VA will re-adjudicate approximately 14,000 community care dental claims previously processed on or after April 1, 2021. Those claims contained one or more line item denials due to missing or inconsistent area of the oral cavity and/or tooth anatomy details. This only involves dental claims submitted to VA by dental providers who are working with VA through a Veterans Care Agreement (VCA). It does not affect dental claims submitted to Optum or TriWest

VA is working with the American Dental Association to update guidance and claims submission requirements related to area of the oral cavity, tooth numbers and surfaces.

Re-adjudication is not a guarantee that claims will be paid. VA will process them in accordance with requirements in place prior to April 1, 2021.

Community dental providers perform a vital service for Veterans on behalf of VA. Thank you for your patience and continued support of the Veterans in your community.

For more information, visit File a Claim for Veteran Care - Community Care (va.gov)

As of April 1, 2021, all Assisted Reproductive Technology (ART)/In Vitro Fertilization (IVF) care coordination has transitioned to VA with support from Community Care Network (CCN) third party administrators (TPA) Optum Public Sector Solutions (Optum) and TriWest Healthcare Alliance (TriWest). This transition coincides with the end VA’s Patient-Centered Community Care (PC3) network on March 31, 2021.

Going forward, ART/IVF services and care coordination are being managed by local VA medical facility community care offices with network support provided by Optum in CCN Regions 1-3, and by TriWest in Region 4.

To ensure seamless care coordination, TriWest, as TPA for the PC3 network, performed a warm hand-off with VA staff to ensure Veteran couples receiving IVF care in Region 4 did not experience a gap in care.

Support

•  VA In Vitro Fertilization Treatment
• CCN regional map and breakdown by state
• Questions? Contact the IVF Team

Community Care Optometrist Committed to Veterans

Dr. Jesse Dominguez, CCN Region 4 Optometrist, has served Veterans under VA community care since 2015. He and his staff consider it a special honor to care for Veterans at his practice in Phoenix, Arizona.

As a young boy, Dominguez recalls spending nights at a close friend’s home whose father served in Vietnam. In the middle of the night, Dominguez would sit and comfort his friend’s dad who suffered from vivid war flashbacks.

This experience had a profound impact on him as a young man, leading him to go out of his way to show appreciation to every Veteran he meets, especially at his office. Read article on VAntage Point.

Community providers: CCN improvements help you care for our Veterans

Over the past few years, VA has been making steady progress to improve how it works with local community providers who deliver care to Veterans on behalf of VA.

Key to this transformation has been VA’s Community Care Network (CCN), both a network and contract vehicle between VA and community providers.

CCN addresses some of the biggest challenges Veterans and providers have had to contend with in the past. Those include referrals, scheduling, care coordination, customer service challenges between VA and Third Party Administrators (TPAs), and claims processing issues. Read article on VAntage Point.

Webinar: Treating Veterans with PTSD, TBI and Sleep Disturbances: Lifestyle Factors and Brain Blood Flow Regulation (July 13, 2021, 12-1:00 pm ET)

Attendees of this webinar will learn about the latest research into how post deployment health concerns such as post-traumatic stress disorder, traumatic brain injury and sleep disturbances can impact cerebral blood flow regulation and to determine the necessary modifiable lifestyle factors, such salt consumption, exercise, and hydration, are necessary for healthy brain blood flow regulation.

Register for the webinar through VHA TRAIN. Don’t have an account? Create one.

Go to WRIISC Provider Training for more provider education and training opportunities.