Expanding Our Role
As mentioned in our letter to providers, TriWest will be assisting the Department of Veterans Affairs (VA) in administering the Patient-Centered Community Care (PC3) Program and Veterans Choice Program (VCP) across the entire nation. If you are a provider who is new to TriWest, welcome! If you are a TriWest contracted provider or Choice-registered provider, please reference all information on our existing Provider Portal.
We have a team of representatives at 1-866-245-3820 waiting to assist you with any questions you may have as we temporarily expand our PC3 and VCP responsibilities into the territory previously handled by Health Net Federal Services (HNFS). We hope the information on this page will provide you with more details regarding this transition.
Your participation in the network is greatly appreciated. Thank you for joining our mission and proudly caring for Veterans within your community!
TriWest has worked collaboratively with VA from the start of PC3 and VCP across 28 states in the western and southern parts of the U.S. Along with VA, TriWest addressed challenges within these programs to improve implementation and operations to better serve Veterans.
TriWest’s performance today is strong. With a current network of more than 210,000 community care providers, we have systems in place to rapidly build a provider network within the regions previously handled by Health Net. To-date, Veterans have received more than 9.2 million total appointments in TriWest’s service areas.
Why This Change?
- VA’s contract with Health Net, which covers half of VA’s PC3/VCP regions, ended on September 30, 2018.
- VA determined the only way to quickly and effectively perform the work for network development and administrative services is to tap into the support of TriWest, which already performs the same services in the other half of VA’s regions.
- VA will expand TriWest’s services to the entire nation. TriWest collaboration will ensure that network and administrative services are meeting Veteran and community provider needs by the end of January 2019.
What Do I Need to Do?
- Ensure you’ve signed a contract with TriWest (your Health Net agreement is no longer valid). If you need to request a contract, please visit our Join Our Network page.
- Register for a secure account on Availity at www.Availity.com. TriWest has a Payer Space on Availity where you can also access the TriWest Provider Portal.
- Once added to the TriWest network, change your claims submission to WPS Military and Veterans Health (WPS MVH). Review our provider-billing page for links to WPS MVH.
- Sign up for a webinar and take our education that is tailored to help providers better understand Department of Veterans Affairs (VA) Patient-Centered Community Care (PC3) and Veterans Choice Programs (VCP) processes for their region. You can find these materials in TriWest’s Learning and Development tab within TriWest’s Payer Space on Availity.
- Take a look at the SAR/RFS matrix tool to determine if your authorization requests come to TriWest as a Secondary Authorization Request (SAR) or go to the authorizing VAMC as a Request for Services (RFS).
- Please download our handy Checklist tool to get started!
Who Do I Contact with Questions?
Specific questions related to this TriWest expansion can be answered by contacting TriWest at 1-866-245-3820, or firstname.lastname@example.org.