American Veterans have experienced increasing access to private medical care over recent years. Based on the proposed Access Standards within the VA’s new Community Care Program that trend is expected to continue. However, procuring reimbursement for veteran care has historically been a slow, laborious process for the providers. Combined with declining resources, many healthcare finance professionals have been forced to focus their efforts on collecting revenue from claims that offer a greater ROI. The result has been an increase in VA claims A/R balances and aging for private providers across the country.
VA-Authorized Private Care Appointments:
•2016: 3.7 Million
•2017: 6.1 Million
•2018: 7.2 Million
Feb 2019: VA announces new proposed Access Standards by which Veterans will be eligible to receive private care, further reducing eligibility requirements.
March 2019: Proposed Federal Budget includes $8.9 Billion for formation of the VA Community Care Program, “providing greater choice on where Veterans receive their care.”
Whether TriCare, VA Choice or traditional VA Medical Center, all Veteran related claims are unique and have specific requirements that must be met to effectively procure reimbursement. Unfortunately, even when those requirements are met, it most often requires persistent, follow-up efforts to reach claim resolution. Without the resources to dedicate to such a typically small percentage of their total patient revenue, Veteran claims begin to have a big impact on a private provider’s overall average days A/R.
Due to the difficulties associated with procuring reimbursement for Veteran care, most private healthcare providers recover a low percentage of the potential revenue. At VCP, we implement our Proprietary Process to increase Veteran claim recovery rates, often many times what providers are able to achieve on their own.
As Veteran claims balances have continued to grow, so has the aging of the receivables. It is common for a private provider to have Veteran claims aged two years and greater. VCP helps our clients expedite recovery of both aged and new Veteran claims, helping to reduce average aging of the entire A/R.
With so many payers to pursue, many providers have been forced to focus their internal efforts towards recovering claims offering the highest ROI opportunities. VCP handles the entire claims process for our clients, allowing them to reallocate resources and improve efficiencies within their organization.