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HNFS to No Longer Accept Medical Documentation Beginning Jan. 1, 2019

Wednesday, December 12, 2018

In order to ensure coordination of care with its providers, the U.S. Department of Veterans Affairs (VA) requires non-VA providers who treat veterans under Patient-Centered Community Care (PCCC) and Veterans Choice Program (VCP) to return medical documentation in a timely manner. Health Net Federal Services, LLC’s (HNFS’) duties to manage care under PCCC and VCP were transitioned back to VA on Oct. 1, 2018. HNFS is accepting medical documentation for HNFS-authorized PCCC and VCP care through Dec. 31, 2018.  

Any medical documentation not yet submitted for HNFS-authorized PCCC and VCP care is now overdue per the terms of the provider agreement. You must fax all outstanding medical documentation by Dec. 31, 2018, to HNFS. Please visit our Medical Documentation page for submission instructions.  

After Dec. 31, 2018, HNFS will no longer accept medical documents and its medical documentation fax line will be deactivated. At that time, you must deliver medical documentation directly to the authorizing VA Medical Center (VAMC) specified in the authorization. 

Please inform staff of these important updates:

  • Medical documentation for HNFS-authorized services is now overdue and must be faxed to HNFS no later than Dec. 31, 2018.
  • HNFS cannot accept and process medical documentation delivered by U.S. mail.
Authorization Issued By Date of Service Medical Documentation
Submisison Date
Where to Submit
HNFS (on behalf of VA) Prior to Oct. 1, 2018 Prior to Jan. 1, 2019 HNFS via fax only
HNFS (on behalf of VA) Prior to Oct. 1, 2018 On or after Jan. 1, 2019 VAMC
VA Any Any Follow directions on VA authorization

Do not fax medical documentation to HNFS after Dec. 31, 2018, unless you are specifically requested to do so for claims reconsideration. HNFS will not be able to route medical documentation to the appropriate VAMC after Dec. 31, 2018.