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Author: UCA Admin/Tuesday, July 02, 2019/Categories: Industry News
[Content provided by TriWest Healthcare Alliance Provider Education]
From sudden flu symptoms to minor skin infections, many providers have wondered what exactly the new urgent care benefit* under the Department of Veterans Affairs (VA) covers.
In short, the benefit defines coverage based on exclusions, more so than inclusions.
The Basics of Covered Services
VA’s new urgent care/retail walk-in benefit is designed to treat non-emergent medical issues that can escalate to an emergency if not addressed immediately. In fact, VA defines urgent care as the treatment of non-emergent symptoms needing immediate attention.
Examples of these types of medical issues include flu symptoms, ear infections, strep throat, minor burns, and pink eye. However, this list is not all-inclusive and may vary depending on the situation. Therefore, TriWest Healthcare Alliance recommends providers look to exclusions to better understand what VA covers.
As a general rule of thumb, the urgent care benefit does not cover routine primary care or preventive screenings. VA’s full list of excluded codes for the urgent care benefit is available at: www.triwest.com/UC-excluded-codes.
Remember! Take the Training to Learn More
Because the urgent care benefit is still very new and evolving, TriWest Healthcare Alliance has developed a free, live webinar to help explain it in greater detail. The webinar offers urgent care providers a better understanding of the program’s processes and procedures.
Follow these steps to register for the webinar:
UCA members can also access a free pre-recorded webinar regarding enrollment, reimbursement, and other issues here.
*VA’s new urgent care/retail walk-in benefit is available to eligible Veterans, for a specific and limited scope of urgent care.
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