The Veterans Choice Program (VCP) was created in 2015 in order to expand access to care in the community for veterans who have either: 1) been (or will be) waiting more than 30 days for Department of Veterans Affairs (VA) medical care; or 2) live more than 40 miles away from a VA medical care facility or face one of several excessive travel burdens.
How Can Osteopathic Physicians Provide Care in VCP?
DOs interested in participating directly in VCP must establish a contract with one of the contractors, Health Net Federal or TriWest Healthcare Alliance. DOs do not need to join PC3 to participate in the Choice Program.
To participate, DOs must:
Accept Medicare rates.
Meet all Medicare Conditions of Participation and Conditions for Coverage.
Be in compliance with all applicable federal and state regulatory requirements.
Have a full, current, and unrestricted license in the state where the service(s) are delivered.
Have the same or similar credentials as VA staff.
Submit a copy of the medical records to the contractor for medical care and services provided to veterans for inclusion in the VA electronic record
- Not be listed in the Centers for Medicare and Medicaid Services (CMS) exclusionary list
How to participate:
Determine which of the two contractors you should contact (Health Net or TriWest) based on your geographic location.
All Patient-Centered Community Care (PC3) providers are automatically eligible to participate in the Choice Program.
Contact the appropriate contractor using the information listed below.
Contact Information for Health Net:
Hours: 6 a.m. -7 p.m. EST Monday through Friday, excluding federal holidays
Provider Customer Service Phone Number: (866)-606-8198
Contact Information for TriWest:
Hours: 8 a.m. — 10 p.m. EST, Monday through Friday, excluding federal holidays
Provider Services Contracting: (866)-284-3743
Other Ways to Care for Veterans in the Community
The VA also has flexibility to establish partnership agreements with physicians outside of the Veterans Choice program to fill critical gaps in care. These agreements provide osteopathic physicians outside of the VA or the Choice Program with an opportunity to partner with the VA to care for veterans in their community. DOs who complete such an agreement can then be contacted to provide care when either of the following circumstances arise:
To deliver specific services when the VCP contractors in an area are unable to schedule an appointment within the contractually required timeframe; or
To deliver specific services that are not offered by the VCP contractors in an area.
Upon providing such services, physicians will be paid at Medicare rates or above by the VCP.
Learn more about this program or download a provider agreement.
What about Timeliness of Payments?
Earlier this year, the VA announced that it is speeding up payments to VA community providers operating in the Choice program in order to ease provider burdens and enhance veterans' access to care.
Previously, payments to Choice providers were not allowed until a copy of the veteran's medical record was submitted. Now, community providers under the Choice program will no longer be required to submit medical records prior to payment being made. To facilitate the change, VA has modified the Choice Program contract, making it easier for Health Net and TriWest to promptly pay providers. The VA continues to require pertinent medical information be returned to ensure continuity of care; however, it is no longer tied to payment.
The VA plans to work toward a single community care program that is easy to understand, simple to administer and meets the needs of veterans, community providers and VA staff. VA envisions a more automated claims system, where it is able to auto-adjudicate or process a high percentage of claims, enabling the Department to pay community providers promptly and correctly, while adopting a standardized regional fee schedule to promote consistency in payment.