When the time comes to refer your TRICARE patients to a specialist for care, one option is the Department of Veterans Affairs’ (VA) Veterans Health Administration (VHA).

With 154 medical centers, 875 ambulatory care and community-based outpatient clinics and 43 residential rehabilitation treatment programs the VA’s integrated health care system is one of the largest in the country. Through its many facilities, the VHA offers numerous treatment options for TRICARE beneficiaries.

Most of the VA facilities in the South Region are network providers with TRICARE. VA facilities in Alabama, Georgia and South Carolina have entered into negotiation with Humana Military with the expectation they will become TRICARE network providers by October 1, 2006.

VA facilities that are not in the network may not be authorized to pay for health care services received at their facilities. Therefore, when referring a TRICARE beneficiary to the VA for care, be sure the facility is an authorized TRICARE network provider.

While VHA’s primary mission is to provide the nation’s veterans with health care services, VHA also supports the Department of Defense during times of conflict.

In addition to offering TRICARE beneficiaries access to common medical and surgical services, VHA also plays a significant role in the treatment of spinal cord injuries (SCI), traumatic brain injuries (TBI) and blind rehabilitation (BR). In the South region, VHA has SCI centers in Augusta, Ga.; Dallas, Houston and San Antonio, Texas; Memphis, Tenn.; Miami and Tampa, Fla.; a TBI center in Tampa; and BR centers in Augusta, Ga.; Birmingham, Ala.; and Temple, Texas.

The Tampa VA Medical Center has also been designated as a “Polytrauma Rehabilitation Center,” designed to treat polytraumatic injuries and disability requiring specialized rehabilitation processes and coordination of care throughout the course of the patient’s recovery.

With all of the specialized services offered by various VA facilities, it’s important to remember the facility needs to be in the TRICARE network before you refer a TRICARE beneficiary for services.

  
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Consult reports are required to be returned to the primary care manager or initiating provider within 10 working days of the patient encounter. For routine specialty referrals for initial office visits, all outpatient services and inpatient services, you must provide complete and legible documentation for these reports to be accurate and useful.

Returning consult reports, operative reports and discharge summaries to the initiating provider is important for timely follow up and continuity of care. Please be responsive to the request when asked to return a consult report for TRICARE beneficiaries.

Providers who treat TRICARE beneficiaries coming from the local military treatment facility may receive a faxed reminder to return a consult report for a recent visit/service. Your office should return the consult report, operative report or discharge summary requested and use the designated fax reminder as the cover sheet. Please use the fax number listed in the upper right corner of the reminder page. This fax number is shown only on the reminder fax to providers for each beneficiary consult return request. This is to avoid having providers use the indicated fax number to send documentation on all other TRICARE beneficiaries.

  
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Created: March 8, 2007