CCN and PC3 Providers: Instances of Slightly Delayed Claims
TriWest has successfully transitioned its claims processing to PGBA. TriWest thanks you -- our network providers -- for your partnership during this claims conversion. Through the process, some CCN and PC3 providers may have experienced a slight delay in claims processing. We ask for your patience during this time and apologize for the delay. Both TriWest and PGBA are working in tandem and have started to process temporarily delayed claims as of Aug. 16, 2021. TriWest and PGBA expect to be current with claims processing within the next four weeks.
If you do not receive payment following the processing, you can call to obtain claims status from TriWest Claims Customer Service at 877-CCN-TRIW (877-226-8749) from 8 a.m. to 6 p.m. in your time zone or visit Availity to use the secure “Chat with TriWest” feature.
Provider Transition Information
VA Transitions from PC3 to CCN in Regions 5 and 6
Check this page often for updates on the Department of Veterans Affairs (VA) transition from Patient-Centered Community Care (PC3) to the Community Care Network (CCN).
PC3 ended in Region 4 on March 31, 2021. Care through PC3 continues in CCN Regions 5 (Alaska) and 6 (Pacific Islands) at this time.
PC3 Ended March 31, 2021, in Region 4
Patient-Centered Community Care (PC3) ended in Region 4 on March 31, 2021. Ongoing care delivery is now provided through the VA Community Care Network (CCN).
Effective April 1, 2021:
- New authorizations for care must be under CCN.
- Providers should not submit a Request for Service (RFS) to continue care under PC3. Only CCN contracted providers may send an RFS to VA for a new approved referral/authorization under CCN if they have not already received an updated authorization.
Are You in the TriWest Network?
VA requires all providers to be fully contracted, credentialed, and in-network with TriWest to participate in CCN and continue receiving referrals for Veterans under CCN. If you have not signed a CCN contract to continue to care for Veterans, contact TriWest at 866-286-4174.
If Veteran care has not yet been transitioned to CCN, direct the Veteran to contact their local VA Medical Center to request an extension of care under CCN if ongoing care is needed.
- TriWest will continue to pay PC3 claims on approved referrals for dates of service through the authorization expiration date or March 31, 2021, whichever comes first.
- Region 4 providers should submit all PC3 claims to PGBA within 30 days for timely reimbursement. To check PC3 claims reimbursement status, login to Availity to search or call 877-CCN-TRIW (226-8749) to speak to a Claims Customer Service Representative.
TriWest thanks you for supporting the important mission to care for our nation’s Veterans. We value your partnership.
PC3 Continues Along with CCN in Region 5 - Alaska, Until Sept. 30.
Until CCN is fully deployed, care through PC3 continues in Alaska and is currently scheduled to end no later than September 30, 2021. CCN launched in Kodiak, Alaska, on April 1, 2021 and expanded to the entire state of Alaska on June 15, 2021. To learn more about CCN in Alaska, visit https://CCN.TriWest.com.
Continue to check back for more information.
PC3 Continues in Region 6 – Pacific Islands (Guam, American Samoa, N. Marianas)
Care through PC3 continues in Region 6 at this time and is currently scheduled to end no later than September 30, 2021. Continue to check back for more details.