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VA focusing on more timely payments to community providers

Manchester VA Medical Center
January 10. 2018 11:40PM




The U.S. Department of Veterans Affairs (VA) announced a series of actions last week to improve the timeliness of payments to community providers.

“It is vital to the health of our network of providers that we provide payment in a timely and consistent fashion,” VA Secretary Dr. David J. Shulkin said. “Our outside providers are an essential part of our network and we need to improve our system of payments for their services.”

Short-term actions include:

• Publishing a list identifying providers with a high-dollar value of unpaid claims, to be published this week at https://www.va.gov/communitycare/providers/.

• Creating rapid-response teams to work with these providers to reach financial settlement within 90 days.

• Increasing the number of claims processed by vendors by 300 percent in January 2018 and by 600 percent in April 2018, with a goal of 90 percent clean claims processed in less than 30 days.

• Establishing multiple entry points for providers to check the status of their claims, including a dedicated customer service team and the VA’s Vendor Inquiry System (VIS) at https://www.vis.fsc.va.gov.

In addition, long-term actions include:

• Deploying multiple IT improvements within the first six months of 2018 that streamline the claims submission and payment process to reduce time for payments significantly.

• Aligning with the VA’s existing third-party administrators on concurrent performance improvement goals to rapidly improve aspects of their performance to ensure veterans have continued uninterrupted access to care.

• Awarding four new contracts in 2018 for implementation in 2019 to establish the new community care network that includes elements designed to ensure prompt payment of claims.

• Working with Congress to consolidate and simplify all VA community care programs, including provisions for prompt payment of claims.

• Ensuring transparency with the VA’s claims processing performance by publishing the VA’s claims processing timelines on a monthly basis.

The VA’s current third-party administrators — Health Net Federal Services and TriWest Healthcare Alliance — manage the VA’s community care networks and process payments to community providers.

“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.”

David McIntyre, president and CEO of TriWest said, “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.”

Community care providers can view a list of resources available to them at https://www.va.gov/COMMUNITYCARE/providers/resources.asp.

A video about the new community care network can be viewed at https://youtu.be/v45WAGdCaEc.


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