Veterans Affairs Community Care Network Update

For those contracted with TriWest to serve veterans in VACCN Region 4, the claims processor had a programming issue that is causing some claims to be paid at 75% of the billed amount. The HCAOA VA Advisory Council is in contact with TriWest leadership, and the claims processor, PGBA, is implementing a fix. We understand the frustration these payment issues cause. Members are recommended to watch payment records for July and August claims carefully to ensure any underpaid claims are rectified over the coming weeks.

For those serving veterans in the VACCN in any state, this is a reminder that TriWest and Optum need to verify the current credentials (re-credential) for all network providers every third year around the anniversary of the provider's contract. Email from Optum or TriWest should not be considered spam. The re-credentialing process will require submission of a current W-9, insurance, biographical info and, if applicable, a current home care license. This is standard procedure to maintain a current provider network for the VA.