Welcome to another Facility Revenue micro-learning
segment. Our topic this time: the VA
Patient Statement. More commonly referred
to as the VA billing statement.
Let's take a look at some things that
we're going to be talking about. Here is
our overview:
the lesson objectives, background,
understanding your VA patient statement,
the statement redesign, the VA patient
statement fields, charge descriptions, VA
patient statement messages.
We will also look at VHA healthcare billing
cycle, late fees to include interest in
administrative fees and lastly the
Consolidated Copayment Processing
Center
(CCPC) Lockbox System. Learning objectives:
at the end of this mico-learning
segment participants will be able to,
using the materials provided and in
accordance with Facility Revenue
guidance, identify key fields of the
VA patient statement, identify timeline
for the VHA healthcare billing cycle,
identify the steps in the CCPC Lockbox
process.
Here's some background on the VA patient
statement. As Facility Revenue
technicians, one of your key functions is
to provide customer service to Veterans
who are inquiring about their accounts. You'll
be doing research and answering
questions regarding the patients'
accounts using the billing statement in
many cases. Patient billing statements
provide Veterans with information on
specific charges, account balances, and
the rights and obligations associated
with medical care received through the
VA. When veterans have co-payment
responsibility for healthcare services
received, the Consolidated Copayment
Processing Center
(CCPC), sends out patient billing
statements.
CCPC electronically receives first
party co-payment information from VA
Medical Centers and issues over two
million patient billing statements each
month. Understanding your patient
statement.
Here's a visual aid handout that the VA
has actually provided to our Veterans so
that they can better understand the
patient statement. You'll see that there
are letters that are correlating with
descriptions off to the left-hand side
of this handout. This is something that
you can provide to the Veteran so that
they can better understand the billing
statement. One quick note for you is the
VA billing statement was actually
redesigned
in 2013. We'll take a closer look as we
zoom in and narrow down to the details
of the various parts of the billing
statement in the next few slides. Let's
talk about the VA patient statement
fields. We'll start by talking about the
facility name and address which is found
in the top left-hand corner of the
billing statement. We see it represented
here with the red box up above.
Let's zoom in. Name and address of the
facility where the Veterans receive care,
or for integrated systems, the address of
the main facility where the statement
was generated. This is the address for
all mail, except payments. Our next field:
statement question address change, and
that's found on the top right hand
corner of the billing statement.
Let's zoom in. This is the phone number
for HRC first-party contact center, not
the VA facility. Our next field: methods
of payment, and that's highlighted by the
red box there in the top right-hand
corner here.
Ok, let's zoom in. There are four methods
of payment that we would use here in the
VA. We can use the online method by going
to www.pay.gov,
by mail to the address
that's listed below on the payment
coupon, in person at any VA Medical
Center, or by phone at 1-888-827-4817. What
we just discussed is the facility name
and address, statement questions, address
change, and the methods of payment.
Let's continue. Let's take a look at the
activity close date, the patient name, and
the account number section, and that can
be found, again, on the top left hand just
below the facility name and address. We'll
zoom in.
Activity close date. Payments received
after the date shown will appear on the
next patient statement.
Patient name: last name, first name of the
patient. Account number:
the Veteran's unique number that begins
with a three-digit code for the station
ID associated with care, or for
integrated systems, the number of the
main facility where statement was
generated, must be included when making
all payments.
Next we'll take a look at the statement
date, which is found there on the right hand
side. We'll zoom in. The date the statement was
actually printed. Statements from all
facilities are released on a designated
date. And that's our look at the activity
close date, the patient name, the account number,
and the station date. We'll move on to our
next slide and continue looking at our
patient statement fields. Let's take a
look at the account summary line. We'll be
looking at previous balance, payment
received, new charges, pay by date, and
the balance. They can all be found in the
center of the screen, on this line here,
this is what we call the account summary
line. So as we go, let's zoom in and
discuss. The previous balance is the
amount from the previous statement.
Payment received: amount paid by the
Veteran and/or their insurance company.
New charges: new charges added to the
statement. Pay by date: to prevent late
fees, pay by this date. And of course we
have the balance. Balance due as of the
activity close date.
One thing to note here: the previous
balance minus the payment received plus
the new charges equal the balance due.
And this is the account balance summary
line. Now we'll go over and take a look
at some description items.
Let's continue our review of the patient
statement fields. We're going to look at
the description section and the notes
that are within, both for prescription and
for treatment,
we're going to look at the amount
that is being charged and of course
we'll look at the billing reference
number. And all of that information can
be found in the center section of the
billing statement. And now it's highlighted
and we'll start by taking a look at what
we would find if we were looking at the
prescription. We're going to go ahead and
zoom in on the prescription now.
Ok, these are all the items. The first
item that we have is actually the
description on medication.
This is a medication co-payment charge;
it includes the RX number, the field
date or date of service, the RX name, days
amount, the quantity, the physician, copay
charges, and the copay charge amount,
excuse me.
Next we have the copay amount which is
twenty-seven dollars, and lastly we have
the billing reference number. This is a
VA internal number assigned to each item
billed, commonly referred to as the "K"
number. Veterans should refer to
this number when asking about the
charges on their statement. And let's
go ahead and take another look now at what
we would find what we're looking at the
out payment copay charge. In this case
what you see is the out payment copay
charge. It says here that this is an
outpatient encounter or outpatient
charge and you see the visit date, of
course, we see the amount that's actually
charged for that which was $15 and again
we see that
K number that's assigned to each bill
uniquely, and the one thing that I will
remind you of is that the three digits
in the very front represents the station
number for the facility, or for
integrated facilities, or integrated
systems if you will, the number for the
main facility which is a three-digit
code. And we'll continue to our next slide.
Now let's take a look at the payment
coupon which can be found on the bottom
part of the billing statement. It's a
detachable formed by the way,
ok, and we see it highlighted there or
identified by the red box there. And after
that we're going to take a look at the
credit card payments and the mail to
address which is also found in the very
bottom there. And as we zoom in on the
payment coupon let's
take a quicker or a closer look at the
various sections of the payment coupon.
The payment coupon or the bottom
portion of the building statement is the
payment coupon. It's detachable and
you'll fill it in with the
information that's necessary prior to
mailing it in with the payment. It does
need to be mailed in along with the
payment. Please do not include letters
or notes or other materials. Missing
information will delay payment posting.
Let's take a look at the credit card
information that is required. Here what
we're going to be needing in terms of
credit card information. What's required
is the credit card number and expiration
date, the credit card type, signature, and
of course payment information as you
look down below here. The signature and
the payment amount that you would be
entering and you would be mailing this
to the Consolidated Copayment
Processing Center, or CCPC, and that's the
lockbox located there in
Atlanta, Georgia.
It's a centralized location to which
payments must be mailed and that's
anytime that you're going to be mailing
a payment in and again here's all the
information that we need on the payment
coupon. On our next slide what you're
going to see are some common abbreviations
that are used on the billing statement,
everything from administrative charge
down to the field date, the insurance type,
interest charges and various other
things that you'll see
and at the very bottom you see the RX
pound (#) for prescription. On the back
of the billing statement we have here
what we call questions about the
copayment status and of course you see
to the right hand side of this paper or
the right-hand side of this document
what's called a notice of rights and
responsibilities. You'll find
on the notice of rights and
responsibilities you'll see collection
information on how to pay your bill,
information or instructions on how
to do that, late charges, waivers,
compromise offers, repayment plans, and
disputes. When you look at this
particular document you'll find if
you're reading this
there's information to help you to
understand or to help our Veterans
understand
everything that they need to do in the
process of when it comes to their
obligations or their rights and
responsibilities, and of course to the
left hand side of the screen you see
that there are questions about the copayment
status.
These are what we call frequently asked
questions. We'll move on to our next slide and
briefly what we're going to talk about
is the billing cycle. Billing cycle for
VA healthcare accounts began when
billable healthcare services are
provided to the Veteran. Patient is sent a
statement every 30 days which will list
all charges that have been added to
their account since their last statement.
Charges to the account must be paid
within 30 days of the statement date. If
payment is not received
within a 30-day period it may be
considered delinquent and interest and
administrative fees may be assessed. If the
Veteran has an account balance, they may
receive up to three monthly statements
from the last billing activity.
Inpatient, outpatient, and medication
copay charges posted to a Veteran's
account are considered billing
activities. Payments posted to a Veteran's
account are not considered billing
activities. Veterans' payments are applied
to the oldest charges on the account.
Just a couple of other tidbits for
you:
the VA does not itemize inpatient bills,
VA is unable to change the billing date
or the due date of a Veteran's bills. Charges
initially appear on a statement as
new charges and are listed under the
description. Charges over 30 days all
appear as previous charges and are not
listed on the statement. Late fees:
interest and administrative. VA adds late
charges on balances which remain unpaid
30 days after the statement date. These
charges consist of interest and
administrative fees at rates that are
established each year. An administrative
charge of one dollar and eighty-seven
cents will be added monthly to accounts
not paid in full or established on
every payment plan agreement within 30
days of the statement date. An interest
rate of one percent per year is applied to
each account that is delinquent or being
paid on a repayment plan.
Lastly, let's talk about the Consolidated
Copayment Processing Center lockbox system.
CCPC: a centralized collection point and
the safe way that VA automates medical
payment processing using a web browser
interface. The VA manages all first-party
billings and payments for medical
services, makes deposits, accesses online
databases, and produces up-to-date
reports. Remember the payment coupon? CCPC
receives the tearaway coupon and payment
is scanned at the commercial banking
partner, Bank of America. CCPC also does
research and corrections when required.
And as you look at the chart here you
see the flow from where the process
starts all the way through. I won't go
through all the details on that if you
just take a minute you can actually see
where we start the whole process and
where it ends.
And that's about all you need to know
about the VA patient statement. We looked
at the background, we talked to you about
the handout that the VA actually
provided so that Vets have a better
understanding of the VA patient
statement. We looked at the VA patient
fields, charge descriptions, VA patient
statement messages which are the rights
responsibilities and obligations on the
back of the billing statement. We talked
about the VHA healthcare billing cycle,
late fees associated with charges, and
again we wrap it up with the
Consolidated Copayment Processing
Center lockbox system. We hope that
you've learned something from this micro-
learning session and remember it's all
about the Vet.
Thank you.
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