Yep, exactly.  UHC/OPTUM will be taking over the network starting in February I believe, so there will be a transition time that we will essentially have 3 different networks, so it’ll be very important to reference the Affiliation/Network/Billing attached to each referral.  Triwest will transition out by June of 2020 or whenever the most current auths expire.  There will also still be the VCP (Veterans Choice) network in which we currently bill for anything not going to Triwest, then we will have the new CCN network (Through UHC/OPTUM) starting I believe in February.

 

This was the take away I got from the conference, so I hope this helps!

 

Lots of changes!

 

 

We have one patient from the Fargo VA, the auth number begins with VA000…  The Affiliation is Veterans Care Agreement, Network is Veterans Affairs Payment.  We are billing the Fargo VA.   It will be a good habit to always look for that Affiliation and Network.   Thank you for that print screen.

 

 

 

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I should have added this little snip because this is confusing as well.  It lists Triwest as the Affiliation, and as the network, but then for payer status states VA is the primary payer.  That is what really confused me, so when I called my contact, that’s when she assured me it’s billed to Triwest.  See below. 

 

 

 

All the new referrals/auths will come with that new referral/auth number starting with VA0000…., but yes, you will still be billing Triwest.

 

I was quite confused about this myself, then called my VA contact and she assured me the billing goes to Triwest as long as that’s what it states on the new referral.  After I received the initial response with that referral/auth number, the hard copy from Triwest came about 2 days later.

 

I hope this helps!

 

 

Good afternoon,

We have recently received new authorizations from Triwest that have an authorization number beginning in VA000… This is different than the authorizations we were previously getting beginning with 437-PC… It says primary payer Triwest but the new authorization number looks like a VA auth number. Our authorization specialist called Triwest and was told we need to be billing VA and follow up with traditional VA for any further concerns regarding the new authorization. She then called VA and the representative told her that she was unaware that the authorization numbers changed and we should be billing Triwest. Has anyone been experiencing the same issue? We are not sure who we should be billing. This is for skilled services. Thank you!

 

April Hanson

Patient Accounts

Perham Living

Ph: 218.347.1894

F: 218.347.1885

April.Hanson@perhamhealth.org

Dedicated to health and wellness throughout life.

 

 

 

 

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