPAs should be submitted back to VA as part of the Veteran’s care coordination process. The 275 transaction process is not intended for these documents.

For beneficiary care, the 275 transaction process for supporting documentation can be used for every type of service and includes, but is not limited to, the emergency care documentation noted above, history and physical reports, and any other document type normally sent via paper in support of a beneficiary claim.

Community providers may also choose to submit 837 and 275 EDI transactions to Change Healthcare through a clearinghouse of their choice.  Community care providers who are interested in submitting claims and supporting documentation electronically should contact VA's clearinghouse, Change Healthcare, by calling 844-217-1199 or visiting their website at https://www.changehealthcare.com/contact/sales. 

VA implemented new email encryption software, Azure Rights Management Services (Azure RMS), on August 24, 2019, to improve the security of Veterans’ protected health information and personally identifiable information (PHI/PII).

Community providers previously used Virtru Pro encryption to exchange sensitive information with the VA.   VA transitioned away from Virtru Pro on August 24, 2019, and implemented Azure RMS as its enterprise-authorized email encryption software.

Emails encrypted with Azure RMS can be seamlessly read and responded to securely through existing email providers, once the settings are adjusted correctly, or opened in a web browser.

Providers still have access to emails encrypted with Virtru Pro and are able to read and reply to those messages. VA users can then open those emails in the Virtru Pro Secure Reader via a web browser.

This software update is part of VA’s modernization efforts to make communications more secure and reliable.

References

Please see the following website for more information on what Azure means for external users: https://support.office.com/en-us/article/how-do-i-open-a-protected-message-1157a286-8ecc-4b1e-ac43-2a608fbf3098?ui=en-US&rs=en-US&ad=US. Please note, this website is external to the VA network. VA is not responsible for the privacy practices or the content of non-VA websites.

Also available is the Azure Rights Management Services (Azure RMS) Encryption Software fact sheet at https://www.va.gov/COMMUNITYCARE/docs/pubfiles/factsheets/FactSheet_25-07.pdf#.

For further assistance, please contact VHARMSTeam@va.gov.

VA recently established a new  VHA TRAIN MISSION Act Curriculum training site (VHA TRAIN MA). This site hosts accredited online courses to meet the mandatory MISSION Act training required for community providers who wish to partner with VA and provide health care for Veterans

The VHA TRAIN MISSION Act Curriculum training site also hosts non-mandatory online, no-cost, continuing medical education curriculum for community providers.  Community providers are a vital part of VA's high-performing health care network to make sure Veterans who have served our country, as well as their families, get the timely, high-quality health care they need.  To learn more about available accredited training, visit VHA TRAIN MA at train.missionact.org/main/welcome.

You can learn more about the VA MISSION Act here. For other assistance, or help with  VHA TRAIN – MISSION Act Curriculum Account Creation, please contact the MISSION Act help desk at support@missionact.org.

October 17, 2019:  VHA Office of Community Care Overview -  This webinar provides an overview of community care programs and policies, focuses on how to file clean claims, and goes into other topics such as eligibility, referral, top rejection reasons and other provider issues.  Register for the webinar.

October 24, 2019:  VHIE Community Partner Education -An overview of the Veterans Health Information Exchange (VHIE) products, 1) Query-based Exchange and 2) VA Direct Messaging, used for secure electronic data exchange between the VA and Community Providers, in support of enhanced care coordination for Veteran Patients. The live, knowledge-based webinar will provide useful insights on VA’s overall health information exchange experience which will benefit other organizations who are working on their own exchange efforts. Additionally, it will provide specific examples and steps of how VA’s partners can support Veteran care by engaging with VA in health information exchange activities.

Registration available at https://www.train.org/vha/course/1087351/live_event  

Go to the VA's community care Provider Education & Training  Resources webpage for a full listing of upcoming webinars and links to recordings of past webinars.