Community Care Network Providers

Take a Look: Enhanced Claim Status Tool on Availity

TriWest and Availity have enhanced the provider claims search experience on Availity.com by updating the Claim Status functionality. The tool now gives you a more intuitive and robust workflow to check the claim status of your Veteran members.

Improvements include:

  • More ways to search and filter results
  • The ability to have simultaneous multiple and different search options
  • The ability to view multiple claims status simultaneously
  • The ability to export search results into a CSV Excel file
  • A more detailed “claims status detail view,” allowing providers to see the reason for a claims denial

Search claims by:

  • Member ID
  • Tax ID
  • Service date
  • Claim number

Login to your Availity account and click on the Claims & Payments option located on the top-left corner of the main screen. Under Claims & Payments, select the Claim Status option.

Proudly Caring for Our Nation's Heroes

Department of Veterans Affairs (VA) Community Care Providers: Thank you for caring for our nation’s Veterans.

Here you can access training and tools for:
  • VA’s Community Care Network (CCN)
  • VA’s Patient-Centered Community Care (PC3) program

Access Information by Contract Status

 CCN Providers  PC3 Providers

Send Claims to PGBA Effective June 9

TriWest VA Claims must be sent only to PGBA effective June 9, 2021. WPS MVH will no longer accept new claims. Any paper claims received by WPS MVH after June 8 will be forwarded to PGBA via USPS for a limited period of time. Claims submitted electronically using the previous Payer ID will be rejected. Find out where to send claims for timely payment and what Payer ID to use now.

Community Care Network Resources

 

CCN Secure Login (Availity)

Access TriWest’s Payer Space on Availity for secure transactions, CCN quick reference guides, the Provider Handbook, and live or on-demand training.

 

Access VA's Referral Network

Use VA's HealthShare Referral Manager (HSRM) to request additional services, review referrals, and upload medical documentation.

 

Search Claims

Options include secured access via Availity.com or IVR automated access: (877) 226-8749.

 

Take CCN Training

Watch a CCN bite-sized MicroLearning video, or register for an interactive CCN onboarding webinar conducted by our Provider Training Team.

Join Our Network

Interested in joining the network to care for Veterans in your community? Join now!

 

Corporate Philosophy

Hear about the importance of serving Veterans from members of our senior leadership team.

 

Read Our Newsletter

Stay updated on VA community care. Read the monthly e-newsletter, Provider Pulse.

 

Proudly Caring for Our Veterans

Let your community know that you proudly care for Veterans with a print-ready sign for your office and a "badge" for your website!

 

Dental Resources

Access Delta Dental resources including the Provider Handbook, Dental Office Toolkit, and learn more with training videos on Availity.

 

VA Fee Schedule

VA calculates its fee schedule to align with industry best practices. See VA’s site for details.

TriWest Serves Community Care Network Regions 4 and 5

VA purchases care in the community to ensure Veterans receive the health care services they need. The new consolidated approach to purchasing this care is through the Community Care Network, or CCN.

CCN covers all U.S. states and territories with an established set of regional boundaries aligned to state borders to provide local flexibility and increased access to care. VA relies on the third party administrators to develop and administer regional networks of high-performing, licensed, and contracted health care providers.

On Aug. 6, 2019, VA awarded TriWest a contract to administer the new CCN in Region 4, which includes 13 western states. TriWest began full health care delivery in Region 4 in late August 2020. On Oct. 1, 2020, VA awarded TriWest a contract to administer CCN in Region 5 (Alaska). Health care delivery under CCN in Region 5 started on April 1, 2021 and expanded to the entire state of Alaska on June 15, 2021. TriWest continues to administer the Patient-Centered Community Care (PC3) program in CCN Region 6 at this time.

To learn more about TriWest, visit the About section of this site.

Updated: 9/20/2021 1:20:55 PM