VA Community Care Network (CCN)


NARRATOR: The Department of
Veterans Affairs Community Care Network, or CCN, is VA’s
direct link with community providers to ensure
we provide Veterans with timely, high-quality
health care. CCN serves as a contract vehicle and
a network of high-performing, credentialed community providers
that VA partners with to provide health care to Veterans in their
local community. VA’s partnership with community
providers is critical for meeting the health care needs of
Veterans across the United States and its territories. For
community providers, joining CCN is the best way to serve and
care for our nation’s Veterans. CCN is VA’s preferred method of
purchasing community care through all VA medical
facilities. VA contracts with Third Party Administrators, or
TPAs, to perform certain functions. This includes
developing and administering the regional networks of community
providers that make up CCN, resulting in familiar business
practices for community providers. CCN is made up of six
regions aligned to state boundaries: Region 1 consists of
northeastern states; Region 2 includes midwestern states;
Region 3 covers southeastern states, Puerto Rico, and the
U.S. Virgin Islands; Region 4 includes most western states and
Hawaii; Region 5 covers Alaska; and Region 6 consists of
American Samoa, Guam, and the Northern Mariana Islands.
Services offered through CCN include the following: medical,
behavioral health, surgical, complementary and integrative
health services, durable medical equipment for an immediate need,
pharmacy for an immediate need, and dental. In addition, with
CCN, along with other improvements VA is making,
Veterans and community providers can expect expanded health care
services, improved provider customer service, improved
accountability, improved health information exchange, improved
referrals and scheduling, and improved payment timeliness to
community providers. To be part of CCN, community providers must
establish a contract with the TPA for your region of CCN; have
a National Provider Identifier (NPI) from the National Plan and
Provider Enumeration System, which is issued at no cost; use
the NPI and referral number to conduct all business activities
with VA, including medical, dental, and pharmacy
transactions; be credentialed in accordance with the requirements
for your region of CCN. Community providers work
directly with the TPA to complete the credentialing
processes. Under CCN, VA directly manages Veteran
customer service touch points, while TPAs respond to inquiries
from VA staff and community providers. When VA refers a
Veteran to a community provider who is part of CCN, the referral
goes directly to the community provider. Referrals are not sent
through a TPA, which allows the provider-to-provider
relationship and communication to remain intact. Community
providers must receive an approved referral from VA before
treating an eligible Veteran in most circumstances. Exceptions
include emergency and urgent care. With CCN, appointment
scheduling usually occurs directly through the Veteran’s
local VA medical facility or directly by the Veteran. VA
maintains a master directory of all community providers
authorized to care for Veterans. To support proper care
coordination, community providers who are part of CCN
must submit medical documentation directly to VA,
preferably by an accepted and secure method of electronic
transmission. Through CCN, the claim and payment process allows
for consistent and timely payments to community providers.
As part of this process, community providers must submit
claims to the appropriate TPA assigned to your CCN region,
with the referral number, and within the timeline required.
Once the claim is received, the TPA processes, adjudicates, and
pays the claim. Participation in CCN means community providers
are paid in a timely manner because TPAs have contractual
requirements for timeliness and accuracy of payments. Generally,
health care services provided by community providers are
reimbursed based on rates established by the Centers for
Medicare and Medicaid Services, or CMS. CCN is a key part of
making community care work better for Veterans, community
providers, and VA staff. For community providers, joining CCN
is a great way to honor and care for those who have served our
country. We hope you will consider joining the VA network.
To join CCN, community providers should contact the TPA assigned
to your region. To learn more, visit our website at this
address.

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