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.