In a study conducted last year, the Government Accountability Office found that documentation, coding and billing errors—as well as inadequate management oversight—led to unbilled patient services at 18 medical centers within the Veterans Affairs Department.
Documentation errors, lax oversight tied to unbilled services at VA
Written testimony to a House subcommittee addressed the results from a June 2008 GAO study that analyzed services at 10 medical centers with low billing performance and eight medical centers under the VA’s consolidated patient account centers, or CPAC, initiative that were considered to be “high performers.” The federal agency’s research showed that 10 non-CPAC medical centers reported average days to bill that ranged from 109 days to 146 days in fiscal 2007 compared with the VA’s goal of 60 days. Meanwhile, considerable coding, billing and other problems led to more than $254 million, or 21%, of the total in unbilled medical services costs at those centers. The total amount that the VA had categorized as unbillable in 2007 was about $1.7 billion. While some medical services are not billable, the report said, management had not validated reasons for related unbilled amounts of about $1.4 billion to ensure that all billable costs were charged to third-party payers.
“The failure to make timely follow-up contacts and delays in initiating contacts with third-party insurance companies on unpaid amounts increase the risk that payments will not be collected or that payments will be substantially delayed,” Kay Daly, director, financial management and assurance at the GAO, said in written testimony to the health subcommittee of the House Committee on Veterans’ Affairs. “Of the population of fiscal 2007 billings that were used for our stratified random sample, VA had collected about 47% as of September 25, 2007.”
The GAO said it made seven recommendations to the VA, including following up on unpaid amounts, and that the VA concurred with its suggestions.
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