Veterans' health care, proper plan needed to modernize system for paying community providers : report to congressional committees.

Format:

Book

Government document

Language:

English

Subjects (All):

United States. Veterans Health Administration--Rules and practice.

United States. Veterans Health Administration.

Veterans--Medical care--United States.

Health insurance claims--United States--Data processing.

Health insurance claims--Data processing.

Veterans--Medical care.

United States.

Genre:

Rules.

Physical Description:

1 online resource (iii, 57 pages) : color illustrations

Other Title:

Proper plan needed to modernize system for paying community providers

Place of Publication:

[Washington, D.C.] : United States Government Accountability Office, 2016.

Summary:

Due to recent increases in utilization of VA care in the community, VHA has had difficulty processing claims in a timely manner. Congress included a provision in law for GAO to review VHA's payment timeliness and to compare it to that of Medicare and TRICARE. This report examines, among other objectives, (1) VHA's, Medicare's, and TRICARE's claims processing timeliness; (2) factors that have impeded VHA's claims processing timeliness and community providers' experiences; and (3) VHA's recent actions and plans to improve its claims processing timeliness. GAO obtained fiscal year 2015 data on VHA's, Medicare's, and TRICARE's claims processing timeliness. GAO also visited 4 of 95 VHA claims processing locations (selected based on variation in geographic location, performance, and workload); reviewed VHA documents and 156 claims from the 4 locations; and interviewed officials from VHA, Medicare, TRICARE, and selected community providers and state hospital associations. Results from GAO's analysis cannot be generalized to all VHA claims processing locations or community providers. GAO recommends that VA develop a written plan for modernizing its claims processing system that includes a detailed schedule, costs, and performance measures. VA concurred with this recommendation and plans to address it through the planned consolidation of its VA care in the community programs.

Notes:

"May 2016."

"GAO-16-353."

Title from title screen (viewed on May 12, 2016).

Includes bibliographical references.

OCLC:

949854399