VA Losing Millions By Failing To Bill Third Party Insurers

The Department of Veterans Affairs (VA) is supposed to bill all private health care providers for services they provide veterans for conditions not related to their service. Those services range from providing medical care to supplies to prescriptions. Veterans usually do not pay any balances their insurance does not cover.

The VA, however, is not billing those third party medical care providers as required by law. According to a report issued by the VA’s Office of Inspector General (OIG), in failing to do so, the VA is losing more than $110 million billable income every year.

More specifically, the OIG found the VA does not bill third party insurers for almost 50% of what they should be billing. Citing “ineffective and unreliable” practices, the OIG referred to the VA’s failure to bill as they are mandated a “missed opportunity.”

Part of the problem likely lies with specific medical center guidelines. For instance, during their investigation, the OIG discovered some VA medical centers had no  leadership or direction as to when they should bill a private insurer. At the same time, some VA medical centers’ billing department could not produce evidence they have ever billed a private insurer.

This isn’t the first time the OIG has discovered these insufficiencies. The OIG report did make some recommendations as to the changes the VA must make in their billing practices, and the VA agreed with those changes.

 

If you are a disabled veteran who has been denied disability compensation or have not yet applied for benefits from the VA, contact Veterans Help Group. You may be entitled to certain programs and benefits so contact our veterans disability rights firm today.