The short answer
You contract and credential with the regional administrator: Optum for Regions 1 to 3 or TriWest for Regions 4 and 5. You also complete VA's required training. Joining doesn't bring referrals by itself; VA decides each one, and you work inside each Veteran's authorization.
How do you join the Community Care Network?
Through the company that runs the network in your region. VA's fact sheet on becoming a community provider says providers aren't enrolled automatically. You sign up with the regional third-party administrator:
| Regions | Administrator |
|---|---|
| 1, 2, 3 | Optum |
| 4, 5 | TriWest |
VA has begun replacing these contracts with next-generation contracts. The current regions stay in place until the transition. See CCN Regions, Optum, and TriWest.
What does joining involve?
Per VA's fact sheet:
- Contract with the administrator for your region.
- Get credentialed by that administrator.
- Complete required training through VHA TRAIN, such as VA's opioid safety course, and keep it current to keep getting referrals.
- Not be excluded from federal programs. VA checks the HHS OIG exclusion list and SAM.gov.
After that, you need access to VA's referral system, HealthShare Referral Manager (HSRM), to receive and manage referrals. See What Is HSRM?
How do referrals and claims work once you're in?
- VA decides each referral. The Veteran has to qualify for Community Care, and VA has to choose you.
- You work inside the authorization. It lists the approved services and dates. Anything more needs a Request for Service. See VA Community Care Authorizations for Therapists.
- Claims go to the administrator, and VA's fact sheet says claims must be filed within 180 days of the care.
- No balance billing. VA's payment is payment in full for authorized care. The network's provider manuals also bar charging Veterans for missed appointments.
Is it worth it for a solo practice?
It can be. Veterans need therapists, and VA's mental health access standards push many referrals into the community. But be realistic about the admin: contracting, credentialing, HSRM, authorizations, RFS paperwork, and claims with two layers (VA and the administrator). Some therapists join and get few referrals, because volume depends on local VA demand.
Ask your local VA Community Care office how much behavioral health demand they have before investing the time.
How ValorWell handles this
ValorWell takes on the VA Community Care side for its therapists: credentialing for its pathways, authorizations, HSRM, Requests for Service, claims, and denials. You see the Veteran and complete your notes.
You're paid weekly for sessions documented that pay period, and denials don't come out of your pay. You can keep your own CCN contract or private practice too; ValorWell is nonexclusive.
Important limits
- Referrals aren't guaranteed, whether you join directly or through a network.
- Contracts are changing. VA's next-generation CCN contracts may change regions, administrators, and processes.
- Rates are set by contract, generally no higher than Medicare rates except in specific situations under 38 CFR 17.4035.
- Optum and TriWest have their own provider manuals. Read yours; it controls the details.