How Do I Get My Payments From the VA? – an FAQ

Our clients throughout the country have continuously struggling to get payments from the VA. Recognizing this as a huge problem, Omni EMS Billing wanted to be able to get some definite answers directly from the VA, as well as a resolution.

Omni was able to arrange a meeting with the regional directors of the VA last month and glean some very important information about improving the process of getting payments from the VA. The following is an FAQ that should answer some of the more pressing questions about the VA’s processes:

Q1. How do I get payments from the VA?

There are 2 sides of the VA from which you can receive payments: Fee-Basis & Travel. How you receive payment will depend on which side gets the claim.

Fee-Basis deals with emergency transports to & from a non-VA facility. Payments come via EFT Preliminary Fee Remittance Advices are provided for each payment either by mail or electronically through Zirmed.  They usually arrive after the EFT is made.

Travel side deals with authorized travel benefits or transportation to and from a VA facility. Payment for this side comes via EFT as well but the process of getting this payment is through producing invoices through the Tungsten website to retrieve your payments. If you have never done this before, see below for the process.

Q2. What can I do improve the process of receiving payments?

There are several things you can do or double check to improve the process of receiving payments:

☑ Ensure the patient’s social security number is in the run report or hospital facesheet and is accurate when sent to us for processing. Claims will reject from the VA system if the SSN is missing or does not match.

☑ Ensure you are enrolled with the Treasury Department to receive EFTs. The Treasury department does not write checks for VA payments and you will not receive payments unless this is set up. If you have not set this up, please complete VA-FSC VENDOR FILE REQUEST FORM and fax to the fax number on the form.

☑ Ensure you have registered with the Tungsten website (Quick tutorial video on registering). You will not be able to receive payments from the travel reimbursement division of the VA unless you generate an invoice through their website:

1. The VA will send a fax or spreadsheet with a PO number for each payment that is ready to be paid out.

2. Go to the Tungsten website, enter the PO number, and generate an invoice for each payment.

3. The payments will then be processed and EFT-ed into the bank account that was registered with the VA

Q3. How do I check my VA claim status?

The VA has implemented a new system that allows providers to check the status of their claims/payments online. If you have not registered with them, you can do so with the above link. Omni is currently working with the VA to check status for all our clients as well.

 

Q4. Why am I getting a rejection for my VA claim with the notice “vendor documentation incomplete”?

This means that the payment address the VA has on file for your service does not match the payment address on the claim. This usually happens if the payment address has been changed but not updated with the VA. You can easily fix this by completing VA-FSC VENDOR FILE REQUEST FORM with the updated information and faxing to the fax number on the form.

Once you have updated the address, please inform us so we can re-file the claim.

Q5. Why am I getting a rejection for my VA claim stating medical records are required?

Some claims require hospital/ER records and bill in addition to the PCR report attached to the claim, and the claim will be denied due to this information missing. If the claim is denied due to this reason, the remit will be sent to the address on Box 33 of the claim form and to the veteran as well.

It is the veteran’s responsibility to make sure the medical records are sent by the hospital to the VA to continue processing the claim.

Please note, however:

  • If the hospital does not bill the VA and only bills Part A the claim will be denied and never be paid. It is patient responsibility.
  • If the VA does finally receive the bill and records from the hospital they will reopen the claim and re-process at that time.  It still does not mean that the claim will get paid, just processed.

 

3 Reasons to Become Best Friends with Your Local Hospital Contacts

3 Reasons to Become Best Friends with Your Local Hospital Contacts

You know that person at the local hospital registration desk that you exchange two words with when you transport a patient? Take some time to get to know him or her. Ask about their kids and family. Joke around. Take them some snacks from work. Here are 3 reasons to keep in touch with contacts at the hospitals to which you typically transport your patients:

 

#1. Hospitals can be a good source of patient information

Busy crew members may not necessarily have the time or the ability to gather patient demographic and insurance information from the patient. This is where hospital facesheets come in handy – they may have more accurate information about the patient than any verbal information you may have received.

If nothing else, it can be a good backup resource to make sure the information you received from the patient is accurate.

 

#2. Hospitals can fax facesheets to your service

A good relationship with a contact at the hospital will help facilitate a negotiation where you can have the hospital fax you facesheets of the patients you transport to their facility, after-the-fact. This will give the hospital a chance to verify and provide more complete patient information, as well as remove the necessity of your crew members waiting at the hospital for the facesheets.

 

#3. Increase referrals through your contacts

If you have a good relationship with your hospital contact, sometimes it might lead to more referrals for your service. As they know you and can put a face to the name of your service, they are more likely to remember your service when a situation arises and a referral is needed.

 

Grant Helferich is employed as the Director of Client Performance and Training with Omni EMS Billing in Wichita, Kansas. He is a former member of the KEMSA Board and has also served as the treasurer and president of the KEMSA Administrator’s Society. He was certified as an EMT, EMT-I, M.I.C.T. , and T.O. II. Grant has worked EMS for over 35 years in roles such as an EMT, EMT-I, M.I.C.T., Field Supervisor, Flight Paramedic, Cardiovascular Specialist, Assistant Director, and Director of EMS.
Be Prepared! Here’s 4 Tips to Handle Changes to Medicare Cards in 2018

Be Prepared! Here’s 4 Tips to Handle Changes to Medicare Cards in 2018

Changes are coming to Medicare on April 2018. As we mentioned in our previous article, CMS will be issuing new Medicare cards to patients that replace social security numbers with a new Medicare Beneficiary Identifier (MBI) number.

medicare

Courtesy of medicare.gov

This change is going to affect all providers, including EMS providers. It’s always better to be proactive than reactive, so follow these 4 tips to help your service be better prepared for the changes.

#1. Talk to the patient

Never underestimate information you can get from a patient first-hand. Don’t only rely on the hospital face sheet to get you the required information. Ask your patient when they are in the back of the ambulance or the nursing facility if they have received the new Medicare card. If they haven’t, this is a chance to educate the patient in case they were not aware of the change. If possible, get a copy of the Medicare card.

#2. Educate the staff

It’s important that this information be equally circulated throughout your service. Your staff are in the optimal position to get this information directly from the patient. If they are all equally informed about the Medicare card change, they can ensure that the Medicare information is gathered on the first attempt. If the patient is unaware of the change, your staff are also in an optimal position to educate the patient and get them prepared for the change.

#3. Get a copy of the patient’s ID

If possible, get a copy of the patient’s driver’s license or State ID. This will serve as a good supplemental patient information source, especially if the patient does not have their new Medicare card.

#4. Hand out information with HIPAA

When handing out your HIPAA policy to patients, you can add a small leaflet informing the patient to keep an eye out for the new Medicare cards that will be coming by mail.

 

Grant Helferich is employed as the Director of Client Performance and Training with Omni EMS Billing in Wichita, Kansas. He is a former member of the KEMSA Board and has also served as the treasurer and president of the KEMSA Administrator’s Society. He was certified as an EMT, EMT-I, M.I.C.T. , and T.O. II. Grant has worked EMS for over 35 years in roles such as an EMT, EMT-I, M.I.C.T., Field Supervisor, Flight Paramedic, Cardiovascular Specialist, Assistant Director, and Director of EMS.
5 Patient Demographics that Need to be Included in PCRs

5 Patient Demographics that Need to be Included in PCRs

Having good patient demographics in patient care reports is the core to being able to bill claims accurately and efficiently. Watch the video to learn about the 5 most important patient demographics you need to provide in PCRs.

Note: In 2018, Medicare will no longer use social security numbers on Medicare cards and will be issuing brand new identifier numbers. Be prepared to switch out from using the old numbers to the new ones in your systems.

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Q&A session with Grant Helferich: HIPAA Awareness

Q&A session with Grant Helferich: HIPAA Awareness

 HIPAA

 

HIPAA has been the elephant in the room that no one really wants to talk about. When HIPAA was first enacted, audits and fines were rare. However, with the government outsourcing audits, HIPAA violations have undergone much more scrutiny with ever-increasing fines for violators.

 

Grant Helferich, Omni’s Director of Client Performance and Training, recently attended a seminar on continued HIPAA compliance. As you can see in his picture above, he takes HIPAA very seriously! He provides a few simple tips to staying HIPAA compliant in the following Q & A session:

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