Collections

From whom does VA collect revenue?

VA collects reimbursements from insurance companies and copayments from certain veterans for medical treatment of nonservice-connected conditions. VA also collects copayments for medications provided on an outpatient basis to treat nonservice-connected conditions.

VA is authorized to recover the cost of medical care for nonservice-connected conditions from health insurance programs (except Medicare and Medicaid) providing coverage for veterans, including policies held by veterans, spouses or guardians. This is why veterans are asked about their insurance coverage when applying for treatment at VA medical facilities. Even for veterans with service-connected disability ratings of 40 percent or less, VA collects insurance reimbursement for treating their nonservice-connected conditions. VA will contact their insurance carriers to verify coverage and submit claims to the carriers for the billable services.

How VA is using new technology to enhance collections?

VA has developed and implemented software in medical facilities to implement electronic data interchange (EDI), allowing them to send claims automatically to health insurance carriers through a national clearinghouse. These electronic exchanges result in faster claims to insurers and faster payment to VA because the software edits claims for errors, eliminating time-consuming reworking. VA continues to develop and integrate technology into current practices to enhance care and revenue collection.

These technological improvements and some new processing methods in development will result in even greater reimbursements to VA and, ultimately, improved health care services for veterans.