VA Billing Issues: Still Have Outstanding Health Net Claims?
A Congressional Inquiry Could Be Your Best Bet to Get Them Paid
If your office still has outstanding claims with Health Net, you may be able to open a Congressional Inquiry as a last resort attempt to recoup payment for services authorized and delivered through Health Net. The MAC office has received reports from some of our members that they have been getting the runaround from Health Net regarding unpaid claims, and after doing some research it seems as though a Congressional Inquiry may be their best bet in resolving outstanding payment issues.
Helping constituents who are having problems with a federal agency or department is one of the most important functions of a Member of Congress. Keep in mind, however, that while your congressperson cannot override a decision made by a federal agency, they can often intervene on a constituent’s behalf to answer questions, find solutions, and/or cut through the red tape.
To begin a Congressional Inquiry, your Member of Congress will need a written and signed letter before intervening on your behalf. This “privacy release form” will allow your congressperson to make a Congressional Inquiry to the Department of Veterans Affairs on your behalf. Contact your Congressperson’s local office to find out more about the paperwork and procedures necessary to opening a formal Congressional Inquiry. To find your U.S. representative, go to https://www.house.gov/representatives/find-your-representative. If you need additional assistance in determining your congressperson, contact Tim at the MAC office at (517) 367-2225 or email@example.com, and he will assist you.
Veterans Choice Program Officially Ends – and New Veterans Community Care Program Begins – June 6th
As you know, the Department of Veterans Affairs’ Veterans Choice Program (VCP) will officially be phased out of the VA system on June 6, 2019. The Veterans Community Care Program (VCCP) will be the new vehicle for “non-VA” care to be delivered to Veterans outside of VA hospitals and will be effective June 6, 2019. What this means for individual chiropractic offices who see Veterans across the state is still somewhat unknown.
Many MAC doctors have been treating Veterans through the Patient Centered Community Care (PC3) program, which has been, and will continue to be for the coming months, administered by TriWest. The VCCP and PC3 programs will likely be merged in the coming weeks. We do not foresee doctors who are credentialed with TriWest experiencing any change in their authorizations of care, claims, or processing of payments.
Doctors who are still functioning off authorizations of care that were generated directly from one of the five Michigan VAMCs (e.g., Battle Creek, Saginaw, Ann Arbor, Detroit, and Iron Mountain), are not credentialed with TriWest, OR have authorizations for care that are through the Veterans Choice Program, should contact their local VAMC immediately to ensure that there is not a lapse in care and/or payment. NOTE: This June 6, 2019 cutoff date will override any dates that may be listed on the initial authorization for care if the authorization is through the Veterans Choice Program.
If you are unsure about whether you are credentialed with TriWest, or would like to become credentialed with TriWest to treat Veterans in your community, call EmpowerChiro at 1-800-819-9571 to find out more.