Veterans Choice Program
<p><strong>INFORMATION FOR AFFILIATES</strong><br /> Requirements for independent providers interested in participating in the Veterans Choice Program </p> VeteransAffiliates

INFORMATION FOR AFFILIATES
Requirements for independent providers interested in participating in the Veterans Choice Program

Requirements for Independent Providers

AffiliateHelpAscension has established a contractual agreement with TriWest Healthcare Alliance and national provider registration with Health Net Federal Services, LLC.

Providers who are not employed by Ascension but are interested in participating in the Veterans Choice Program must contact Health Net or TriWest.

Potential providers must meet all Veterans Choice Program requirements, including Third Party Administrator (TPA) appointment authorizations and access to care standards as well as medical record documentation and claims handling requirements. Provider participation requirements can be accessed in full online at the Health Net and TriWest websites: www.hnfs.com and www.triwest.com.

  • Independent providers interested in becoming a Veterans Choice provider must establish a provider agreement with either Health Net or TriWest.
  • Health Net: Please visit http://www.healthnetpc3provider.com/p3c/?register=true and review the Terms of Participation. You will be prompted to fill out the appropriate fields with your information. All providers must meet the VA certification standards and must agree with the program requirements prior to rendering services to the veteran.
  • TriWest: Please visit www.triwest.com/provider, scroll halfway down the page, and click register as a VCP provider. After clicking the link, you will be directed to the registration form and prompted to fill out the appropriate fields with your information. Once submitted, you will receive a welcome letter via email, mail or fax. Contact the Veterans Choice Program line at 1-866-606-8198 and select option 2 for questions.
  • Providers interested in becoming a Veterans Choice provider must establish a provider agreement with Health Net or TriWest. Provider criteria includes, but is not limited to:
    • Provider agrees to accept the reimbursement rates as the only payment expected for veterans for authorized services.
      • Veterans have no copayments or cost-shares in this program. As such, a veteran will not be billed directly for any services or supplies furnished under this contract. The only exception to this is if the veteran has Other Health Insurance (OHI). In the case of Other Health Insurance for a non-service connected claim, it is appropriate to collect a copayment from the veteran for the OHI, if applicable.
    • Providers must accept Medicare rates, and meet all Medicare Conditions of participation and Conditions for Coverage as required by the U.S. Department of Health and Human Services (see http://www.cms.gov/Regulations-and-Guidance/Legislation/CFCsAndCoPs/index.html for further detail).
    • Providers on the Centers for Medicare and Medicaid (CMS) exclusionary list shall be prohibited from network participation (see http://oig.hhs.gov/exclusions/index.asp for further detail).
    • All services, facilities, and providers shall be in compliance with all applicable federal and state regulatory requirements.
    • All providers shall have a full, current, unrestricted license in the state where the services are delivered and must have same or similar credentials as required by VA staff.
    • Providers must submit a copy of the veteran’s medical records to the third-party administrator for medical services provided.
    • Provider must submit medical documentation as required by the TPA.