There are several ways in which providers can be reimbursed for services provided to Veteran clients. Information about these are provided below.
Patient-Centered Community Care (PC3)
Patient-Centered Community Care (PC3) is a nationwide VA program to provide eligible Veterans access to some types of medical care when the local VA medical facility cannot readily provide the care. For example, this may be because there isn’t an appropriate specialist at the local VA medical Center or Clinic. Eligible Veterans can receive access to primary care, inpatient specialty care, outpatient specialty care, mental health care, limited emergency care, and limited new born care for enrolled female Veterans following the birth of a child.
1. An eligible Veteran visits their VA primary care provider and it is determined that he or she requires primary or specialty health care that is not readily available at the local VA Medical Center (VAMC).
2. The Non-VA Medical Care Office within the VA authorizes the Veteran for care through PC3 if care is not available through another VAMC, sharing agreement, Academic Affiliate or pilot.
3. The Veteran is contacted by a regional contractor within five days of authorization to set up an appointment. (The contractor should ensure that the Veteran’s commute is within the standard.) VA sends the medical information to the non-VA provider.
4. The Veteran sees the local PC3 provider within 30 days of appointment scheduling.
5. The Veteran’s records are returned to the VAMC within 14 days for an outpatient visit or within 30 days for an inpatient visit.
6. VA continues to provide and coordinate patient care. Veterans may be surveyed about their health care experience to give patient feedback which helps ensure PC3 meets Veterans’ needs.
Download the PC3 Contracts Fact Sheet
Information for Veterans
If you are a community provider interested in joining the networks approved for contracting with VA through PC3, Health Net or TriWest networks, please contact the networks directly for more information (see below). You can also email the program directly at PCCC.Info@va.gov.
To determine which of the two Third Party Administrators (TPA) you should contact (Health Net or TriWest) based on your geographic location click here.
Health Net Federal Services:
• PCCC Preferred Provider Network
TriWest Healthcare Alliance:
• Join Our Provider Network
The Veterans Choice Program
The Veteran Choice Program (VCP) is part of the Veterans Access, Choice, and Accountability Act of 2014 (VACAA). The VCP, which began in the winter of 2014, is a temporary program that supplements PC3 and allows coverage for more services and provides Veterans more flexibility in their choice to receive care in the community or through VA. For example, Veterans can receive care through the VCP if the VA cannot schedule an appointment within 30 days of the Veteran’s preferred date or if they have to travel over 40 miles to get to their closest VA or if it is too difficult to get to a VA (for example, if they have to travel by plane).
Health Centers or providers may participate in the VCP by either (1) joining Health Net or TriWest PC3 provider networks or (2) by signing a separate VCP provider agreement with Health Net or TriWest.
Download the fact sheet on how to become a Veteran Choice Act provider
FAQs about the Veterans Choice Act
Call the Choice Program Hotline to Get Started: 866-606-8198
TRICARE supports providers' work with Service Members and Veterans who are retired from the military through reimbursement for medical and behavioral health services outside of a military treatment facility. TRICARE is a part of the Military Health System, under the auspices of the Assistant Secretary of Defense for Health Affairs. It covers an ever growing 9.6 million beneficiaries, including active duty members and families of the Army, Navy, Marine Corps, Air Force, and Coast Guard, as well as retirees from each of the above services and their families. A critical adjunct to the active component are the National Guard and Reserve forces; these men and women have repeatedly left hearth and home for extended periods of intense combat, returning to their communities (and yours). As an authorized participating provider, you are agreeing to treat TRICARE beneficiaries for the reimbursement allowed by law.
Each TRICARE region has its’ own managed care support contractor (MCSC). If you’re already a TRICARE-authorized provider or if you want to become a TRICARE-authorized provider, call your regional MCSC. View contact information for your regional MCSC.
The Substance Abuse & Mental Health Services Administration (SAMHSA) provides a valuable roadmap for becoming a TRICARE authorized behavioral healthcare provider.
Mental Health Care Volunteer Opportunities at the VA
As a mental health professional, you have a new opportunity to volunteer your time and talents to help our Nation’s Veterans. You will expand your professional network while providing care for our nation's Veterans, a truly important and rewarding cause. You can even earn continuing education credits and maintain clinical hours for licensure. This applies to professionals who meet the existing VA qualification standard.