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Everything You Need to Know About EFTs and the VA CCN Program

The VA Community Care Network (CCN) is VA’s direct link with community providers to ensure Veterans receive timely, high-quality care. CCN uses industry-standard approaches and guidelines to administer services, pay for services promptly, and manage the network to its full potential.

There have been some recent changes to how providers receive electronic funds transfers through the CCN. Triwest EFT enrollment used to go through CAQH Enrollhub. However, due to recent changes of Triwest/VA CCN EDI going through PGBA, providers must now enroll for EFT/ERA through PGBA. 

Providers who were previously enrolled with EFT through CAQH Enrollhub will start receiving paper checks until they are re-enrolled through PGBA. PGBA requires two paper check numbers issued within the past 30 days to process Triwest/VA CCN EFT enrollment.

What are Electronic Fund Transfers and Why Do They Matter?

An electronic funds transfer is the electronic transfer of money from one bank account to another, either within a single financial institution or across multiple institutions, via computer-based systems, without the direct intervention of bank staff.

Receiving your VA CCN payments faster because EFTs transmit money directly into your bank account. You no longer have to go to the bank to deposit your money or wait for a check in the mail. Utilizing EFTs further streamlines your revenue cycle and reduces the number of daily tasks your practice has to perform.

What are Regional Networks in the VA CNN Program?

CCN comprises six regional networks covering all U.S. states and territories and is being deployed in a phased approach. Once fully implemented, CCN will be the preferred national network VA uses to purchase care for Veterans in their community.  VA CCN Program

CCN comprises six regional networks. It covers all U.S. states and territories and relies on Third Party Administrators (TPAs) to develop and administer regional networks of high-performing licensed health care providers on behalf of VA. CCN has an established set of regional boundaries aligned to state boundaries to provide local flexibility and increased access to care. Each regional network of CCN serves as the contract vehicle for VA to purchase care in the community. With CCN, there is a focus on transparency, accountability, quality, and increased communications between VA and Veterans.

The regions are as follows:

Region 1:

  • Connecticut
  • Delaware
  • District of Columbia
  • Maine
  • Maryland
  • Massachusetts
  • New Hampshire
  • New Jersey
  • New York
  • North Carolina
  • Pennsylvania
  • Rhode Island
  • West Virginia
  • Vermont
  • Virginia

Region 2:

  • Illinois
  • Indiana
  • Iowa
  • Kansas
  • Kentucky
  • Michigan
  • Minnesota
  • Missouri
  • Nebraska
  • North Dakota
  • Ohio
  • South Dakota
  • Wisconsin

Region 3:

  • Alabama
  • Arkansas
  • Florida
  • Georgia
  • Louisiana
  • Mississippi
  • Oklahoma
  • Puerto Rico
  • South Carolina
  • Tennessee
  • Virgin Islands (U.S.)

Region 4:

  • Arizona
  • California
  • Colorado
  • Hawaii
  • Idaho
  • Montana
  • New Mexico
  • Nevada
  • Oregon
  • Texas
  • Utah
  • Washington
  • Wyoming

Region 5:

  • Alaska

Region 6:

  • American Samoa
  • Guam
  • Northern Mariana Islands

What is the Latest Development of EFTs and the VA PC3 Program?

If you are in TriWest Region 4 or 5 (Alaska) and previously received EFTs from the VA PC3 program, you may begin seeing paper remittance. This is due to the transition of the VA PC3 program to VA CCN program. PGBA handles electronic claims and fund transfers for the VA CCN program in Region 4 and 5. To continue receiving EFT, you will need to register for PGBA EFT enrollment in the link below. PGBA requires 2 paper check numbers issued by VA CCN within the past 30 days to process the EFT enrollment.

What To Do In Order to Continue Receiving Electronic Fund Transfers?

Once you have submitted your EFT application, it takes approximately thirty (30) days to receive and process EFT requests. After your EFT application is processed, it takes seven (7) days for EFT to begin. After the 7-day period, you will receive EFT payments (for any VA CCN claims you submit) in the next payment cycle. A payment cycle is generally 2-3 days. Claims received after your EFT enrollment has been processed will be paid electronically. Until then, you will receive paper checks.

The good news is that you can submit VA CCN claims for multiple providers. PGBA processes EFT payments based on NPI. Payment for all locations under the registered NPI will be transmitted to the financial institution transit/routing and account number indicated on the EFT Authorization Agreement. If a specific location requires payment to a different account, it must have a different NPI and you must submit a separate EFT Authorization Agreement form.

Where Can You Register for the PGBA EFT Enrollment?

Download the EFT Authorization Form found on TriWest Payer Space on Availity.com. Print and complete the EFT registration package and mail it to: PGBA, LLC., PO Box 108853, Florence, SC 29502-8853. Once you receive a notification letter, you'll start receiving your payments through EFT. 

There are no fees to sign up for EFT, but you are encouraged to double-check with your bank to determine if they apply any fees to EFT.

August 9, 2021
 - by Antonio Arias, MBA, CHBME
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