Question Veterans Admin Insurance (VA)

amjamil

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we provide psychiatry/psychology services to nursing facilities. all our patients with VA insurance are being denied die to no authorization however our entity is not able to request auth ourselves from this payer. We see patient PER a referal order from the PCP at the nursing facility... how do others get reimbursement from VA payer? any tips? we have over 500 outstand claims from 2018 to today
 

trarut

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Columbus, OH
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All services for all VA patients are being denied? Are the referrals for the initial visit with your provider only? I work in oncology so just a wee bit different :) but once a patient is established, we are able to request our own authorizations for additional visits with the VA. The initial referral/authorization still has to come from the VA provider or PCP sending the patient to us.
 

PatriciaWright

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Newport News
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If the original referral was not for Psychiatric services, you will not get paid. The PCP should have gone back through the VA and got you a referral. Also remember the VA only covers Military related illnesses in some specialty cases. If they have Medicare I would try filing to them.
 
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