Provider Pulse – March 2023

Sign up for HSRM to Access VA’s Referral Network

HealthShare Referral Manager (HSRM) is a web-based system that is both provided and used by the Department of Veterans Affairs (VA) to generate and submit referrals and authorizations to community providers.

HSRM simplifies and streamlines the referral and authorization process, as well as the process for uploading medical documentation. By utilizing HSRM, providers can expect shorter wait times when contacting the authorizing VA Medical Center (VAMC) regarding Veteran care.

Follow these steps to obtain access to HSRM:

Registration, training, and technical support for HSRM are available to providers at no cost.

For more information visit VA’s Community Care web page, or see the HSRM web system quick reference guide.

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Wait Times for Claims Calls Decreasing

We are pleased to share recent improvements in our Claims Customer Service area. The addition of several new team members, combined with the introduction of a new complex claims team and telephone service alternatives, has significantly reduced the wait time for providers calling TriWest with claims related questions. We are now answering calls, on average, in less than 30 seconds.

We apologize for any inconvenience you have experienced and appreciate your patience as we strive to provide the level of quality service you deserve.

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COMPACT Act Expands Coverage for Acute Suicidal Crisis Care for Veterans

Effective January 17, 2023, as a result of the Veterans Comprehensive Prevention, Access to Care, and Treatment Act of 2020, otherwise known as the COMPACT Act of 2020, Veteran coverage for acute suicidal crisis care is expanding.

Emergent suicide care for eligible Veterans in acute suicidal crisis at a VA or non-VA facility is a covered benefit. This means Veterans who meet certain criteria are eligible for urgent care or emergent care if it is an acute suicidal crisis.

Find valuable information in TriWest's CCN Urgent Care & Emergency Care Quick Reference Guide and VA's press release.

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Provider Handbook Updates

New content is being added to the Medical Documentation section of the CCN Provider Handbook as outlined below.

VA Medical Policies Help Guide Care

The Department of Veterans Affairs (VA) publishes medical policies for community care providers to help ensure that recommended care meets VA clinical criteria. The policies help guide providers but are not intended to replace clinical judgment. The policies also do not affect provider reimbursement for care.

To view VA's most current medical policies, visit the Community Care Medical Policy page on VA's website. For more detailed information, take the Medical Policy webinar on VHA TRAIN.

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Updated: 1/24/2024 12:29:30 PM