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Home health care company drops veteran patients over VA payment

Union Leader Correspondent

August 15. 2018 10:10PM

LONDONDERRY — A home health care company based in Londonderry, Right at Home, has stopped taking veteran patients because they say the the U.S. Department of Veterans Affairs has been too slow at paying their claims.

Janet Sullivan, the co-owner of the New Hampshire home care franchise, said communication with the Manchester VA Medical Center and New England regional office in Boston has increased over the past week and since a Boston Globe story first told her story on Tuesday.

“We are working together,” Sullivan said.

Most recently, she was told by officials at the Manchester VA that it is planning to hold a summit of local home care providers in September. The Manchester VA said it will offer assistance and education to providers in rolling one-hour increments.

Manchester VA spokesman Kristin Pressly also said the facility is in the process of hiring an Office of Community Care Provider Relations Specialist.

Ultimately, she hopes to have $60,000-worth of unpaid claims paid in full and some kind of assurance from the VA that delays like the kind she says she’s experienced won’t happen again before starting to offer care to veteran patients served through Manchester again.

Sullivan said the company has been in business since 2008 and expanded into the Seacoast region last year.

On Friday, Aug. 10, Sullivan and her husband Rich stopped serving 16 veterans connected to the Manchester VA because they said couldn’t afford to continue billing $3,000 a week for veteran care that wasn’t being reimbursed in a timely manner.

“We finally had to put a stake in the ground,” Sullivan said.

As the tardy payments mounted, Sullivan said she and her husband had to put $20,000 of their own money into the business to pay their staff and other expenses.

She said they gave the VA ample notice and personally called each affected patient two weeks prior.

“This was the worst thing we’ve ever had to do,” Sullivan said. “I had people in tears when I talked to them over the phone.”

Many of her patients form personal relationships with the home care providers, and they rely on the caregivers for things like stocking groceries and other non-medical services. Some patients offered to pay out-of-pocket, but Sullivan said many can’t afford to do that for more than just a few weeks.

Statewide, Right at Home serves 80 to 100 clients. The veterans represented approximately 10 percent of the company’s revenue. But Sullivan said the company is still growing and actively recruiting more home care providers. Her main concern is for the veterans.

Sullivan described a circuitous route her claims must make; after first snail-mailing her 1500 VA claim form with care notes from each caregiver attached to the Manchester office, it gets sent out to Tampa, Fla., then digitized and sent to Boston where claims processors send it to Austin, Texas. In Austin, it changes hands between a technical institute and the U.S. Treasury office there, according to Sullivan.

While she has had almost daily communication with officials in the Manchester and Boston office, she said neither she nor those local officials have a means of contacting processors in Tampa or Austin.

In July, things became more complicated when a policy change suddenly required Sullivan to fill in entire Social Security numbers instead of just the last four digits, which was acceptable for the past decade. The returned claims from that policy change amounted to about $24,000 of the unreimbursed funds, she said.

In a statement, the VA said it has processed all the claims that have been submitted correctly and stands ready to process claims that need to be resubmitted.

Sullivan said she resubmitted 76 claims about a week or two ago and those have been sent out for processing. She expects it will take another two to three weeks to get payment on those. On Tuesday, she hand-delivered another 39 returned claims that needed to be resubmitted to the Manchester VA.

There could be more failed claims that she’s unaware of, Sullivan said, because there is often a lag of weeks or months between the time a claim is rejected and she is notified.

Sullivan said she is still able to serve about four or five veterans who are connected through the Bedford, Mass., VA. For some reason Sullivan can’t account for, those claims are processed on time, she said.

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