VA provides care to veterans through community providers when VA cannot provide the care needed. Community care is based on specific eligibility requirements, availability of VA care, and the needs and circumstances of individual veterans.
Your provider has entered your referral, now what?
The Office of Specialty Care will review your referral to determine if the service is available at the VA or should be deferred to the community.
What happens if my referral is stored in Virginia?
- If the VA offers the requested services, expect a call from a VA official within 3 business days.
- After an unsuccessful phone contact attempt, you will receive a letter in the mail to help you schedule an appointment.
- Your referral can be canceled after 14 days of unsuccessful contact.
- Please turn on your voicemail and do not block VA calls. Read the letters the VA sends you. If you have any questions, please call us at 307-778-7550, select option 6.
What if my referral goes to Community Care?
- Expect a call from the Community Care Service in 3 working days. If you do not receive a call, please contact the Community Care Office at 307-778-7550, select option 6 and follow the prompts.
- You can also contact the Community Care Service by sending a secure message to MyHealtheVet
The Community Care Service will:
- Help you choose the network’s preferred community provider.
- Submit your referral and medical documentation.
- Mail an appointment letter with instructions on how to schedule your appointment with the community provider.
You are responsible for:
- Schedule your appointment with the community provider.
- Notify the Community Care Office of the appointment by calling 307-778-7550, select option 6.
- I’m checking the mail for the power of attorney letter. This letter will contain the number of visits allowed, the services approved, the specialist’s contact information, and the approved time frame for treatment.
What do I do after I receive my power of attorney letter?
Keep this letter for your records and bring it to your first meeting. You are responsible for:
- Attending your appointments within your permission dates.
- Contacting your referral provider if additional services are required after the authorization expiration date.
How can my VA provider review my records in the community?
- Ask the community provider to fax the results of your visit to 307-778-7360 to be added to your electronic health record for your provider to review.
- You can get the community records and take them to the VA to be loaded into your medical record.
What is the fastest way to contact VA medical teams?
What should I do if I receive a bill for care that has been authorized?
- If you do not agree with your account balance, call the phone number listed on the account to ensure the community provider has a copy of your referral authorization and correct sponsor/guarantor information. If they have your referral permission correct but still can’t resolve the issue, call the Community Care Office for help.
Other important referral information
- Seeking care from a community provider without valid authorization can result in significant out-of-pocket costs. Please make sure you have the appropriate permission before seeking non-emergency help in the community.
- Understand that meeting types may vary. Many providers can conduct appointments by phone, telehealth (virtual), record reviews, or in person.
- If you are eligible for beneficiary travel, please contact the travel office for VA reimbursement requirements and community appointments by calling 307-778-7550 extension 7224.
How to prevent billing problems:
- Never go to a community provider without permission or go beyond the dates of your permission. If you need an authorization number or dates of service, consider calling 307-778-7550, select option 6.
- If you go to the Community Emergency Department, call 844-724-7842 within 72 hours.
What to do if you are contacted by a bill/payment provider
If you have a bill or questions about paying claims
Contact VA C4 (Community Care Contact Center) – Includes US Pacific Territories.
C4 Phone: 877-881-7618.
Opening hours: from 5:45 to 18:15
If you are contacted by a community provider about a bill or unpaid claim
Refer the community provider to the TriWest Call Center at 877-226-8749 (This phone line is for TriWest network providers only).
The TriWest Claims Call Center will assist providers with how to file claims, claim status updates and claim denials.
If you have adverse credit reports and debt collection problems as a result of using public care
Contact the VA Bad Credit Hotline at 877-881-7618.