TriWest Healthcare Alliance® and WPS Military and Veterans Health have partnered to provide the Veterans Affairs (VA) Community Care Network (CCN) for Region 4 (Ariz., Calif., Colo., Hawaii, Idaho, Mont., N.M., Nev., Ore., Texas, Utah, Wash., and Wyo.) and Patient-Centered Community Care (PC3) coverage for Alaska and Pacific Islands.
If you have questions regarding EDI enrollment, please call 800-782-2680 option 1.
Providers can also access the Department of Veterans Affairs (VA) community care programs’ Provider Handbooks and Quick Reference Guides through the TriWest Payer Space on Availity. After you log-in with a secure password, navigate to the TriWest Payer Space and access materials under the “Resources” tab.
The electronic payer ID is: VAPCCC3
For detailed reimbursement or claims questions, please call 855-PCCCVET (855-722-2838). Choose option 3 as a provider and then option 3 to speak to a claim representative.
If your office submits EDI claims through a clearinghouse, it may already be an approved clearinghouse with WPS. Visit our VA EDI Connection listing to see if your clearinghouse is approved.
Use the below link to complete your EDI enrollment to submit electronic claims using an approved clearinghouse.
If you do not already have an approved clearinghouse, TriWest has partnered with Availity® to provide an easy, cost-free option to submit your claims electronically. With Availity’s Basic Clearinghouse offering, you can submit claims electronically without any cost to your practice.
To submit your Veterans Affairs (VA) Community Care Network (CCN) claims using the Availity Provider Portal, complete the actions outlined below.
Complete your EDI enrollment.
As you complete your EDI enrollment, be sure to use this Trading Partner ID and Clearinghouse information:
Electronic Payer ID: VAPCCC3-VA PATIENT-CENTERED COMMUNITY CARE PROGRAM
For questions regarding the completion of your EDI enrollment, please call the EDI Marketing Team at 800-782-2680, option 2.
For additional options, please visit TriWest Healthcare Alliance.
Electronic Funds Transfer (EFT) is available for VA providers. EFT replaces the paper checks you currently receive for claim payments. This process allows your payment to be deposited directly into your checking or savings account, and eliminates the delay or inconsistencies you may encounter with mail procedures.
EFT payments are typically deposited into your specified bank account two business days following the budget approval. Electronic Funds Transfer payments have a different number sequence than your current paper checks.
The number of EFT transactions initiated by WPS is dependent on the number of bank accounts to which your office requires EFT payments to be posted. If you currently use more than one legacy provider number or NPI there will be more than one EFT transaction per day.
Your Electronic Remittance Advice will be your office's notification of the payment that is posted to your accounts. Notification of your payment into your accounts will come from your bank. Contact your bank for their notification procedures. To enroll for EFT, go to our Enrollments page.
The easiest way to receive your Provider Remittance Advice (PRA) is through ERA, which is an electronic version of a payment explanation. ERA is more convenient for you. When you sign up for EFT and ERA, you will find out about your payment via ERA about two days prior to the funds transfer. You can also request to suppress your paper PRAs for even further paper savings.
When you choose to receive Electronic Remittance Advice or ERA directly, your files will be sent to you in the X12 835 format, version 5010A1, and can be downloaded from our secured internet site WPS Gateway Express.
For enrollment to receive and download ERA (835) directly from WPS, you will need to go to our Enrollments page.
To receive Electronic Remittance Advice (ERA) through a clearinghouse, go to our Enrollments page.