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HNFS No Longer Accepting New Patient-Centered Community Care and Veterans Choice Program Claims

Thursday, January 2, 2020

The timely filing deadline for submitting new Patient-Centered Community Care (PCCC) and Veterans Choice Program (VCP) claims to Health Net Federal Services, LLC (HNFS) has passed. Providers were originally given until March 26, 2019, to submit claims to HNFS (for HNFS-authorized services). The U.S. Department of Veterans Affairs (VA) recently extended that deadline to Dec. 31, 2019. We will process through completion all new claims received by Dec. 31. Providers can continue to check claim status through www.availity.com

Claims reconsideration requests

To request reconsideration of a claim or an allowable charge review for HNFS-authorized services, contact HNFS’ Provider Services line at 1-844-728-1914 within 90 days from the remittance advice date. HNFS cannot consider requests received outside this 90-day window. Adjustment determinations are made on a claim-by-claim basis. Please allow 30–45 days for HNFS review. You will receive a new remit from HNFS with the determination. 

Billing veterans

In accordance with VA policy, providers are not to bill veterans or collect copayments for authorized VCP and PCCC services. Under PCCC, veterans do not have any out-of-pocket costs or copayments. Under VCP, the veteran may have a copayment, but he or she will be billed directly by VA, not by the provider or HNFS. If your effort to bill the veteran is related to claims payment, please contact HNFS to request a claim review.