Community care VA Cheyenne Health Care

Your provider submitted your referral, now what?

Special Care Services will review your referral to determine if the service is available in the VA or should be transferred to the community.

Step 1

What happens if my referral is placed in the VA?

• If the VA provides the requested service, expect a call from a VA staff member within 3 business days.
• After one unsuccessful phone contact attempt, you will receive a letter in the mail to help you schedule your appointment.
• Your reference may be deleted after 14 days of unsuccessful contact.
• Please turn on your voicemail and do not block calls from VA. Read the letter the VA sent you. If you have questions, please call us at 307-778-7550select option 6.

What if my referral goes to community care?

• Expect a call from the Community Care Office after 3 working days. If you do not receive a call, please contact the Community Care Office at 307-778-7550Choose option 6 and follow the prompts.
• You can also contact the Community Care Office by sending a secure message. MyHealtheVet

The Community Care Office will:

1. Network Preferred helps you choose a community service provider.
2. Send your referral and medical documentation.
3. A scheduling letter will be mailed to you with instructions on how to schedule your appointment with the community provider.

Step 2

You are responsible.

1. Make an appointment with the community provider.
2. Call the community care office to inform about the appointment 307-778-7550select option 6.
3. Looking at the permission letter. This letter will contain the number of authorized visits, the authorized services, the specialist’s contact information, and the authorized time frame for treatment.

What do I do after I receive my authorization letter?

Keep this letter for your records and bring it to your first appointment. You are responsible.

1. Attending your appointments on approved dates.
2. If you need additional services after the license expires, contact your provider.

How can my VA provider review my community records?

• Ask the community provider to fax the results of your visit 307-778-7360 Adding to your electronic health record for your provider to review.
• You can access community records and bring them to the VA to upload to your medical chart.

Step 3

What is the fastest way to find VA medical teams?

What should I do if I receive an approved care bill?

• If you do not agree with the balance on your account, call the phone number listed on the account to verify that the Community Provider has a copy of the referral authorization and correct sponsor/guarantee information. If they have your referral authorization correct, but still cannot resolve the issue, call the Community Care Office for assistance.

Step 4

Other useful reference information

• Seeking care from community providers without a license can result in significant out-of-pocket costs. Please ensure you have the appropriate authorization before seeking community non-emergency care.
• Understanding appointment types may vary. Many providers can conduct appointments over the phone, telehealth (virtual), record reviews, or in person.
• If you are eligible for beneficiary travel, please contact the travel office by calling for reimbursement requirements for VA and community appointments. 307-778-7550 Extension 7224.

How to avoid billing challenges:

1. Never go to a community provider without permission or outside of your permission days. If you need a license number or dates of service, consider calling 307-778-7550select option 6.
2. If you go to the emergency room in the community, call 844-724-7842 in 72 hours.

What to do if contacted for bills/payment provider

If you have a bill or questions about a claim payment
Contact VA C4 (Community Care Contact Center) – Includes US Pacific states.
C4 Phone: 877-881-7618.
Working hours: 5:45 am to 6:15 pm

If you are contacted by a community provider regarding an invoice or unpaid claim
Call the community provider to the TriWest Claims Call Center at 877-226-8749 (This hotline is for TriWest Network Providers only).
TriWest’s claims center helps call center providers learn how to submit claims, update claims status, and process claim denials.

If you have a negative credit report and debt collection issues as a result of using community care
Contact the VA Adverse Credit Helpline at 877-881-7618.