Provider Pulse – February 2022

Questions about CCN? TriWest Training Can Help!

TriWest Healthcare Alliance (TriWest) has a full array of webinars to help you better understand Department of Veterans Affairs (VA) Community Care Network (CCN) processes via its Learning Center on Availity.com.

Topics include information about PGBA claims submission, appointing and approved referrals/authorizations, urgent and emergent care, and other CCN processes and procedures. The full list of webinar topics include:

• All Inclusive CCN Module – Review all aspects of VA's CCN processes and procedures in a two-hour presentation.
• Appointing and Authorizations – Learn the CCN appointing and approved referrals/authorization processes.
• Availity – Learn how to navigate the TriWest Payer Space on Availity.
• Behavioral Health – Review provider requirements, telehealth services, Evidence-Based Psychotherapy, medical documentation and critical findings.
• Billing Basics – Learn about the basics of billing for provided services, including common industry terminology, how to fill out claims submission forms, and CCN claims submission requirements.
• Chiropractors, Acupuncturists, Massage Therapists – Learn about acupuncture reimbursement, as well as the CCN authorization and claims processes for acupuncture, massage therapy, and chiropractic care for accurate billing and proper payment.
• Home Health – Learn about identifying different levels of care, initiating care, claims processes for home health providers, and helpful TriWest provider resources.
• PGBA Claims Training – Learn about TriWest’s claims processor, PGBA, how to submit a claim, codes and requirements, and how to set up EDI, EFT, and ERA.

Register for these CCN webinars:

• Log in to https://www.availity.com/. If you don’t have an account, register for one for free.
• Navigate to the TriWest Payer Space.
• Click on the TriWest Learning Center.
• Register for one or more webinars.

For help registering: TriWest Learning Center Quick Reference Guide.

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Don’t Forget the Referral/Authorization Number with Your VA Claims

As a reminder, providers must include the VA referral/authorization number with all VA CCN and Patient-Centered Community Care (PC3) claims submissions.

If you don’t include the VA referral/authorization number, your claim will be denied. The only exception is urgent care.

Remember:

1. Providers are required to share the VA referral/authorization number with the ancillary providers included in a Veteran’s episode of care.
2. Ancillary providers are required to use this same VA referral/authorization number when submitting their claim for the specific episode of care.

Top Tips for Faster Claims Processing

Avoid these top 3 most common errors we see in claims processing. And to get paid faster, without returns, send these tips to your billing team.

To find the status of your claims, visit Availity.com where we've added more ways for you to search for claims. In Availity, select Claims & Payments and then the Claim Status option.

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