Community care | veterans affairs

YOUR PROVIDER HAS ENTERED YOUR REFERRAL, NOW WHAT? The specialty care service will review your referral to determine if the service is available in the VA or if it needs to be deferred to

the community. ------------------------- STEP 1 WHAT HAPPENS IF MY REFERRAL IS KEPT IN VA?  If the VA offers the requested services, expect a call from a VA staff member within 3 business

days. After one unsuccessful telephone contact attempt, you will receive a letter in the mail to help you schedule your appointment. Your referral may be canceled after 14 days of

unsuccessful contact. Please have your voicemail turned on and do not block calls from the VA. Read the letters the VA sends to you. If you have questions, please call us at select option 2.

WHAT IF MY REFERRAL GOES TO COMMUNITY CARE? Contact Community Care to see if your referral is approved and opt in. Contact the Community Care Office at select option 6, then option 5 and

follow the prompts. You can also contact the Community Care Office by using secure messaging in myhealth.va.gov.  COMMUNITY CARE OFFICE WILL: * Assist you in choosing a network preferred

community provider. * Send your referral and medical documentation. * Send you a scheduling letter in the mail with instructions on how to schedule your appointment with the community

provider. OR * Schedule your appointment for you. ------------------------- STEP 2 YOU ARE RESPONSIBLE TO: * Watch the mail for the authorization letter. This letter will contain important

information about your approved authorization. * Schedule your appointment with the community provider if you choose to self-schedule. * Notify the Community Care Office of the appointment

by calling select option 6, then option 3 or use My HealtheVet. WHAT DO I DO ONCE I OBTAIN MY AUTHORIZATION LETTER? KEEP THE LETTER FOR YOUR RECORDS AND TAKE IT TO YOUR FIRST APPOINTMENT. 

YOU ARE RESPONSIBLE FOR: * Attending your appointments within the dates of authorization. * Ensuring your community provider submits a Request For Services (RFS) form to VA if additional

services are needed 60 days before the authorization expiration date. HOW CAN MY VA PROVIDER REVIEW MY COMMUNITY RECORDS? Ask the community provider to fax the results of your visit to to be

added to your electronic health record for your provider to review. You can obtain the community records and bring them to the VA to be loaded into your medical chart.

------------------------- STEP 3 WHAT IS THE FASTEST WAY TO CONTACT THE VA MEDICAL TEAMS? Create an account online at www.myhealth.va.gov.  Or you can call the My HealtheVet help desk at .

WHAT SHOULD I DO IF I RECEIVE A BILL FOR CARE THAT HAS BEEN AUTHORIZED? If you disagree with the balance on your bill, call the phone number listed on the bill to ensure the community

provider has a copy of your referral authorization and correct sponsor/ guarantor information. If they have your referral authorization correct, but are still unable to resolve the issue,

call the Community Care Office for assistance. ------------------------- STEP 4 OTHER IMPORTANT REFERRAL INFORMATION * Seeking care from a community provider without a valid authorization

can result in significant out of pocket costs to you. Please make sure you have the proper authorization before seeking community non-emergent care. * Understand appointment types may vary.

Many providers may conduct appointments by telephone, telehealth (virtual), record reviews, or in-person. * If you are eligible for beneficiary travel, please contact the travel office for

the requirements of reimbursement for VA and community appointments by calling ension 17224.