Understanding the Relationships: TRICARE, the VA and CHAMPVA


Department of Veterans Affairs Health Care Facilities Partner with TRICARE

All Department of Veterans Affairs (VA) health care facilities in the North region participate as TRICARE network providers. They can provide primary care, but more often they are used for specialty care. Beneficiaries should always check with the specific VA facility to confirm the availability of specific services.

VA Patients and TRICARE

VA patients are Veterans with service-connected disabilities. Health Net Federal Services, LLC (Health Net) reports network providers to the VA as TRICARE network providers. Network providers are asked to accept requests from the VA to provide care to Veterans. The VA has the right to directly contact providers and request they provide care to VA patients on a case-by-case basis. If you agree to see a VA patient, the referral and instructions for seeking reimbursement from the Veterans Affairs Medical Center (VAMC) will be provided by the patient at the time of the appointment.

Health Net requires network providers (individual, home health care, free-standing laboratories and freestanding radiology only) who accept VA patients, to serve as participating providers and accept assignment with the VA. If seen by a TRICARE network provider, any documentation of and reimbursement for the care provided to the VA patient is a matter between the referring VAMC and the provider.

All TRICARE network providers are listed in the Network Provider Directory as willing to receive VA queries on availability. If you choose not to accept VA inquiries please contact Health Net at 1-877-TRICARE (1-877-874-2273) to update your status.

CHAMPVA and TRICARE

CHAMPVA is a health care benefit that provides coverage to the spouse or widow(er) and children of eligible Veterans.

Health Net reports network providers to CHAMPVA as TRICARE network providers. Health Net requires network providers (individual, home health care, freestanding laboratories, and free-standing radiology only) who accept CHAMPVA patients to serve as a participating provider and accept assignment with the VA.

All TRICARE network providers are listed in the Network Provider Directory as accepting CHAMPVA patients and accepting assignments on claims. If you choose not to accept CHAMPVA patients, please contact Health Net at 1-877-TRICARE (1-877-874-2273) to update your status.

View the CHAMPVA Fact Sheet for more information regarding CHAMPVA claims. You also can view the Claims Processing and Billing Information section of the TRICARE North Region Provider Handbook for more information.