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Follow these three steps to know where and when to file your claims to ensure you are reimbursed in a timely manner. (Note: These tips do not apply to claims for emergent and urgent care.)
- Know How the Care Has Been Referred
VA must refer and authorize community care (excluding emergent and urgent care). There are four routes in which VA authorizes care, and the referral route determines who will pay the claims.
If you have provided services as an ancillary provider, please contact the provider to whom the referral was issued for information on how the care has been referred.
- Know Where to Send Your Claim
Follow the table below to determine where to submit your claim and how. Providers are always encouraged to file claims electronically to avoid processing delays.
*Important: CCN Regions 4-5 and PC3 claims have a new Payer ID and mailing address. Claims submitted electronically using the previous Payer ID will be rejected. Please update your records.
- Know Your Timely Filing Requirements
Claims for authorized care must be submitted within 180 days of the date of service.
Support
When a Veteran is transported in an emergent manner or without prior approval by an ambulance, VA should be notified within 30 days. The best way an ambulance provider can notify VA is through claim submission within 30 days from the date of transport.
If a claim for emergent ambulance transport cannot be submitted to VA within 30 days, notify us by phone at 844-724-7842. For more comprehensive information about ambulance transport, please visit: VA OCC Ambulance Transportation Fact Sheet.
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On September 30, 2021, VA will retire the VHA TRAIN MISSION Act (MA) Curriculum (VHA TRAIN-MA) training website. All courses from the VHA TRAIN MA site will transfer to the main VHA TRAIN website and be available for all learners to access. A select few courses will continue to require an NPI number at registration. This transition will not require downtime and will be seamless to VHA TRAIN users.
The VHA TRAIN MA site was originally created to host mandatory MA training and accredited online courses for community providers. VHA TRAIN serves that same purpose and will continue to provide education for community providers so you can effectively care for our Nation’s Veterans.
For questions, please contact the VHA TRAIN help desk.
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Check out the latest community care articles posted to VA’s official VantagePoint blog:
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Webinar: Clinical Practice Guidelines for PTSD: An Update from 2019 (August 10, 2021, 12-1:00 pm ET)
This webinar discusses Post Trauma Stress Disorder (PTSD), a common problem in Veterans returning from combat, and provides current best practice treatment updates and guidelines, including psychotherapy and other interventions.
Registration for the webinar will be available through VHA TRAIN. Don’t have an account? Create one.
Go to WRIISC Provider Training for more provider education and training opportunities.
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Webinar: VHA Office of Community Care Overview (August 19, 2021, 1-3:00 pm ET)
This webinar provides an overview of community care programs and policies, focuses on how to file clean claims, covers topics such as urgent and emergent Veteran care, eligibility, referral, and other critical provider issues.
Register for the webinar through VHA TRAIN. Don’t have an account? Create one.
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Webinar: Traumatic Brain Injury (TBI) Diagnosis and Management (August 26, 2021, 1-2:00 pm ET)
This webinar discusses the unique aspects of Veterans with TBI and enhances providers' ability to develop an effective treatment plan.
Register for the webinar through VHA TRAIN. Don’t have an account? Create one.
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Webinar: HSRM Training (Every Monday, 2-4:00 pm ET and Tuesday, 1-3:00 pm ET)
This webinar provides an overview of HealthShare Referral Manager (HSRM), VA’s online system for the referral and authorization management process for Veteran care and gives an in-depth walk through of the system.
Register for the webinar through VHA TRAIN. Don’t have a VHA TRAIN account? Create one.
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