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Provider Pulse – September 2022

REMINDER: Urgent Care Centers Must Call TriWest to Verify a Veteran’s Eligibility for Care

VA Community Care Network (CCN) urgent care facilities must call TriWest to verify a Veteran’s eligibility to ensure there is no delay in care for the Veteran, or delay in payment for the facility.

Eligibility verification calls create a record for claims payment. If a call is not placed, claims will be denied due to having no authorization on file. It also ensures Veterans can obtain prescriptions without delay.

As a reminder, the process for Veteran urgent care services is as follows.

  • The Veteran will self-present upon visiting a TriWest network urgent care location.
  • The clinic will ask the Veteran for their:
    • Date of birth
    • Last four digits of their Social Security number (SSN)
    • Home VA medical center
    • Home address
  • The clinic staff calls TriWest at 833-4VETNOW (833-483-8669) to confirm the Veteran’s eligibility using the DOB and SSN information.

Thank you for always checking a Veteran’s eligibility BEFORE providing urgent care services.

For more information, please see the CCN Urgent Care & Emergency Care Quick Reference Guide.

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Help Veterans Beat the Flu in ‘22

Flu vaccines will be available to Veterans at retail pharmacies and urgent care locations through April 30, 2023, at no cost.

If a Veteran would like to receive a flu vaccine from his/her preferred VA Medical Center, please advise the Veteran to call ahead to ensure flu vaccine availability.

To learn more, visit VA’s flu web page.

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Take the Toxic Exposure E-Learning Modules

With the recent signing of the PACT Act, you can learn more about toxic exposure within the military community with five of VA’s e-learning modules.

Providers can receive a Level 1 certification and continuing medical education credits (CEUs) upon successful completion of the War Related Illness & Injury Study Center’s (WRIISC) modules and passing a comprehensive exam.

Visit the War Related Illness and Injury Study Center on VA’s website for more information.

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Remember to Submit Claims and Reconsideration Requests Timely

Providers should make every effort to submit claims within 30 days of rendering services. Adhering to this recommendation will help speed up payment to the provider’s office. Under VA’s CCN contract, timely filing of initial claims is limited to 180 days after rendering services. Reconsideration requests for denied or disputed claims must be received within 90 days of the date the claim was processed. Corrected claims must be received within one year of the claim’s processing date.

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Help Welcome Military Families Home for Blue Star Welcome Week

Blue Star Welcome Week is Sept. 24 – Oct. 2, 2022, aimed at helping the 600,000 active-duty and transitioning military families who move each year find a better sense of belonging in their local community. TriWest Healthcare Alliance (TriWest) is a proud sponsor of this year’s campaign, and wants to encourage you to do your part to help welcome home these military families.

To show your support, view the Blue Star Welcome Week flyer and scan the QR code to sign a virtual welcome card, as well as access a print-ready sign that you can display in your office to help spread the word!

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Provider Handbook Updates

Reminder: The CCN Provider Handbook is now web-friendly and easy to navigate. Rather than a single document, each topic of interest is divided into its own web page, making it easier to find the information you need.

Bookmark the latest version: https://www.triwest.com/CCNProviderHandbook.

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Updated: 9/15/2022 11:15:01 PM