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San Francisco VA Health Care System

 

All About Patient-Centered Community Care

The PC3 process

For enrolled Veterans, if needed health care is not readily available through VA, our Non-VA Medical Care Office provides authorization to receive non-VA care, coordinated through a PC-3 contractor (for our region, it's TriWest).

Friday, March 21, 2014

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Patient-Centered Community Care (PC3) is a nationwide VA program that offers health care contracts to provide eligible Veterans access to specialty care, mental health, limited emergency care, and limited newborn care when VA cannot readily provide the services.

This means the VA will schedule non-VA appointments for enrolled Veterans, through a contractor, to decrease wait and travel time and to get the specialty medical care our Veterans need and deserve.

In our region, that contractor is TriWest. A representative from TriWest will call the Veteran patient to schedule an appointment with a qualified in-network provider.

How does this benefit our Veterans?

• Appointments for enrolled Veterans are scheduled by TriWest within 5 days (and within 48 hours for urgent care) after authorization receipt.
• Appointment will be held within 30 days.
• Appointment commute time to a contracted appointment will be under 60 minutes for Veterans living in urban areas; under 120 minutes for rural areas; and under 240 minutes for highly rural areas.
• Patients may request that their appointment be made with a particular non-VA provider that they are currently seeing (even outside the TriWest network). TriWest will do their best to accommodate the request.
• Veteran receives personal contact confirming appointment and reminding of appointment.
• Patient may specify a preference to a provider gender, if needed.

Additionally, contracted clinics and providers’ performance are strictly monitored, ensuring the highest standards of quality. Contracted care providers must comply with federal and state regulations and meet or exceed Medicare conditions of participation and conditions for coverage.

The Veteran’s medical records are returned to their VA Medical Center or VA Community Clinic within 14 days as an outpatient; 30 days as an inpatient; and all critical findings are reported within 24 hours.

Prescribed medications will continue to be issued through VA, although in an emergency situation when it is not possible to obtain medication through a VA pharmacy, PC3 providers may write a prescription for up to a 10-day supply.

PC3 services may include: inpatient specialty care; outpatient specialty care (including skilled home health and home infusion therapy); mental health care; limited emergency care; and limited newborn care for enrolled female Veterans after delivery.

PC3 services do NOT include: primary care; dental; nursing home; long term acute care hospitals; homemaker and home health aide services; chronic dialysis treatments; and compensation and pension examinations.

For any questions about PC3 or TriWest contracted care, please speak with your VA primary care provider for additional information or a referral.

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