Trouble with Veterans Choice Program? Here’s Some Troubleshooting Advice

North Carolina Medical Society members have contacted us regarding issues they are having with the Veterans Choice program. If your practice is experiencing problems with prior authorizations or claims payment, we offer these recommendations directly from Nakai Stroman, the North Carolina contact for Health Net, which administers the Veterans Choice program for the VA.

Before you contact her, please be sure you have followed the proper process as outlined on the Health Net Federal Services website.

Authorization Issues

Please refer to this webpage to ensure the authorization process is being followed correctly:

If you have taken the correct steps and are not hearing anything back within a week please contact, Stroman via email at nakai.x.stroman@healthnet.com.

  • Please include your group’s name and reason for the email in the subject line.
  • In the body of the email include the specific information regarding the authorization request such as reason for the request, patient name, DOB, authorization request number and a valid fax number for your office.
  • Be sure to encrypt the email for HIPAA compliance.

Payment of Claims

Claims need to be submitted electronically or through snail mail to the claims address.

Medical documents, i.e. visit notes, labs, etc. need to be submitted separately and include the barcoded fax cover sheet included in the provider packet, which also can be downloaded from this website.

If you are following these steps and not receiving a denial, communication, or payment then please email Stroman directly at nakai.x.stroman@healthnet.com with the following information:

  • Email subject line: group name and the reason for email;
  • In the body of the email the TIN, NPI and pay to address;
  • Any claim submission reference numbers in the body of the email.

Stroman also provided a Provider Orientation presentation that may be useful to anyone involved with the Veterans Choice program.

If you continue to experience problems, contact the NCMS Solution Center or by calling 919-833-3836 x142.

 
 

Share this Post