Thousands of Vets May Have Wrongly Been Billed for Emergency Care
By Richard Sisk
8 Aug 2019
At the start of fiscal 2016, claims backlogged more than 30 days totaled 482,000, or 28% of the total of 1.7 million claims, the report said. However, the backlogged claims had increased to 36% of all claims by November 2018, the report said.
Veterans may have wrongly been billed by the Department of Veterans Affairs for emergency room medical treatment at non-VA facilities totaling at least $53.3 million, according to the office of the VA Inspector General.Hospital emergency room sign. Getty Images
Following an audit, the IG estimated that "about 17,400 veterans, with bills totaling at least $53.3 million, were negatively affected" by either initial denial or ultimate rejection of their claims for reimbursement.
The IG also estimated that that "if corrective actions are not taken, these errors could result in $533 million in improper underpayments to claimants over five years."
The IG's 70-page report, titled "Non-VA Emergency Care Claims Inappropriately Denied and Rejected," said the reimbursement issue rested with the VA's Claims Adjudication and Reimbursement Directorate (CAR) in the VA's Office of Community Care.
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