HSRM Portal for VA Referrals Most clinics develop a manual process for managing their VA referrals and authorizations—they simply create a workflow and flag these within their practice management software. A manual process is sufficient if you have two or three VA patients, but if you are in an area where you receive several referrals…
Keeping Up with a VA Verification
The Moving Parts of VA Verification The VA verification process is not one and done. There are many moving parts. Once a clinic receives an authorization, the clinic must create a process to document and communicate all of the requirements and limitations, as outlined in the authorization, to the treating provider. The process should include…
Verification with a Twist
Follow the Rules Typical verification starts with the insurance card the patient provides upon arrival or during the initial phone call. The clinic either calls the payer using the number on the back of the patient’s card or logs in to a payer’s website to verify both eligibility and coverage. VA patients, on the other…
Verifying VA Coverage & Benefits
There are six regional networks for VA community care. Within those regions are assigned third party administrators that manage the coverage and benefits. It is absolutely vital that a clinic create a verification process prior to rendering service to a VA beneficiary. This tutorial will walk the clinic through the necessary steps to obtaining referrals…
FAQs-Medicaid Verification
Frequently Asked Questions-Medicaid Verification Q: Do all Medicaid covered patients have Medicare as primary? A: No, Medicare is an age-based federal health insurance program for individuals 65 and over (some younger if disabled) while Medicaid is a state based public assistance program for needy individuals of all ages. If a patient qualifies for both Medicare…
Verifying Medicaid Benefits
Medicaid coverage and eligibility can be a moving target since states base policies on current legislation and available funds. Because of the variety of restrictions, it’s vital to confirm benefits for every patient and every visit, in order to bill correctly and compliantly. This tutorial provides guidance on locating information online and additional information on…