DOM Providers in the Community Care Network (CCN) of the VA
By NMSAAM Insurance Chair, Dr. Caterina Di Palma, DOM
If you provide services to veterans through the CCN program of the VA, you have been automatically enrolled as a provider for other health insurance company plans that contract with Tivity to credential providers: Humana NM Acupuncture, Voucher Health & Wellness Program, and WholeHealth Living Choices that offers its members a 20 or 30% discount on the cost of a treatment with you. Tivity has not asked for your consent to be included. You are automatically enrolled if you have not opted out. However, you DO have a choice, you can opt out by emailing practitionerupdates@tivity.com. Once you opt out, you are still on the panel for 90 days to provide “continuity of care” to your patients who are their members.
Tivity, a subsidiary of TriWest, is being paid to credential providers for the Veterans Administration (VA) Community Care Network (CCN). That credentialing automatically adds you to the provider list of Humana NM Acupuncture, Voucher Health & Wellness Program, and WholeHealth Living Choices.
Last month, WholeHealth Networks asked me to register on their new website to review their Provider Manual and fee schedule. The details are: for one date of service, you can charge a maximum of 2 CPT codes or 2 treatment units. That may translate to 30 minutes of treatment time depending on how you schedule. The payment could be around $73 minus the patient copay. One of my patients had a $30 copay, the other a $15 copay. You can use an E&M code 2 times in a year.