Pay-to Provider Set-up

Pay-to Provider Set-up At Veterans Health Administration

Pay-to Provider in the VA database is the entity which is seeking payment for a claim (who will receive the payment). Each VA database can have one or more Pay-to Providers. Each VA database must have at least one Payto Provider.

The Pay-to Provider does not need to have a physical location. It can have a street address or a Post Office Box number. With Patch IB*2*516, sites will gain the ability to define a second set of Pay-to Providers to be used on claims with the Rate Type of TRICARE REIMB. or TRICARE. To define the Non-MCCF Pay-to Providers, the steps are the same as the following steps for regular Pay-to Providers. A new section has been added to the IB Site Parameters. With Patch IB*2*608, sites will gain the ability to define the Rate Type to be used for Non-MCCF PayTo Providers (formerly the TRICARE Pay-To Providers) address. The system will use the Non-MCCF Pay-To address data on claims with specified Rate Types only when the Non-MCCF Pay-To Providers address is not the same as the billing Pay-To Providers address.

  1. Define Default Pay-to Provider.
  2. Associate Divisions with non-Default Pay-to Provider. When adding a second Pay-to Provider, users will be prompted to make it the default Pay-to Provider, Is this the default Pay-To Provider? NO//. If users make the new Pay-to Provider the default provider, all divisions will be associated with the new default. If users do not make the new provider the default, then they will have to associate select divisions with the new Pay-to Provider.
  3. Rate Types for Non-MCCF Pay-to Provider.

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