Get the care you earned without the bills you didn’t. At Veterans Desk, Inc., we’re here to make VA Community Care work for you. As a nonprofit help desk, our mission is simple: help Veterans get timely, stress-free medical appointments and keep unnecessary medical debt out of their lives. Whether you need a quick checklist or live help, we’ve got you covered.
Why This Guide Matters in 2025
For years, VA Community Care was frustrating slow approvals, confusing steps, and surprise bills that no Veteran should face.
That changed in May 2025, when the VA launched a streamlined one-click referral system through the HealthShare Referral Manager (HSRM). With a single clinician sign-off, referrals can now be authorized in seconds, with no second approvals and far fewer delays.
This guide helps you and anyone supporting you use the system correctly, avoid billing mistakes, protect your credit, and get care without stress.
The New Referral Process Explained
Seven Simple Steps to a Bill-Free Appointment
Share these steps with caregivers or case managers.
- Clinical Decision
Your VA clinician documents the medical need and confirms eligibility (distance, wait time, or unavailable service). - Same-Day Authorization
HSRM issues a 10-digit authorization number immediately, visible in the VA Health & Benefits app. - Notification Packet
You receive a PDF (and often a mailed letter) listing covered services, CPT codes, provider details, and billing instructions. - Scheduling
You or the TPA (TriWest or Optum) schedules the visit. Confirm your address with both the scheduler and clinic. - Day of Appointment
Show your authorization. Write “Bill VA CCN” on intake forms. - Provider Documentation
The clinic uploads visit notes and Form 10-10172 (or equivalent) within 7 days. - Payment & Close-Out
VA pays the claim. Your EOB should show a $0 balance.
Important: Added services (extra PT visits, imaging) often require additional authorization. Always confirm before leaving.
Three Common Billing Mistakes—and How to Prevent Them
1. Outdated Address
Bills may go to the wrong place and reach collections.
Fix: Update your address at VA.gov, DEERS (if applicable), and the clinic.
2. Wrong Payer Selected
You may be marked as self-pay or billed private insurance.
Fix: Present your authorization at check-in and email it to billing before leaving.
3. Missing Documentation
If notes aren’t uploaded, the claim can stall.
Fix: Ask for confirmation that records were uploaded, including date/time.
Why it matters: While some VA protections exist, private collectors aren’t bound by them. Early fixes protect your credit.
Five Smart Ways to Stay Ahead
- Keep your address updated with all systems: VA.gov, DEERS, and your clinic.
- Bring both a printed and digital copy of your authorization to each appointment.
- Turn on alerts in the VA Health & Benefits app to track your claims.
- Always get upload confirmation before leaving the clinic.
- If you receive a bill, call 877-881-7618 immediately to request a “debt hold” while it’s sorted.
What’s Changed in 2025—and What Hasn’t
What’s New:
- One-click referrals via HSRM
- Faster authorizations
What Stays the Same:
- Authorizations still have limits, CPT codes, and expiration dates
- Care outside the scope may be denied
Always verify coverage before services are provided.
Special Cases That Can Cause Confusion
- Separate Bills:
Hospitals may bill radiology or anesthesia separately.
Fix: Confirm all services are listed. - Labs & Imaging:
Often separate providers.
Fix: Ensure they’re included—or request updates first. - Telehealth or Out-of-State Care:
Providers must be licensed and CCN-approved.
Fix: Confirm authorization includes telehealth. - Emergency vs. Urgent Care:
Go to the nearest ER in emergencies; notify VA ASAP. For urgent care, call first. - Follow-Ups:
Authorizations expire.
Fix: Ask how many visits remain at each appointment.
What To Do if a Bill or Collection Notice Arrives
- Pause—don’t pay immediately.
- Call the clinic’s billing office and explain: “This was an authorized VA Community Care visit. Please rebill VA under authorization number [your number] and remove me as the responsible party.”
- Send your authorization letter and a screenshot from the VA app to the clinic’s billing department.
- Call 877-881-7618 to request a debt hold.
- Document every step—record dates, names, call summaries, and keep copies of all emails or letters.
If a collection agency contacts you:
Send them a letter with the date of service, the authorization number, and a request to remove the account from collections and bill the VA instead.
Sample Phrases You Can Use
At Check-In:
- “I’m using VA Community Care. This is my authorization. Please bill the VA using the payer ID listed.”
If They Ask for a Copay:
- “VA authorizations mean the VA is responsible for payment, not me. Please call the number on the authorization while I’m here if needed.”
Email Subject to Billing:
- “VA Community Care Rebilling Request – Authorization #[Your Number] – Veteran: [Your Name]”
Understanding Travel, Lodging, and Hidden Costs
- Travel Pay:
If eligible, file your mileage or transportation claim promptly using the Beneficiary Travel Self-Service System (BTSSS). - Lodging:
Ask your VA Social Worker about nearby Fisher House locations or hotel vouchers if you need to travel for specialty care. - Lost Wages or Childcare:
These are not covered by the VA, but Veterans Service Organizations (VSOs) may offer support. Be honest with your VSO if financial obstacles are keeping you from care.
For Clinics and Providers: Protecting Veterans and Getting Paid
If you’re a CCN-contracted clinic, remember your responsibility includes protecting Veterans from billing errors:
- Always use the correct payer ID and CPT codes.
- Upload notes and forms promptly after the visit.
- Train your front desk staff not to treat CCN patients as self-pay.
- Before scheduling follow-ups, verify units and authorization dates.
- For a separate facility and professional billing, ensure both claims include the authorization number.
When you do it right, Veterans avoid financial harm, and your clinic receives payment without delays.
How Veterans Desk, Inc. Supports You
- Plain-English Tools: Checklists, template letters, and front-desk explainers.
- Verified Provider Directory: Find real, contracted CCN clinics only—no gimmicks.
- Live Support Calls: Quick help with referrals, billing issues, or collections.
- Policy Alerts: Timely updates on debt rules, claim deadlines, and VA changes.
- No Data Selling. Ever: We’re funded by providers and donors—not by collecting or selling your personal information.
Quick FAQs
- Can I change providers?
Yes, but you’ll need a new authorization or a transfer. Always confirm before switching. - What if my imaging gets denied after the scan?
Ask the clinic to submit a correction or retro-authorization, and request a billing hold from Community Care. - Why does the clinic want my private insurance?
For Community Care, the VA is the payer. Politely decline and present your authorization again. Speak to the billing manager if needed. - How do I confirm my claim was paid?
Check the VA Health & Benefits app. Look for a $0 balance EOB. If something seems wrong, call 877-881-7618.
Take These Actions Today
- Download our Pre-Visit Checklist—keep a copy in your bag or car.
- Schedule a Free Navigator Call—get quick help with billing or authorizations.
- Share This Guide—you might just save someone else from medical debt.
Veterans Desk, Inc.
Plain language. Real help. No surprise bills.
IMPORTANT NOTICE
Educational use only. No medical or legal advice.
Veterans Desk is a 501(c)(3) nonprofit, not a government agency, and not affiliated with the U.S. Department of Veterans Affairs or any federal or state agency.
Veterans Desk does not provide medical treatment, prescribe medications or collect or store protected health information (PHI).
Veterans Desk provides only education and navigation support.
All healthcare decisions belong to you and your licensed clinicians.
Emergency: 911 | Veterans Crisis Line: 988 (Press 1)