VA Community Care billing and enrollment
Billing for care provided to veterans through the VA Community Care Network.
Working with VA Community Care
Veterans can receive care from community providers when the VA authorizes it. The Community Care Network (CCN) is administered by third-party administrators by region: Optum and TriWest Healthcare Alliance.
Credentialing and enrollment
Providers join CCN by contracting with the administrator for their region. Care must match an approved VA referral, including the services and dates authorized.
Prepare
Licenses, NPI, CAQH and group details checked and updated.
Apply
Application submitted for each provider and location.
Follow up
Status checked every 1 to 2 weeks until approval.
Confirm
Effective date and participation confirmed before billing.
Claims, eligibility and portals
Claims go to the regional administrator, not to the VA directly, and must include the referral information. Services outside the referral are not paid.
Denials we prevent with VA Community Care
- Care provided without an approved referral
- Services or dates outside the referral
- Claim sent to the wrong administrator
- Missing referral number on the claim
- Provider not in the CCN network
Questions about VA Community Care
Do we need a referral for every veteran visit?
For community care, yes. The VA must approve the care first, and services must stay within the referral.
Other payers and related services
Trademarks belong to their owners. MedAi Billing Solutions is an independent billing company, not affiliated with any payer or government agency.
Get help with VA Community Care claims
Send a few details and we will set up a short call to review your claims, denials and A/R. No cost and no commitment.
We sign a Business Associate Agreement before we handle any patient data.