Welcome

Thank you for joining the Community Care Network (CCN) through TriWest Healthcare Alliance! If you reached this page to join our network and request a contract, please fill out the form below. Otherwise, we hope the information on this page will provide you with more details on the CCN and TriWest.

The CCN is part of the next generation of Department of Veterans Affairs (VA) community care programs contracts. TriWest has been selected as the third party administrator for CCN Region 4. We are excited for this opportunity to continue partnering with VA to improve Veteran health care in this country.

TriWest is owned by non-profit Blue Cross Blue Shield plans and University Hospital Systems. These owners also serve as our network partners in most of the geographic spaces in which we operate. TriWest is working with our local network partners to establish your contract.

Above, please find more information about the CCN, TriWest, and the network you have joined, or would be joining.

Please take a moment to review a sample provider contract, as well as the terms and conditions of the program which are outlined in the Provider Handbook.

If you have any questions about this webpage or the process, please feel free to email us at ccnprovider@triwest.com or call 866-286-4174.

If you are a facility/group with 25+ providers please use the Provider Roster List and email your list to TriWest at providerservices@triwest.com.

We look forward to partnering with you and your team.

Respectfully,

Frank Maguire, MD
Frank Maguire, MD
Chief Network Officer


Provider Contract Request

* = Required
Date Entered:
12/14/2019 11:12:18 PM
Name (must fill in the Provider's First and Last Name OR the Facility/Group Name. That is, enter the W-9 legal name.)
Provider First Name *
Provider Last Name *
OR
Facility/Group Name *
Federal Tax ID *
CAQH Number
Type of Practice *
States Served *
hold the 'CTRL' key down to select multiple items
ACO or PCMH?
Provider Point of Contact
Name *
Email *
Phone *
Fax
Optional
 
Primary Practice Address
Street Address 1 *
Street Address 2
Optional
City *
State *
Zip Code *
Comment

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