Timeline for Reporting Critical Findings

Under Patient-Centered Community Care (PCCC) and Veterans Choice Program (VCP), the U.S. Department of Veterans Affairs (VA) defines critical findings as a test result value or interpretation that, if left untreated, could be life threatening or place the Veteran at serious health risk. Critical values/results are those results from laboratory, cardiology, radiology departments, and other diagnostic areas that, upon analysis, are determined to be critical, regardless of the ordering priority.

Please refer to the chart below for critical findings reporting deadlines. The authorization that accompanies your provider notification packet will have the contact information for reporting findings to VA.

All findings must be followed up by submission of complete medical documentation to Health Net Federal Services, LLC within the time frame indicated in each individual provider packet.

Critical Finding Return Date

Veteran requires one of the following: 

  • urgent follow-up care after completion of the authorized episode of care
  • urgent additional care during the authorized episode of care
  • urgent specialty care beyond the expertise of the community provider, when a separate authorization is required
  • urgent treatment from the referring VA provider
24 hours
Critical findings on outpatient imaging or laboratory testing, or during evaluation and treatment

24 hours by phone, upon completion of the test, evaluation or treatment

Newly-identified suicide risk in a Veteran not referred for inpatient mental health treatment
A new diagnosis of cancer, any clinical suspicion of possible new malignant finding or progression of previously diagnosed cancer.
48 hours of diagnosis

Note: Contact with VA (for example, name of person contacted, date and time of contact) shall be documented in the impression section of the diagnostic imaging report, or elsewhere in the medical documentation for non-imaging-related critical findings.

Veterans Crisis Support

Support for your patients who are U.S. Veterans:

  • 1-800-273-8255 Press 1
  • Confidential chat at VeteransCrisisLine.net or text to 838255

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