01
What it covers
The program follows a patient through your practice. Intake: which program pays, what the referral is, why the authorization number has to be on the file before the visit. Eligibility and the authorization window. What a precertification ID is and what happens on the date it is missing. What to say when a veteran asks about a bill — and why the answer is never a bill.
- VA community care: the referral is the authorization; Optum Serve and TriWest by region; VA direct for agreements and emergency care.
- TRICARE East and West, CHAMPVA, and how each differs from VA community care.
- Intake that sets the processor once, correctly.
- Timely filing, reconsideration and corrected-claim clocks — who watches them and where.
- The statement and collections sequence the practice has agreed to, so every desk says the same thing.