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VHA Office of Community Care
Provider Advisor
Table of Contents
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The Department of Veterans Affairs (VA) Fee Schedule, which determines reimbursement rates for some inpatient and outpatient health care professional services, is now available on the Veterans Health Administration (VHA) Office of Community Care (OCC) website at https://www.va.gov/COMMUNITYCARE/revenue_ops/Fee_Schedule.asp.
Easier Access
Community providers are no longer required to submit a Freedom of Information (FOIA) request to obtain VA fee schedules. Since FOIA requests are no longer required, this will result in more timely access to the VA Fee Schedule and reduce administrative delays. Third Party Administrators (TPAs) will make payments according to the VA Fee Schedule.
Real-time Access
Real-time access to the VA fee schedule is intended to provide more timely service to community providers. The VA Fee Schedule is downloadable to an Excel spreadsheet and may be filtered by specific VA medical center locations and medical codes.
Regular Updates
At a minimum, VA will update the VA Fee Schedule quarterly.
VA will specify the effective date(s) for any updated VA Fee Schedule rates as updates are published.
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HealthShare Referral Manager (HSRM) is VA’s new online system to better manage and streamline Veteran community care referrals and authorizations. For more information about HSRM, community providers can visit the Office of Community Care Webpage. Two new resources now available include:
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HSRM Community Care Point of Contact (POC) List – Provides a consolidated list of representatives from each VA Medical Center’s Office of Community Care. Community providers can refer to this document to identify their point(s) of contact to discuss their deployment of HSRM.
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HSRM Community Provider Account Creation Information Sheet – Provides all the registration steps a community provider must take in order to obtain access to HSRM.
Upcoming Training Sessions
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!
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Are you dental provider interested in caring for our nation's Veterans? Partnering with VA through our Community Care Network (CCN) has a variety of benefits, including:
- Prompt payment within 30 days of receipt of clean claims, including resubmissions.
- Ability to deliver high-quality dental care to our nation’s Veterans.
- Utilization of industry-standard approaches and guidelines to administer services and a managed healthcare network.
Applying to become a VA dental provider is simple and quick. The first step is finding your CCN region. CCN provider partnerships are administered by a third-party administrator (TPA) in each of six regions. Provider partnerships for Regions 1, 2 and 3 are administered by Optum Public Sector Solutions, Inc. (Optum), part of UnitedHealth Group, Inc., while the TPA for Region 4 is TriWest Healthcare Alliance (TriWest). VA will announce the administrator for Regions 5 and 6 at a later date. You can find which region you are located in on the CCN Regional Map.
After identifying your CCN region, please follow the instructions on the following webpages to apply to become a CCN dental provider.
For more resources about becoming or being VA CCN dental provider, please see the following:
VA References:
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VA offers a webinar series designed to provide the knowledge community providers need to address post-deployment health concerns of returning combat veterans.
On March 10, 2020, VA is offering a course on Fibromyalgia and Veteran Care. This webinar provides an overview of clinical and research updates for fibromyalgia and how these are applicable to the care of deployed veterans. Criteria diagnosis, underlying pathophysiology, research evidence, clinical management strategy construction and innovative integrative and complementary health approaches for fibromyalgia will be discussed.
VA staff register through TMS: Webinar on Fibromyalgia and Veteran Care on TMS
Community providers register through VHA TRAIN: https://www.train.org/vha/course/1090016/live_event
Email questions to Urbano Delgado, Urbano.Delgado@va.gov, or Donna Sowders, Donna.Sowders@va.gov .
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March 19, 2020: 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.
March 26, 2020: Traumatic Brain Injury (TBI): Diagnosis and Management -The purpose of this training will be to inform community providers about Traumatic Brain Injury(TBI) and the differences that Veterans with TBI may present with compared to civilians with TBI. They will be informed about VA’s TBI/Polytrauma System of Care, the need to develop an individualized plan of care for Veterans with TBI , and how to connect their Veteran patients to VA resources. Additionally, they will learn about online tools and training resources highlighting issues related to Veterans and Service members with TBI.
Registration links also 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.
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You have received this message because you are subscribed to the VHA Office of Community Care - Monthly Provider Updates publication, a monthly publication that provides the latest updates that affect VA community providers. Access your Subscriber Preferences to make changes to your subscription or Unsubscribe. Get this as a forward? Sign Up to receive updates from Veterans Health. Having questions or problems? Please visit Subscriber Help for assistance.
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