TriWest Extends PC3 Referrals

TriWest is extending Patient-Centered Community Care referrals: Summary

TriWest is extending Patient-Centered Community Care (PC3) referrals previously set to expire March 1, 2020 – July 31, 2020, to a new expiration of September 30, 2020.

Based on new COVID-19 guidance from the Department of Veterans Affairs (VA), TriWest is extending Patient-Centered Community Care (PC3) referrals previously set to expire March 1, 2020 – July 31, 2020, to a new expiration of September 30, 2020. This means affected providers will NOT have to submit a Request for Services (RFS) to extend these authorizations for their Veteran patients if these extensions meet the Veteran’s needs without requiring more visits than authorized in the initial standardized episode of care (SEOC).

TriWest Update

The following TriWest guidelines apply:

  • Episodes of care cannot exceed 365 days in total with any extension
  • Inpatient, Emergent, Urgent, and Home Health referrals are excluded

TriWest will automatically update authorizations with the new end date of September 30, 2020. These extensions to authorizations will be completed over the coming month and will be viewable by logging onto the secure portal at triwest.com/provider.  There is no further action required by providers.

The VA originally planned a 60-day extension to authorization letters that ended between March 1, 2020, and July 31, 2020.  However, this update replaces the 60-day extension with a new end­ date of September 30, 2020.  Due to COVID-19, this extension will give community providers more time to offer needed services to Veteran patients.

More COVID-19 Information Available From TriWest

More information regarding TriWest’s general COVID-19 response can be found at triwest.com/covid-19-provider-resource.  Please visit TriWest.com regularly for updates.

More information about Primoris Credentialing Network

Primoris Credentialing Network is a NCQA Credentialing Accredited specializing in credentialing and provider enrollment with 54+ health plan and network provider enrollment options. Primoris is a family member of Fifth Avenue Healthcare Services. Sister companies include 5ACVO (credentialing and primary source verification specialists) and Fifth Avenue Agency (MPLI and medical malpractice specialists).

Primoris Credentialing Network originally published this article here. For more information on Primoris Credentialing Network, please visit PrimorisCredentialingNetwork.com or Contact Us.

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