Health care delivery to begin under new VA contract

PORTLAND, Ore. (KTVZ) — Tuesday, August 11, marks the beginning of community health care delivery to Pacific Northwest area veterans under the U.S. Department of Veterans Affairs contract awarded to TriWest Healthcare Alliance.

“The new Community Care Network (CCN) contract awards reflect our ongoing commitment to increasing Veterans access to care,” said VA Secretary Robert L. Wilkie, “and were designed based on feedback from veterans and other stakeholders.”

TriWest Health Care Alliance has been managing VA’s community care network in the area but will transition to the new Community Care Network on Tuesday.

VA community providers currently contracted by TriWest will not be automatically enrolled in CCN, so they will be required to sign a new contract with TriWest to continue providing services to Veterans under CCN.

“We are confident CCN will greatly improve care coordination for Veterans here in our area and improve the timeliness of payments to our local community providers,” said Darwin Goodspeed, director of the VA Portland Healthcare System.

Veterans will continue to receive care from community providers during the transition, but there are some limitations.  Current non-VA care authorizations will remain valid through their expiration dates or March 31, 2021, whichever date comes first.

However, if a provider is not enrolled in the CCN, Veterans will not be able to obtain a new authorization to continue care with those non-VA providers.

The new VA CCN serves as the direct link between VA and local health care providers, streamlining the process for providers to be paid for their services. TriWest will manage the provider network and process claims for payment to local providers on behalf of the VA.

This is what remains the same with CCN for Veterans:

• Veterans still need to be referred by their VA provider.
• An authorization must be in place prior to the community appointment.
• Emergency room care and urgent care processes have not changed.

This is a main change for Veterans with CCN:

• Once non-VA care is authorized by VA, VA Portland Community Care staff will assist Veterans in scheduling it.

More information for providers: http://www.triwest.com/en/provider/

For providers, VA has also developed a new secure online portal, called HealthShare Referral Manager, for managing referrals and authorizations.

Go to the CCN website for more information and frequently asked questions.