Argos Health has a dedicated team of individuals specializing in Veterans Affairs (VA) related claims. These accounts require specific medical documentation and proper authorization for all services provided to a Veteran within a designated amount of time to streamline the processing, approval and payment of the claim.
Argos Health offers a “Day of Discharge” assignment to the claim, allowing for prompt and proper delivery of claims to the VA. Our team will verify claim receipt with the VA and perform timely follow-up on each claim in order to expedite resolution.
VA claims have unique rules and regulations with further complexities involved in the denial and appeals process. We work with the provider to manage these complicated cases successfully in order to obtain accurate payment in a timely manner.
As conventional payers rapidly move towards value-based care and provider consolidation accelerates, hospitals and health systems need to consider changes to their revenue cycle and PFS processes and how to keep their employees’ skills and institutional knowledge relevant in a changing industry. This is most likely not the right time to try to develop and maintain expertise around esoteric programs like Patient-Centered Community Care (PC3) and Veterans Choice Program (VCP) that normally make up only a small percentage of a hospital’s revenue.
Given their inherent complexity and a near guarantee of continuing change, VA community care claims are a perfect candidate for outsourcing.
- Expertise and experience. Our team works with hospitals across a variety of geographic regions and have developed the knowledge and relationships needed to effectively work VA claims.
- A true partner. We share our knowledge of the VA’s scheduling and authorization process with the front-end departments at the hospital. This can eliminate common reasons for rejected claims that originate in these areas of the revenue cycle.
- Technology. Technology is the key to efficiency when working with disparate VA systems and procedures.
- Knowledge of other types of complex claims. We offer other complex claims services besides VA claims, allowing a hospital to centralize the management of several types of challenging claims with a single vendor.
- Proven success. We can demonstrate prior success in reducing average payment times and overall VA A/R.