Larry Dandridge

More on VA community health care and getting permission to use a civilian health provider

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The Nov. 23 edition of The Island News’ included my column on the VA’s Community Care Program entitled Veterans have a choice: Civilian provider or the local VA medical facility. That article covered almost everything a veteran, veteran’s family, and veteran’s caregiver needs to know about the Mission Act and the VA’s Community Care Program.

You can find that article at https://bit.ly/3Dxf52X. The article provided readers with links to learn more about The Mission Act, the Community Care program, VA social work, how to find a civilian health care provider that is in the VA’s Community Care Network, how to find the Ralph H. Johnson VA Health Care System (RHJVAHCS) online phone directory, copayments, health insurance, billing, payments, financial hardship and emergency care.

The Nov. 23 article and previous articles on Veterans Benefits have stressed:

The importance of requesting authority (a consult) from the veteran’s Primary or Specialty Care Physician, Nurse Practitioner, or Physician’s Assistant before requesting the VA to schedule or before the veteran schedules an appointment with a civilian Community Care Provider).

The need for every eligible veteran to enroll in VA health care, find out who their Primary Care Physician is, and see (in-person or virtually) their Primary Care Physician, at least once a year — even if you use Medicare, Tricare, or other forms of insurance for health care.

The need for each Veteran to know who their Social Worker (VA expert in Community Care) is and how to reach that VA key health care resource.

Call 800-698-2411 and select Option 1, then Option 3 or visit your closet VA Medical Center or Community Based Outpatient Clinic to verify your eligibility for VA urgent care.

Because this author, with the help of our local VA Medical Center’s Public Affairs Office (PAO), was able to interview the Ralph H. Johnson VA Health Care System (RHJVAHCS) Chief of Community Care, Quana Singleton, on Thursday, Dec. 2, this article provides more information on the RHJVAHCS Community Care (CC) Program.

Community Care 

phone number

The RHJVAHCS Community Care Phone Number is listed in the Medical Center’s online phone directory under the directory’s “C” Section. The CC number is 843-789-6500. All calls are filtered and processed by the Specialty Care Office (Appointment Call Center).

Veteran patients are given direct numbers via mail to contact their personal Community Care scheduler. The VA’s National (Central) CC phone number is 877-881-7618. By the way, when you call 843-789-6500, the person answering the call will announce you have reached Specialty Care Scheduling, which is also frequently called the Appointment Call Center. Don’t be alarmed or believe that you may have reached the wrong office, because Specialty Care Scheduling does handle all Community Care phone calls.

Community Care workload is 5,000 referrals

Currently the RHJVAHCS CC Office is serving approximately 5,000 referrals (veterans) through the VA Community Care Program. The CC Office receives about 100 referrals per day. Because the RHJVHCS is a five-star medical center and is rated in the top 10 percent of all public and private hospitals in the USA for quality of care, customer satisfaction, and other medical care standards, less than five per-cent of the veterans using VA health care in the Low Country of S.C., and Ga., use Community Care.

Community Care workforce and process

The RHJVAHCS Community Care (CC) Department has 103 employees, and each of those employees are highly trained in the Community Care Program. The VA employees in the CC office are Community Care Advanced Medical Support Assistants. When your VA Physician sends a referral (consult) to CC, the referral is reviewed by a CC Registered Nurse, who sends the referral to one of the Community Care Advanced Medical Support Assistants (CCAMSA). The CCAMSA will obtain the veteran’s civilian vendor (doctor) preference and then schedule the appointment.

Community Care letter of authorization

Once the CC Office receives the referral and confirms the veteran is eligible for care in the community (by a civilian provider), the CCAMSA sends a letter to the veteran with the authorization number and instructions.

RHJVAHCS Community Care office hours of operation

8 a.m. to 4 p.m., Monday through Friday. All CC Office business is conducted by phone, email, and U.S. Mail. Due to COVID, the office location, security, and heavy workload, Veterans are not allowed to visit the CC Office.

Approved network of community care providers

Veterans can find a civilian health care provider that is in the VA’s Community Care Network at https://www.va.gov/find-locations/. If there is a specific community provider a veteran wants to see that is not in the VA’s Community Care Network, the VA nay be able to add them to its network. In some cases, a VA staff member will work with the veteran to find other options when:

A community provider cannot be found that meets the veteran’s health care needs.

A community provider was, but no longer is part of the VA’s CC network.

An existing community provider is no longer available.

In summary, to find out more about CC referrals, authorizations, appointment scheduling, or care coordination, contact your Ralph H. Johnson VA Health Care System’s Community Care staff at 843-789-6500. Your Primary Care Physician, Physicians’ Assistant (PA), or Nurse Practitioner (NP) and your assigned social worker can also answer questions about Community Care.

The Island News and the author of this article wish to thank the RHJVAHCS PAO Team, especially Will Brugge, and the Chief of the CC Department, Quana Singleton, for allowing us to interview them and learn more about Community Care.

Larry Dandridge is a retired Lt. Col. In the U.S. Army. He is a Vietnam War era wounded warrior, a combat and 100 percent disabled veteran, a former Infantryman, former Warrant Officer and pilot. Dandridge is also a past Veterans Service Officer, and a current volunteer Patient Adviser, CEO Advisory Council Member, and Patient and Family Advisory Committee Member at the RHJ VA Medical Center, as well as a published author and free-lance writer. He can be reached at LDandridge@earthlink.net.

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