Issue 13 VHA Office of Community Care Monthly Provider Updates

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VHA Office of Community Care
Monthly Provider Updates

 

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Table of Contents

New community care filing claims video available!

Claims video

Interested in learning more about filing community care claims for Veteran care? Watch the Department of Veterans Affairs' (VA’s) new Veteran Community Care Filing Claims video

The video briefly explains how to:

  • File community care claims for authorized and emergency care
  • Avoid denied claims
  • Check the status of a claim

Information provided in the video is useful for anyone who works with, or is involved in, filing claims for Veteran community care.    

Please direct questions to ProviderComms@va.gov.  


Community provider MISSION Act training courses available

VHA TRAIN MA

VA recently established a new VHA TRAIN MISSION Act curriculum training site (VHA TRAIN MA) to host community provider MISSION Act training and accredited, no-cost, online courses for community providers who wish to partner with VA to provide care for Veterans.

VHA TRAIN MA hosts the MISSION Act Section 131, Community Care Provider Opioid Safety Initiative  training course which is required to be completed by community providers with opioid prescribing privileges. In addition, the MISSION Act Section 133 general overview, Community Care Provider - A Perspective for Veteran Care course, which is not required but is highly recommended for all community providers to complete, is hosted on this site.  

Community providers must create an account with VHA TRAIN MA and include their unique National Provider Identifier (NPI).  For other assistance or help with VHA TRAIN MA curriculum account creation, please contact the MA help desk at support@missionact.org.


Learn more about submitting supporting documentation

EDI

Attention health care community providers serving Veterans and beneficiaries: The VA is committed to improving payment timeliness and accelerating claims processing, so we are modernizing our claims processes! Community providers can now electronically submit supporting documentation as a 275 transaction with Electronic Data Interchange (EDI) claims, known as 837 transactions. Contact the Change Healthcare clearinghouse at 844-217-1199 or learn more details regarding this update on the VHA Office of Community Care website


HealthShare Referral Manager (HSRM) FAQs for community providers

FAQs

HealthShare Referral Manager (HSRM) is the VA’s new solution to significantly better manage community care referrals and authorizations. Take a look at the HSRM frequently asked questions by community providers below as you may have some of the same questions.

Q: Which staff members from my facility can use HSRM?
A: Staff members whose responsibilities include processing incoming VA referrals and communicating care information to VA can use HSRM. Your team can learn how to use HSRM by joining one of our community provider training sessions, which are hosted every Tuesday from 1-3 PM EST via Veterans Health Administration Training Finder Real-time Affiliate Integrated Network (VHA TRAIN).

Q: What is the eligibility criteria for using HSRM?
A: Community providers must have an active network agreement (i.e. Community Care Network (CCN), TriWest) or a Veterans Care Agreement (VCA) with one or more VA Medical Centers (VAMCs). Community providers must also reach out to the Office of Community Care at the VAMC(s) they partner with in order to determine the best timing for deployment.

Q: Which categories of care can be processed in HSRM?
A: Currently, HSRM can process referrals for all categories of care except for community nursing home, caregiver bowel and bladder, Indian Health Services/Tribal Health Program, and dialysis. Please note that only community providers who have an active agreement in the Community Care Network (CCN) can process dental referrals in HSRM.

Q: What is the difference between HSRM and Community Viewer?
A: HSRM is a portal that allows VA and community providers to share information such as referral numbers, authorized services, appointment dates, medical documentation, and patient information. Community Viewer is a resource for viewing comprehensive Veteran medical history. Community providers do not have to use Community Viewer to use HSRM.

HSRM Dec Offerings

Registration for one of the weekly introductory trainings can be completed by logging into VHA TRAIN. Please note that a VHA TRAIN account is needed to register. Training is available at no cost and is hosted by HSRM staff who are ready to answer your questions!


Upcoming provider training

provider webinar

December 19, 2019VHA Office of Community Care OverviewThis 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.

December 19, 2019:   Pain Management and Opioid Safety in VHA: Update and Outlook towards 2020   - This live, knowledge-based webinar will provide updated information to community care providers and health care teams about VHA Pain Management approaches and the VA Opioid Safety Initiative. Many Veterans are affected by chronic pain, and 10% of Veterans in VHA have severe and persistent pain, affecting their daily quality of life and function. Opioid medication has limited value for long-term pain care, and every day more than 3 Veterans receiving care in VHA die of an opioid overdose. Thus, VHA pain care has undergone a transformation away from reliance on opioid medication and towards multi-modal pain care that integrates pharmacological approaches, interventional procedures, behavioral and restorative therapies, and complementary integrative health approaches. The webinar provides an update about the opioid crisis as it affects Veterans in particular. The webinar informs the listener about VHA policy regarding opioid safety and enables the participant to access VHA resources for opioid risk mitigation. The presentation also provides guidance on how to access VHA information and tools that allow providers to enhance pain care for Veterans. 

Registration available at https://www.va.gov/COMMUNITYCARE/providers/EDU_Training.asp#webinars 

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


Questions or comments about this newsletter may be sent to ProviderComms@va.gov 

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