There are several steps recommended that you take before requesting a doctor’s services through the Veterans Choice Program:
Check on the VA website: http://www.va.gov/opa/apps/locator/ for doctors in your area that provide the services you are looking for. If a doctor you are already seeing or want to see isn’t listed on the website, call that doctor’s office to see if he/she participates in the Choice Program or is a PC3 provider. If not, would he/she be willing to sign up and participate?
Once you have a doctor selected, call that doctor’s office and schedule an appointment to see the doctor (at least 2 to 3 weeks out). Let them know that a Choice representative will be calling them to set up an appointment and ask the doctor’s office to give the Choice representative the appointment time and date you have already scheduled.
Things you should do when you are requesting a doctor’s services through the Veterans Choice Program:When talking to the Choice representative, let them know you want to see a particular doctor and the date when you are available to see the doctor. Before you hang up, be sure to ask for the authorization number that is going to be assigned. Tell them that you know it is not yet authorized but that you want the number so that when you call back to check on the progress of getting the authorization completed, you have the authorization number and they can quickly find the file in the system.
Things you should do while waiting for authorization and the appointment to be made: Call Choice every couple of days to get a status report as to where it stands in getting authorization and the appointment scheduled. You may have to provide them with information several times to get it completed.
Things you should do once you have seen your doctor and additional services are needed:If your doctor has to refer you to another doctor or if you need services that cannot be completed in his/her office, your doctor will have to ask for these additional services to be approved through the Veterans Choice Program administrator, Tri-West. The required form for requesting the additional services may be found on Tri-West website. Your doctor will then fax his/her request to Tri-West. Ask your doctor or his/her staff when the fax will go out. Call your doctor’s office the day after you were told it would be faxed to see if it was. At that time, ask the person you are talking to for the fax number that was used to send the request. Then wait for 3 to 4 business days from the time it was sent to call Veterans Choice and ask if they have the request. If they can’t find the fax, provide them with the fax phone number that the request was sent from so they can trace that fax in their system. Once the representative finds the fax, ask for the fax identification number so that it may be located more easily at a later date. You may have to do this procedure one or more times, including asking the doctor’s office to send the fax again. Once Tri-West has the faxed request in hand, ask that it is processed right then to move forward for authorization. Again ask for the authorization number.
Things you can do to help your doctor in obtaining approval for additional services:
Call the person in your doctor’s office that handles the Veterans Choice Program and let them know the following:
Once your doctor’s office faxes the request for additional services to Tri-West, the doctor’s office representative, after 3 or 4 business days have elapsed, can call the Veterans Choice Program telephone number (866-606-8198) and ask if their fax was received and if so, has the authorization process begun. If the Veterans Choice representative says he/she can’t find the fax in the system, the doctor’s office staff member should provide the Choice representative with the fax number from which the fax was sent and ask the representative to trace the fax in their system.
Once it is located, the doctor’s office representative should ask the Choice representative to start the authorization process and if possible put it through the expedited process. Once the Choice representative has completed the initial processing, the doctor’s office representative should ask for the authorization number that the system generated so the doctor’s office can use it in any future communications that may be necessary with the Veterans Choice Program.
The main objective of the Veterans Service Office is to provide prevention, protection, advocacy and support services to veterans and their families so they can maximize their quality of life, well-being and potential. The La Plata County Veterans Service Office (CVSO) provides information and assistance to veterans and their families. There is a wide range of benefits available for our nation’s veterans. Every veteran is encouraged to contact the CVSO to find out more about their VA benefits. Your CVSO can assist you in any matter pertaining to the Department of Veterans Affairs.
These services are free of charge. Please visit the La Plata County web site at http://www.co.laplata.co.us/ for more information about what the La Plata County Veterans Service Office can do for you.
The La Plata County Veterans Service Office is co-located with the Durango VA Clinic at 1970 E. 3rd Avenue, Suite 102, Durango, CO. 81301. For clinic appointments, call 970-247-2214. The Veterans Service Office phone number is 970-759-0117. Office hours are 8 a.m. to 12 p.m. and 1 p.m. to 5 p.m., Monday – Friday, except holidays, and appointments are encouraged. Call (970) 382-6150 to schedule an appointment with the Veterans Service Office.