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Community providers are encouraged to electronically report instances of a Veteran presenting to a community emergency room by using VA’s new Emergency Care Reporting (ECR) portal:
This new secure method enhances accuracy of information and allows for faster data processing and faster return of decision information.
For security purposes, portal users will need to complete an email authentication process before reporting emergency services. While portal usage is the preferred method of reporting emergency treatment of a Veteran, providers can also call 844-72HRVHA (844-724-7842) to deliver case-specific information.
Use of the new portal is a step toward discontinuing email as a pathway to alert VA about treatment Veterans receive through a community emergency department. VA will discontinue the e-mail method in 2021 to minimize vulnerabilities to Veterans’ personal protected information.
Authorizations
After processing, providers will receive authorization decision information via email if the required contact information is provided in the emergency treatment report. Currently VA is experiencing a delay in the delivery of decision correspondence. Providers supplying all required information can expect decision correspondence within 72 hours by January 2021.
In-network providers seeking authorization numbers may refer to their Third-Party Administrator (TPA) portal, https://provider.vacommunitycare.com for Optum, and http://www.triwest.com/provider for TriWest. Providers may also call the centralized call center at 844-72HRVHA (844-724-7842) to check the case status and receive decision information.
Seeking Emergency Care
During a medical or mental health emergency, VA encourages Veterans to seek immediate medical attention without delay. Veterans do not need to check with VA before calling for an ambulance or going to an emergency department. In most instances Veterans are eligible to receive VA-authorized emergency care at an in-network facility if VA is notified of the emergent event within 72 hours of the start of care.
Reporting emergency treatment in the community allows VA to assist in coordinating care or transfer of the Veteran to a VA medical facility and helps ensure administrative and clinical requirements that allow VA to pay for the care are met. The local VAMC will engage with community providers who report emergency treatment through the online portal or by phone.
If you have an urgent or emergent need to coordinate care or transfer a Veteran to a VAMC, please make immediate contact with the nearest VAMC. Transfer activity should be conducted directly between providers and the local VAMC. View the list of VA Facility Contact Information for Care Coordination, which includes phone numbers and email addresses to coordinate care directly with local VAMCs.
Providers now have until Dec. 31, 2020 to resubmit claims that were submitted on time, but rejected because they were submitted to the wrong VA payer (VA or a VA Third Party Administrator (TPA)). These claims may be resubmitted even if 180 days have passed since the claim was rejected. Resubmitted claims must be sent to the correct VA payer.
For more information, providers can contact your regional TPA or VA as applicable:
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Please encourage Veterans to get a flu shot this year. Veterans enrolled in VA health care can receive a no-cost flu shot in their local community, paid for by VA.
Studies show that recommendations by providers increase flu vaccination rates. Veterans can follow the steps in this video to get a flu shot at a local community provider, and present the Flu Shot Information Flyer to help guide the billing process.
Resources
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Live registration information sessions for HealthShare Referral Manager (HSRM) are every Wednesday from 3:30-4:00PM ET through VHA TRAIN. The sessions are designed to help community providers establish accounts in HSRM, VA’s online portal for processing community care referrals and authorizations. These sessions provide an in-depth walkthrough of the process to obtain access to HSRM (i.e. verifying your identity with ID.me and completing the End User Tracker). Please check VHA TRAIN for available dates and to register in advance. A free account in VHA TRAIN is required in order to register for the webinar.
HSRM Live System Training
Live trainings for HSRM are also offered on Mondays from 2:00-4:00PM ET and Tuesdays from 1:00-3:00PM ET through VHA TRAIN. These sessions include an overview of HSRM, an in-depth walkthrough of the system, and 30 minutes for audience questions. Training is available at no cost and is hosted by HSRM staff who are ready to answer your questions. Please check VHA TRAIN for available dates and to register in advance. A free account in VHA TRAIN is required in order to register for the webinar.
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Meet Your HSRM Team
Name: Rammy Sbeitan
Role: Senior Trainer
Fun Facts: I’m a bit of an adrenaline junkie so anything that gets your blood flowing, sign me up! I’m also a huge foodie and love trying new restaurants. I have a border collie named Tucker who is the best dog a man could ask for. I love working in health care and have genuinely enjoyed working with everyone at VA.
For any questions about HSRM, please email ccra@va.gov.
Additional Resources
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Provider-focused blog articles are posting frequently on VA’s official VAntage Point blog. Check out the latest ones below:
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At VA, cultural awareness is an essential part of delivering Veteran-centered care. This is true for community providers and administrative staff serving American Indian/Alaska Native (AI/AN) Veteran patients. To support cultural awareness, VA has identified two resources that contain useful knowledge for providers and staff when serving AI/AN Veterans, including:
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SAMHSA Native Culture Card – This guide enhances cultural competence when serving American Indian and Alaska Native communities. It covers regional differences, cultural customs, spirituality, communication styles, the role of Veterans and older adults, and health disparities.
- The IHS Gold Book is a four-part publication in which the Indian Health Service (IHS) reviews progress from the agency’s first 50 years of operation, including lessons learned regarding culturally acceptable public health services.
Support:
Contact Tribal.Agreements@va.gov for additional information.
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