If you are a provider that submits claims directly to the Veterans Administration (VA) under a Veterans Care Agreement (VCA) and experienced disruptions earlier this year due to the Change Healthcare cybersecurity incident, you can file those claims through October 31, 2024.
The VA’s system for nursing home VCA claims submission, using electronic data interchange, is stable and secure. Use VA Payer IDs: 12115 (Veteran medical and transportation). The VA will consider and process these claims under this extended timely filing window. Claims not on file with the VA will need to be resubmitted.
Tips for Submitting Affected Nursing Home VCA Claims
- Use the eCAMS provider portal to check the status of claims submitted to the VA.
- Call the Community Care Contact Center at 877-881-7618 for billing inquiries about claims submitted to the VA.
- For issues with provider vendorization and payment reissues, contact the VA’s Financial Services Center at 877-353-9791.
- More information is available at File a Claim for Veteran Care–Information for Providers - Community Care.
Background
On February 21, 2024, a cybersecurity incident impacted Change Healthcare (CHC). CHC serves as a clearinghouse for numerous claims for payment related to ambulance transportation and health care services under a contract with the VA. This incident prevented providers and entities from submitting claims electronically to the VA.
As of May 8, 2024, the VA is able to receive all claims electronically. Between February 21, 2024, and May 8, 2024, the VA had limited or no ability to receive and process claims due to the incident. During this period of more than 70 days, providers and entities were either unable or limited in their ability to submit claims to the VA for services normally processed for payment, provided either before or during this period.
Legal Issue:
The plain text of various statutes and regulations does not include exceptions for established timely filing requirements. If the VA applied these statutes and regulations without exception, it would be forced to deny claims affected by the CHC outage as not timely filed and thus not payable. This would expose veterans to personal liability for these services in some cases, through no fault of their own. It would also result in inequitable outcomes, where entities and providers furnished services on behalf of the VA but were unable to be paid due to circumstances beyond the control of either the VA or the providers.
On August 22, 2024, the Department of Veterans Affairs posted a Notification of Guidance extending the timely claim filing window as described above.