VA’s community seasonal flu shot program launched Sept. 1, 2020, providing eligible Veterans with a no-cost seasonal flu shot. VA currently partners with more than 60,000 in-network retail pharmacies and urgent care locations to provide flu shots to Veterans.
To serve Veterans using this benefit, retail pharmacies or urgent care clinics must be in-network through one of VA's third-party administrators (TPAs), either Optum Public Sector Solutions, Inc. (Optum), part of UnitedHealth Group, Inc.; or TriWest Healthcare Alliance (TriWest).
For current in-network retail pharmacies or urgent care locations, the chart below describes how to submit claims when you provide eligible Veterans a seasonal flu shot. Please use the information listed below depending upon the Community Care Network (CCN) region where your facility is located and the appropriate TPA.
Billing for In-Network Retail Pharmacies/Urgent Care Locations
After the Veteran’s visit, follow these steps:
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Retail Pharmacies: Provide a copy of the flu shot documentation to the Veteran and recommend they provide it to their VA primary care provider’s office
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Urgent Care: Submit medical billing information to the Veteran’s home VA medical center (VAMC) within 30 calendar days of the date of service using the following information:
TPA Help Desk
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CCN Regions 1-3: Optum - Call CVS Caremark Pharmacy Help Desk at 800-364-6331 (24/7)
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CCN Region 4: TriWest - Call Express Scripts Pharmacy Help Desk at 800-922-1557 (24/7)
Resources
HealthShare Referral Manager (HSRM) has streamlined the referral and authorization management process for Veteran community care, and the number of community providers registering for HSRM continues to grow rapidly. But once you have access to HSRM, what do you do next?
Next Steps
Once community providers complete steps 1 – 4 shown on the Account Creation Information Sheet and receive confirmation that the HSRM Help Desk created their account(s), it is important to verify the following:
- The Point of Contact (POC) for the VA Medical Center you partner with is aware that your facility has access to HSRM
- Your facility and the VA Medical Center have agreed upon a date to start using HSRM (instead of phone/fax/email) to share referral information
- Your facility can see the referrals that are assigned by your partnering VA Medical Center
To check that referrals are being correctly routed from VA to your HSRM account, follow these steps:
- You and VA log into HSRM
- VA shares examples of referrals that have been assigned to you
- You review your Referral List and indicate whether these referrals are visible to you
If there is a mismatch between what has been assigned and what you can see, there may be an issue with the National Provider Identifier (NPI) number that your partnering VA Medical Center can help identify.
- First, VA will tell you what NPI number they assigned the referral to; please verify that it matches one of the NPI numbers you requested access to on your End User Tracker (EUT).
- If VA assigned the referral to the wrong NPI number, they could take action to reassign the referral correctly.
- If you need another NPI number associated with your account(s), submit an updated EUT to the HSRM Help Desk at HSRMSupport@va.gov.
- If the referral was assigned to the correct NPI number and you still do not see the referrals, please open a Help Desk ticket by emailing HSRMSupport@va.gov.
HSRM Live Virtual Training Sessions
Registration for one of the live weekly HSRM trainings can be completed by creating an account and logging into VHA TRAIN. The HSRM training sessions include an overview of HSRM, an in-depth walkthrough of the system, and 30 minutes for audience questions/demos. Training is available at no cost and is hosted by HSRM staff who are ready to answer your questions!
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For any questions about HSRM, please email ccra@va.gov.
VA’s current contract vehicle for Veteran urgent care benefits will transition from Patient-Centered Care (PC3) to the Community Care Network (Region 4) on Sept. 30, 2020. The third-party administrator for Region 4 – TriWest Healthcare Alliance – will continue to administer urgent care in Region 4.
Community providers in CCN Region 4 who want to provide urgent care services to Veterans after Sept. 30, 2020 must establish a contract with TriWest. To join the network, please visit TriWest’s provider website.
For questions and support, community providers should contact TriWest or their local VA medical facility.
To find the nearest VA medical facility, use VA’s Facility Locator.
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VA Safe Firearm Storage Toolkit & Partnered Webcast with USCCA, and Resources for Community Providers
Firearm (and other lethal means) safety counseling can save lives when it comes to suicide prevention. VA and the United States Concealed Carry Association (USCCA) partnered to create a video which provides key data and practices that community providers can put into practice and share across their communities. VA believes suicide prevention is everyone’s business.
VA released the Safe Firearm Storage Toolkit, developed in partnership with the American Foundation for Suicide Prevention*(AFSP) and the National Shooting Sports Foundation* (NSSF), the trade association for the firearms industry. During their podcast in May (Protecting Mental Health and Preventing Suicide During COVID-19), USCCA discussed the importance of storing firearms and lethal means safety, along with discussion from VA, AFSP, and NSSF leaders.
Resources for Community Providers
More information about preventing Veteran suicide and other free consult resources for community providers may be found at:
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