Military Health Programs
HMS provides customized third party liability and coordination of benefits to enable the Veterans Health Administration (VHA) to meet its revenue goals, including those established by the Medical Care Collection Fund. Our efforts on behalf of the majority of VA Medical Centers in all 21 Veterans Integrated Service Networks maximize collections while helping to manage administrative costs.
HMS's commitment to fulfilling the unique service needs of the VHA has resulted in tens of millions of dollars in recoveries for the agency since 2001. Under a Blanket Purchase Agreement through the VHA Chief Business Office, HMS offers pre-screened capabilities at discounted rates. Our "stamp of approval" as a qualified VHA vendor means that VHA facilities can obtain HMS's services without having to issue an RFP.
HMS's specialized services to the VHA include the following:
Insurance Identification & Verification. Our VHA-tailored service approach has resulted in loading more than 140,000 newly identified and fully verified commercial insurance policies to VISTA. HMS's vast carrier data match network enables us to locate previously unknown third party coverage for veterans. With proprietary data matching technology and a dedicated Verification Unit, HMS maximizes the number of insurance identifications and ensures that only accurate results are loaded to VISTA.
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Insurance Re-Verification. HMS's process ensures that insurance data is current and accurate. By applying specialized data matching and verification techniques, HMS can re-verify thousands of records quickly. As a result, recovery dollars increase, costs associated with erroneous billings are reduced, and policy continuations and terminations are located.
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Pre-Registration. HMS can minimize the burden associated with fulfilling VHA Directive 2004-057 for securing updated patient demographic and insurance information prior to appointments. Our easy-to-use Patient Update Form supplements the lengthy 10-10EZR by focusing on key patient demographic and accurate medical insurance information required for billing and recovery. HMS's customer service center responds to patients' questions and initiates follow-up to obtain missing information.
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Buffer File Management. With new policies reaching the buffer file every day, and limited staff to process them, keeping the file up-to-date can be a time-consuming, administrative burden. HMS's buffer file management service enables quick turnaround of records from the buffer file to VISTA. For facilities with a backlog of insurance records on the buffer file, we can verify these records and clean out the file to ensure that potential recovery opportunities are maximized.
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