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Get TriWest Healthcare Alliance PC3 - Initial Evaluation Report 2015-2024
The Tritest Healthcare Alliance Veterans Affairs (VA) PatientCentered Community Care (PC3) Program PC3 Initial Evaluation Report Veterans Name: DoD ID/Benefits # or Sponsor SSN: Evaluation Date: VA.
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Hospitalization FAQ
TriWest's system associates services with an approved referral/authorization number and allows claim payment. Veteran's VAMC approves care and delegates the appointment process to TriWest.
A valid ID card or CAC alone is not sufficient to prove eligibility; providers must verify eligibility online (log in to the Secure Portal) or through the automated self-service tools at 1-844-866-WEST (1-844-866-9378).
Page 4. Version 2. TriWest Healthcare Alliance. Veterans Affairs (VA) Patient-Centered Community Care (PC3) Program.
Specifically, for care with dates of service beginning Jan. 1, 2022, CMS no longer requires RAPs to be submitted with claims. Instead, a Notice of Admission (NOA) must be submitted with home health care claims.
All authorized claims must be filed within 180 days from the date the service was rendered. Claims that are submitted beyond the 180-day limit will be automatically denied for timely filing without additional review (See 38 U.S.C. §1703).
Claims with supporting documentation, such as an Explanation of Benefits (EOB) or Certificate of Medical Necessity (CMN), can be sent electronically (recommended) or via paper submission. To expedite claims processing, use the “Upload Documents" feature on our secure portal.
TriWest is VA's third party administrator for CCN Regions 4 and 5.
Under Claims & Payments, select the Claim Status option. If you have problems checking your claims status, visit Availity to use the secure "Chat with TriWest" feature, or call TriWest Claims Customer Service at 877-CCN-TRIW (877-226-8749) from 8 a.m. to 6 p.m. in your time zone.
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