Special Access to Care
Veterans with any service-connected condition receive priority scheduling of appointments for outpatient medical services and admission for inpatient hospital care.

Priority Groups and You
Once you apply for enrollment, your eligibility status will be verified. You will be assigned to a priority group based on your specific eligibility status.

Congress requires VA to manage the health care system using eight priority groups. These priority groups determine who will be eligible to receive health care benefits each year.

Priority groups range from 1 - 8 with 1 being the highest priority for enrollment. Under the Medical Benefits Package, the same services are generally available to all enrolled veterans.

As of January 17, 2003, VA is not accepting new Priority Group 8 veterans for enrollment (veterans falling into Priority Groups 8e and 8g).

Veterans Service Centers
The Veterans Service Center provides assistance with eligibility, enrollment, financial assessments, burial benefits, beneficiary travel, TRICARE, CHAMPVA and Army Reserve physical exams. The Veterans Service Center can also assist you with billing inquiries, benefits counseling, and updating your personal information. For more information, contact the Veterans Service Contact Center at 1-888-823-9656.

Veterans Identification Card (VIC)
You will receive a Veteran Identification Card. Keep this card with you. You will need to bring it to all inpatient and outpatient visits.

Telcare
Telcare is a toll-free medical advice line for veterans and their families. It is a program of qualified professionals (registered nurses) who provide telephone access to clinical care 24 hours per day, 7 days per week (including weekends and holidays) throughout Central and Western New York. Call Telcare at 1-888-838-7890 with your medical and health care questions or concerns. If you need emergency care, you will be instructed on where to receive immediate attention.

What to Expect
The Veterans Health Administration (VHA) is pleased you have selected us to provide your health care. We want to improve your health and well-being. We will make your visit or stay as pleasant for you as possible. As part of our service to you, to other veterans and to the nation, we are committed to improving health care quality. We also train future health care professionals, conduct research and support our country in times of national emergency. In all of these activities, our employees will respect and support your rights as a patient.

Patients who elect to have their primary care delivered at a VA facility will be assigned a primary care provider. This provider is part of a Primary Care Practice Team of other doctors, nurses and/or clerks at a VA medical center or community based outpatient clinic. The first primary care visit will be set up and scheduled at the patient’s convenience.

During the first visit:

• The patient will meet his/her assigned provider.
• A physical examination will be done. The primary care provider will determine if there is a need for additional diagnostic testing (which may include blood/lab work, x-ray, etc.).
• A complete medical history will be obtained.

The first primary care visit is an important one. This is the time for the patient to develop a relationship with his/her provider and get acquainted with other members of the primary care team. Patients may also receive health education materials and guidance that may include: smoking cessation, depression screening, weight and exercise education, flu vaccine and/or pneumovax, diabetes and colon cancer screening.

Additional screening and education is available based upon specific diagnosis and individual patient medical needs.

In primary care, a strong emphasis is placed on preventive health maintenance. Primary care providers conduct the necessary physical examinations and screenings. Primary care also evaluates emergency medical needs between scheduled visits, arranges medication refills, and orders consultation by specialists.

Choosing Your Preferred Facility
When you enroll, you will be asked to choose a preferred VA facility.

This will be the VA facility where you will receive your primary care. You may select any VA facility that is convenient for you. If the facility you choose cannot provide the health care that you need, VA will make other arrangements for your care, based on administrative eligibility and medical necessity.

If you do not choose a preferred facility, VA will choose the facility that is closest to your home.

Changing Your Preferred Facility
You may change your preferred facility at any time. Simply discuss this with your primary care doctor. Your primary care doctor will coordinate your request with the Veterans Service Center at your local health care facility and make the change for you.

Changing Your Provider/Doctor
You have the right to change health care provider(s). Before making a change, discuss any problems/concerns with your current provider and work toward reaching an agreement. If you cannot reach an agreement, consult the facility Patient Advocate to proceed.

Additional Information About Our Providers
If you would like more information about your health care provider, please contact Credentialing and Privileging at your VA Medical Center. A written request may be required to obtain this information.

You can obtain information regarding your provider’s:

• Professional education - where the provider attended school
• Training - internship, residency, fellowship
• Current state licensure
• Board certification status - whether or not the provider is Board Certified

Co-Managed Care
If you are a veteran who is receiving care from both a VA provider and a private community provider, it is important for your health and safety that your care from both your providers be coordinated, resulting in one treatment plan (co-managed care). This means your VA and private community providers communicate about your health status, medications, treatments, and diagnostic tests.

In order for your VA provider and your private community provider to communicate about your care, we need for you to provide your VA provider copies of the following information from your private community provider’s office:

• The name, address and phone number of your community provider
• Prescription(s)
• Office visit notes supporting the prescription(s)
• Blood work results
• Test results

You will also need to provide information on any insurance coverage you may have.

You may either bring these copies with you to your next scheduled VA medical appointment or have your private community provider fax this information to your VA provider. In the course of your care, you may have recommendations for medications, treatments, and diagnostic tests from your private community provider that you wish to have accomplished through VA. Please understand that it is the responsibility of your VA provider to use their own clinical judgment to decide what medical treatment and tests are appropriate, effective, and necessary. Only then are medications, tests and treatments ordered by your VA provider. Patients who see a non-VA provider and want to have prescriptions filled or have treatment at the VA need to understand the following:

• The VA will coordinate care with a community-based provider so long as that care is provided in a safe and appropriate manner.
• You need to be enrolled in VA health care.
• In order to have prescriptions filled or treatment performed, you need to be seen by a VA health care provider.
• It is your responsibility to provide your VA health care provider with the appropriate medical records from your non-VA provider.
• The VA health care provider has to agree with the medication and/or treatment prescribed.
• The VA health care provider is under no obligation to follow the treatment plan or prescribe a medication recommended by a non-VA provider.

All of the above criteria must be met in order for the VA to provide quality co-managed care. Any questions can be directed to your Veterans Service Center. VA’s comprehensive health care program requires your VA provider to establish and continually review your treatment plan to insure you are receiving the best and most effective care. Your treatment plan includes medications, treatments, and diagnostic tests.

Making an Appointment
Unless it is an emergency, we ask that you make an appointment for your care. You will receive information about making appointments from your preferred facility.

Canceling an Appointment
Please help us provide timely service. If you cannot keep your appointment, please notify us as soon as possible so we can schedule another appointment for you, and use your cancelled appointment slot for another veteran.

Second Opinion
VA does not require a second opinion. If you want a second opinion, one will be arranged for you. If you are receiving medical care from another source (private physician, HMO, etc.) and a second opinion is required and you are enrolled with VA health care, you may use the VA for that second opinion.