Veterans Choice Program: Improving Access to Care for America's Veterans

Episode of Care Limitations

Initial Choice program requirements limited authorizations to 60 calendar days for all services. We received much feedback that this was a significant impediment for providers, who had to spend additional time submitting requests for care extension authorizations for Veterans who were in the midst of chemotherapy treatments, chronic conditions and even pregnancies. Last fall, Congress and VA modified the operating parameters, and TriWest received approval in January 2016 to authorize care based on the clinically appropriate episode of care up to one year. We are hopeful this change will reduce hassle on your end by decreasing the paperwork (e.g., SARs) needed from provider offices in order to continue treatment for Veterans in need.

“Point of Sale” Provider Education

TriWest offers a suite of provider education, both on-demand and through live webinar discussions through our Provider Education department. We recognize that you have limited time and need to know “the basics” when it matters most—when a Veteran is scheduled for an appointment in the office. As of December 2015, providers now have access to the following:

Provider Authorization Letter Redesign

Effective January 2016, in order to minimize confusion regarding which services are covered/authorized, TriWest has re-engineered the authorization letter.

Provider Contact Center Enhancements

Streamlining issue resolution and being available to answer your questions quickly and accurately is a key component of TriWest’s commitment to enhancing your experience working with us. Your feedback has prompted TriWest to carry out several operational changes.