NP VA Account Setup and Authorization
4 min
Purpose
To ensure accurate entry of VA (Veterans Affairs) insurance and authorization information for proper billing, compliance, and timely reimbursement.
When to Use
Use this process:
- When a new VA patient is scheduled with an approved referral
- Before the patient’s first visit
- Whenever a new VA referral or authorization is received
Responsible Role
- Front Desk / Patient Coordinator: Creates the VA insurance policy, case, and authorization
- Billing Team (if applicable): Verifies accuracy and ensures claims are processed correctly
Creating a VA Account
- Go to Patient > Insurance
- Enter the following:
- Payor Insurance Plan: VAOPT – VA CCN OPTUM
- Policy Type: Primary Individual
- Plan Information: VACCN
- Insured ID / Policy #: Patient’s DOB
- Effective Date: Start date of treatment
- Expiration Date: Referral expiration date
- Copay & Coinsurance: Next
- Other Coverage Details: Visit Limits
- Click Save and Close
- Reselect the policy and update:
- Subscriber ID: Patient’s SSN
- Insured SSN: Patient’s SSN
Entering Case Information
- New VA patients require a new case:
- Select Add Case
- Enter the following:
- Name: DEPT OF VETERAN
- Care Type: Wellness
- Guarantor: Self
- Case Bill Type: Insurance
- Date of Onset: Day before initial or re-exam visit
- Initial Treatment Date: Initial visit date
- Click Save and Close
Entering Authorization
- Reselect the case
- Go to Authorizations > Add Authorization
- Enter the following:
- Auth #: VA referral number
- Date Requested: Referral issue date
- Service Type: 33 - Chiropractic
- Status: Approved
- Date Approved:
- New VA patient: Referral issue date
- Approved From: Initial treatment date
- Approved To:
- 60, 90, or 180 days from initial treatment date (per referral)
- Total Authorized: Number of visits approved by the VA
- Rendered Outside of Practice: 0
- Click Save and Close
- Final Steps
- Go to Billing and "Override Default Bill Type with Case Billing Details
- Enter alert with # of visits approved and expiration date