[{"innerBlocks":[],"name":"core\/freeform","postId":1429,"blockType":{"name":"core\/freeform","keywords":[],"attributes":{"content":{"type":"string","source":"raw"},"lock":{"type":"object"}},"providesContext":[],"usesContext":[],"selectors":[],"supports":{"className":false,"customClassName":false,"reusable":false},"styles":[],"variations":[],"apiVersion":3,"title":"Classic","description":"Use the classic WordPress editor.","category":"text"},"originalContent":"As part of its new Community Care Program, the Department of Veterans Affairs will require non-VA healthcare providers to submit electronic claims through a new claims processing system.

The system, which will be deployed in 2019, is part of the VA\u2019s efforts to move away from paper claims and to address the timeliness and accuracy of payments to community care providers.

\u201cWe must ensure community providers are paid in a timely manner so they are willing and able to deliver services to our veterans,\u201d testified VA Secretary Robert Wilkie on Wednesday before a joint Senate-House hearing. \u201cThis automated electronic Claims Administration and Management System (e-CAMS) uses technology with workflow-based analytics to provide feedback on potential bottlenecks and business performance issues in our claims process.\u201d

Also See<\/b>: VA digitizing old paper records to speed veteran disability claims<\/a>

In his testimony, Wilkie said that community providers will have 180 days to submit claims for reimbursement\u2014rather than waiting years to submit them\u2014thereby aligning the VA with industry standards and ensuring providers receive timely payments.

\u201cThis will put the Department of Veterans Affairs in line with the most modern healthcare administrations in the country,\u201d he observed.

Steven Lieberman, MD, executive in charge of the Veterans Health Administration, told lawmakers that by requiring providers to submit electronic claims\u2014except in rare circumstances\u2014it will \u201cspeed up\u201d the process.

\u201cWe also will have an off-the-shelf product that will auto-adjudicate the claims and pay them in a timely manner,\u201d noted Lieberman.

The agency \u201chas an IT problem,\u201d Wilkie acknowledged. \u201cWhen it comes to claims processing, hands have to touch each claim. What we have done is look to the market for off-the-shelf technology that will allow us to automate the claims process.\u201d

The VA Maintaining Internal Systems and Strengthening Integrated Outside Networks (MISSION) Act of 2018, which was signed into law by President Trump in June, is meant to streamline the VA\u2019s community care programs and enable veterans to receive care from community providers.

The MISSION Act requires access to community care if: VA does not offer the care or services the veteran requires; the agency does not operate a full-service medical facility in the state a veteran resides; the veteran was eligible for care in the community under the 40-mile rule in the Veterans Choice Program and meets certain other criteria; VA is not able to furnish care within the designated access standards established by the agency; or a veteran and the veteran\u2019s referring clinician agree that furnishing care or services in the community would be in the best medical interest of the veteran.

Wilkie said that under the MISSION Act the agency has established a Center for Innovation for Care and Payment to come up with new approaches to testing payment and service delivery models for incentivizing performance internally and when VA purchases care in the community.

\u201cThe center has developed a charter and is developing criteria for pilot projects to drive healthcare quality and efficiency,\u201d he added.

A provision of the MISSION Act also requires the VA to implement a process to ensure that community providers have access to available and relevant patient medical histories, such as a list of all prescribed medications.

The law mandates that \u201ccontracted providers submit medical records of any care or services furnished, including records of any prescriptions for opioids, to VA in a timeframe and format specified by VA\u201d and that the \u201cVA would be responsible for recording those prescriptions in the electronic health record.\u201d

A major challenge for the agency is increasing access to care and benefits through the MISSION Act implementation and business transformation, which includes adopting a new Cerner electronic health record system, according to Wilkie.

Both the VA and Department of Defense will implement Cerner\u2019s Millennium EHR platform in an attempt to achieve full VA-DoD interoperability. In addition, the agency is working to achieve interoperability with community providers.

The goal of the latter is to ensure that \u201cwe communicate with doctors in the private sector, community care hospitals, as well as private pharmacies\u2014and to talk to those systems that are not part of the Cerner network,\u201d commented Wilkie.","saveContent":"As part of its new Community Care Program, the Department of Veterans Affairs will require non-VA healthcare providers to submit electronic claims through a new claims processing system.

The system, which will be deployed in 2019, is part of the VA\u2019s efforts to move away from paper claims and to address the timeliness and accuracy of payments to community care providers.

\u201cWe must ensure community providers are paid in a timely manner so they are willing and able to deliver services to our veterans,\u201d testified VA Secretary Robert Wilkie on Wednesday before a joint Senate-House hearing. \u201cThis automated electronic Claims Administration and Management System (e-CAMS) uses technology with workflow-based analytics to provide feedback on potential bottlenecks and business performance issues in our claims process.\u201d

Also See<\/b>: VA digitizing old paper records to speed veteran disability claims<\/a>

In his testimony, Wilkie said that community providers will have 180 days to submit claims for reimbursement\u2014rather than waiting years to submit them\u2014thereby aligning the VA with industry standards and ensuring providers receive timely payments.

\u201cThis will put the Department of Veterans Affairs in line with the most modern healthcare administrations in the country,\u201d he observed.

Steven Lieberman, MD, executive in charge of the Veterans Health Administration, told lawmakers that by requiring providers to submit electronic claims\u2014except in rare circumstances\u2014it will \u201cspeed up\u201d the process.

\u201cWe also will have an off-the-shelf product that will auto-adjudicate the claims and pay them in a timely manner,\u201d noted Lieberman.

The agency \u201chas an IT problem,\u201d Wilkie acknowledged. \u201cWhen it comes to claims processing, hands have to touch each claim. What we have done is look to the market for off-the-shelf technology that will allow us to automate the claims process.\u201d

The VA Maintaining Internal Systems and Strengthening Integrated Outside Networks (MISSION) Act of 2018, which was signed into law by President Trump in June, is meant to streamline the VA\u2019s community care programs and enable veterans to receive care from community providers.

The MISSION Act requires access to community care if: VA does not offer the care or services the veteran requires; the agency does not operate a full-service medical facility in the state a veteran resides; the veteran was eligible for care in the community under the 40-mile rule in the Veterans Choice Program and meets certain other criteria; VA is not able to furnish care within the designated access standards established by the agency; or a veteran and the veteran\u2019s referring clinician agree that furnishing care or services in the community would be in the best medical interest of the veteran.

Wilkie said that under the MISSION Act the agency has established a Center for Innovation for Care and Payment to come up with new approaches to testing payment and service delivery models for incentivizing performance internally and when VA purchases care in the community.

\u201cThe center has developed a charter and is developing criteria for pilot projects to drive healthcare quality and efficiency,\u201d he added.

A provision of the MISSION Act also requires the VA to implement a process to ensure that community providers have access to available and relevant patient medical histories, such as a list of all prescribed medications.

The law mandates that \u201ccontracted providers submit medical records of any care or services furnished, including records of any prescriptions for opioids, to VA in a timeframe and format specified by VA\u201d and that the \u201cVA would be responsible for recording those prescriptions in the electronic health record.\u201d

A major challenge for the agency is increasing access to care and benefits through the MISSION Act implementation and business transformation, which includes adopting a new Cerner electronic health record system, according to Wilkie.

Both the VA and Department of Defense will implement Cerner\u2019s Millennium EHR platform in an attempt to achieve full VA-DoD interoperability. In addition, the agency is working to achieve interoperability with community providers.

The goal of the latter is to ensure that \u201cwe communicate with doctors in the private sector, community care hospitals, as well as private pharmacies\u2014and to talk to those systems that are not part of the Cerner network,\u201d commented Wilkie.","order":0,"get_parent":{},"attributes":[],"attributesType":{"content":{"type":"string","source":"raw"},"lock":{"type":"object"}},"dynamicContent":""}]

VA to implement new electronic claims processing system

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