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General VA refers Veterans to community providers based on MISSION Act criteria, which are broader than PC3 criteria. TriWest is the primary customer service contact for Veterans. Customer Service VA is the primary customer service contact for Veterans.
TriWest Healthcare Alliance was founded in 1996 to provide active duty Service members, retirees, and their families access to quality health care under the Department of Defense TRICARE program.
TriWest has been serving eligible VA patients with care in the community since 2013.
With appointment confirmation, TriWest's systems generate an authorization letter with details on the approved episode of care. The authorization letter is mailed or faxed. For more information visit the TriWest Payer Space on Availity at www.availity.com.
TriWest Healthcare Alliance was founded in 1996 to provide active duty Service members, retirees, and their families access to quality health care under the Department of Defense TRICARE program.
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TriWest is the third-party adminstrator for the Department of Veterans Affairs (VA) Community Care programs. Veterans traditionally receive care through the VA's network of medical facilities.
TriWest cannot pay for out-of-network claims or for care that does not have an approved referral/prior authorization (except for urgent care and emergency care).
Providers must have an approved referral/authorization on file before rendering care, unless the Veteran needs urgent or emergent care. The approved referral/authorization is the community carestarting point.
TriWest is VA's third party administrator for CCN Regions 4 and 5. CCN covers all U.S. states and territories with an established set of regional boundaries aligned to state borders to provide local flexibility and increased access to care.
General VA refers Veterans to community providers based on MISSION Act criteria, which are broader than PC3 criteria. TriWest is the primary customer service contact for Veterans. Customer Service VA is the primary customer service contact for Veterans.

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