- The Department of Veterans Affairs (VA) has announced new goals for claims administration and a significant investment in health IT tools that will help coordinate payment for community providers.
The VA has set the goal of increasing the number of claims processed by 300 percent in January of 2018, and aims to double that number to 600 percent by April. The VA will also attempt to cleanly process 90 percent of its claims within 30 days.
In order to achieve these goals, the VA will use rapid response teams to settle financial commitments in a 90-day period and will publish a list of providers with high-value unpaid claims to a new website.
The agency is also establishing multiple touchpoints for providers to check their claims processes via VA’s Vendor Inquiry System (VIS), which is available through a web portal.
“It is vital to the health of our network of providers that we provide payment in a timely and consistent fashion,” said VA Secretary Dr. David J. Shulkin. “Our outside providers are an essential part of our network and we need to improve our system of payments for their services.”
The is planning a slew of long term investments that improve payment IT functionality across stakeholder segments into 2019.
The agency plans on completing multiple IT improvements by the first half of 2018 to help streamline claims submission to reduce payment times. Additionally, the VA plans to add more transparency to the claims processing cycle by publishing timeliness reports on a monthly basis.
The VA also plans on including its Third Party Administrators (TPAs) and additional stakeholders in other possible claims and payment IT solutions.
The VA aims to align payment performance goals with its TPAs in order to measure performance quickly while ensuring veterans have uninterrupted access to care.
The agency also plans to award four new contracts to stakeholders in 2018 for the 2019 implementation of a new Community Care Network, which includes new design features that quickly ensure claims payment.
Officials added that the VA will work with Congressional leaders to consolidate and simplify all VA community care programs with provisions to improve payment processes.
TPAs including Health Net Federal Services and TriWest Healthcare Alliance praised the VA’s decision to overhaul claims administration.
“It is an honor and responsibility to serve the Veteran community,” said Billy Maynard, CEO of Health Net. “We remain committed to partnering with VA to improve the claims payment process.”
“We could not be more pleased at the aggressive focus on this critical topic. We look forward to continuing to reach the industry-leading performance level we all desire and expect,” added David McIntyre, president and CEO of TriWest.