Strong care coordination between VA and community providers ensures Veterans receive timely and high-quality care. VA’s care coordination model is a Veteran-centered, team-based approach involving five steps:
It is the responsibility of the VA facility community care team to receive these requests, assign staff to manage them, and to confirm eligibility and authorize services indicated in the consult. Referrals and authorizations for community care are managed through the HealthShare Referral Manager (HSRM) system. See below for more information.
Facility Contact Numbers for Care Coordination
Use this list of VA medical facility contacts to locate and contact the nearest VA medical facility community care office in order to coordinate care for a Veteran.
VA has several tools available for community providers that help support the continuity of care Veterans receive, including HealthShare Referral Manager and Azure RMS.
Community Care Provider-Request for Service (RFS), VA Form 10-10172, is used to request additional services or continued care from VA. The requested care may be performed within VA or in the community based on a Veterans eligibility.
The signed RFS is required to facilitate care review and authorization. All supporting medical documentation, such as provider progress notes and procedures, laboratory and radiology reports must accompany the completed form. If more supporting medical documentation is needed, the community provider has three business days to provide the necessary documentation, or the request will be denied.
A blank RFS Form will be sent with all referral packets and is also available online. To complete VA Form 10-10172, fill-out the required fields and indicate the type of service being requested.
Please note: A separate form is required for each service requested.
VA processes requests for care within three business days. The community provider will be notified of the outcome via their preferred communication method. The notification will show if the care is to be provided within VA or in the community. If the care is denied, community providers must contact the Veteran to discuss alternative treatment plans.
A recorded training session on the RFS form, Community Care Referrals (Enduring), is available on VHA Training Finder Real-time Affiliate Integrated Network (TRAIN).
HealthShare Referral Manager (HSRM) is a secure, web-based system VA uses to generate and submit referrals and authorizations to community providers. HSRM allows community providers and VA to better manage community care for Veterans. The system’s robust functionality facilitates reduced turnaround time for processing referrals, providing care, submitting claims, and receiving payment. Registration, training, and technical support for HSRM are available to community providers at no cost!
To receive HSRM updates, please sign up for VHA Office of Integrated Veteran Care (VHA IVC) Provider Advisor newsletter.
If you are interested in using HSRM, first confirm your facility has an active Community Care Network (CCN) agreement with TriWest or Optum, or a Veterans Care Agreement (VCA) with VA. Next, follow the steps below to obtain access to HSRM. Resources mentioned in the following steps are available in the HSRM Training and HSRM Resources sections below.
Figure 1: HSRM Registration Steps for Community Providers
NOTE: The Community Care Referral & Authorization (CCRA) Team strongly encourages community providers to attend the live training webinar hosted on VHA TRAIN prior to obtaining access to HSRM. The training webinars include an overview of HSRM, an in-depth walkthrough of the system, registration guidance and additional time for questions.
NOTE: Please ensure the email addresses entered in the EUT match those used for each respective user’s ID.me account.
NOTE: If your HSRM account becomes deactivated, email hsrmsupport@va.gov, requesting reactivation.
Once these steps are complete, contact the VA medical centers you partner with to let them know you have access to HSRM and to discuss your transition to using HSRM.
For interested community providers, HSRM trainings are offered multiple times each week through the VHA TRAIN website. The HSRM trainings provide an in-depth walkthrough of the system's functionality. Please check VHA TRAIN for available dates and to register in advance. A free account in VHA TRAIN is required to register for the webinar.
A two-part extended HSRM training event is also being offered weekly for community providers. This event will be slower paced, have more time for system demonstrations, and allow participants to speak directly with the trainers. Please check VHA TRAIN for available dates and to register in advance. A free account in VHA TRAIN is required to register for the webinar.
For interested community providers, HSRM registration information sessions are offered weekly through the VHA TRAIN website. The HSRM registration information sessions walk community providers through the process of obtaining access to HSRM (i.e. creating an ID.me account and completing the End User Tracker). Please check VHA TRAIN for available dates and to register in advance. A free account in VHA TRAIN to register for the webinar.
Community providers can also learn about HSRM system functionality through self-paced eLearning, available 24/7 through VHA TRAIN. A free account in VHA TRAIN is required to access the eLearning.
To receive HSRM updates, please sign up for VHA IVC Provider Advisor newsletter.
Do community providers have to pay to use HSRM?No, there is no cost to community providers to use HSRM. It is a web-based application that simply requires internet access.
Do community providers need to be part of the Community Care Network to use HSRM?No, community providers do not need to be part of the Community Care Network (CCN) to use HSRM. Non-CCN community providers may instead have a Veterans Care Agreement (VCA). VA encourages all community providers who receive referrals for Veteran care from VA medical centers to use HSRM for all episodes of care.
Can a VA medical center refer a Veteran to a community provider who is not using HSRM?Yes, VA can refer a Veteran to a community provider who is not using HSRM, as long as the community provider has a record in the VA Provider Profile Management System (PPMS). In that scenario, VA would create the referral in HSRM, generate the "Offline Referral Form," and send it along with other relevant medical documents to the community provider via traditional referral processing methods (e.g., fax, email).
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