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Provider FAQs
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What is Humana Veterans Healthcare Services (HVHS)?
HVHS, established in 2007, is a wholly owned subsidiary of Humana Military Healthcare Services, Inc. (HMHS). HVHS was established to focus on administering healthcare benefits to veterans of the uniformed services.
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What is Project HERO?
Project HERO is a demonstration proposal offered by the Department of Veterans Affairs (DVA) HERO stands for (Health Effectiveness through Resource Optimization). The intent of the demonstration project/ proposal is to develop
a network of health care providers in order to direct eligible veteransto quality care when they can not receive it through the VA.
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When will this program start?
As a partner of the Department of Veteran Affairs, HVHS will begin work on January 2, 2008.
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What is referral management and why is the process so important?
Referral management is the process by which the primary care provider refers the veteran for specialty and inpatient care. HVHS will ensure that timely appointments are made and referral information is communicated to providers, veterans and the claims processing system. An efficient timely referral management system will ensure high-quality specialty care and accurate, efficient payment to providers.
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How will the appointment scheduling process work?
At HVHS, our goal is to ensure continuity of care between the Veteran Administration and the specialty network providers.
An HVHS associate will contact the veteran within 3 to 4 business days following the receipt of an approved referral from the VA. The HVHS associate will facilitate a three way phone call between the veteran, the specialty provider and HVHS to schedule an appointment at a time that is convenient for the veteran.HVHS also has the ability to schedule an appointment on behalf of the veteran, regardless of whether or not the veteran is on the telephone.
HVHS will also send the veteran a letter, confirming the appointment date and time. If for any reason the veteran needs to cancel or change this appointment, he/she may contact an HVHS associate at 1-866-458-6630.
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What is the requirements for returning consult reports to the VA?
Specialty providers that treat HVHS patients are required to forward a consult report to the Veteran Administration via HVHS within 10 days of the appointment. Please forward all reports to HVHS at 1-877-371-6668. This is a secure fax line that meets all HIPAA compliance standards. |
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- NO veteran cost shares to collect.
- NO co-pays to collect from veterans.
- NO deductibles to collect from veterans.
- NO health plans to call to determine any veteran cost whatsoever.
- Providers will be paid directly and promptly by HVHS.
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Who should I call with claims questions?
HVHS will send information regarding local Network Service Representatives to each participating provider. You can call 1-866-458-6630 to reach an HVHS Customer service representative.
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How do I file claims?
Claims can be forwarded to
Humana Veterans Healthcare Services
PO Box 7062
Camden, SC 29021
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How will I know if a veteran has been referred to me for specialty care?
A representative from HVHS will contact you via telephone, with or without the veteran on the line, to schedule an appointment. After the appointment has been scheduled, you will receive a faxed notification that clearly delineates the services that you have been authorized to perform.
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If I am a Provider and I have a contract inquiry who should I contact?
If you are a Provider and you have a contract inquiry you should call 1-866-458-6630.
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