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October Message from Benjamin Altose, Acting Director of Operations, Payment Operations (104P)
Team,
As we transition into the new Fiscal Year, I want to take time to reflect on this past year. As you all know, our organization was subject to a lot of change. Payment Operations (104P) was created and staff were re-aligned under VHA Finance, where we are now serving our nation’s Veterans and their families in six departments: Western Region, Central Region, Eastern Region, Clinical Operations, Internal Controls & Appeals, and eCAMS & Systems Management.
Despite the change and uncertainty, Payment Operations had a very successful year, approving over 1.3 million notifications under 38 USC 1703 in ECR (Emergency
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Care Reporting), resolving over 110,000 customer service tickets in CRM (Customer Relationship Management), resolving over 9,500 adverse credit cases in ACR (Adverse Credit Reporting), processing more than 4.8 million claims in eCAMS (Electronic Claims Adjudication Management System), and processing more than 7,000 appeals.
Payment Operations has been able to keep the focus on our mission — “to administer and execute claims processing functions for VHA community healthcare claims in service to Veterans, their families, and community providers in a quick and correct manner.” I appreciate all your hard work, and I hope that you know it does not go unnoticed.
I look forward to continuing to work with all of you in FY23 as we build on the successes of the past year. To kick off this year, Payment Operations leadership will be holding a Town Hall on October 24th, so please keep an eye out for a forthcoming calendar invite. You will be able to submit questions in advance via a link in the calendar invite. I look forward to meeting with you then and encourage you to take the time to submit thoughtful questions, as it will make the Q&A portion of our town hall more helpful and relevant to you and your colleagues.
Thank you again for your commitment to our mission and all you do to serve our nation’s heroes!
Best Regards,
Ben
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Don't forget that self-assessments are due to Rater by October 17, 2022. Please ensure you submit your self-assessment by this date!
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Q: What should I do with the Jury Duty paycheck I received?
A: Employees must reimburse to their agency fees paid for service as a juror or witness, as they are already being paid under the official Court Leave Policy (opm.gov).
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 October is Breast Cancer Awareness Month, an annual reminder to do a self-check for signs and symptoms, schedule a mammogram and keep in mind those who are fighting breast cancer or have lost their lives to the disease.
Check out this feature from the CDC on Breast Cancer Awareness to learn more about signs and symptoms, risk factors, how to lower your risk, and more.
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The CAEC team is working on building requirements and user acceptance testing for a new program authority known as the Compact Act.
Compact Act will allow for care to be authorized when an eligible individual is in an Acute Suicidal Crisis and will make its debut in the first quarter of FY23. The team is currently awaiting OGC guidance for an official implementation date.
Please let us know! We would like to recognize and thank all of our Payment Operations colleagues who served in the military in next month's newsletter.
If you are a Veteran, please email Emma.Podkul@va.gov with your name, dates of service, and the branch of the military in which you served. Thank you for your Service!
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This month’s HRO Theme is Duty to Speak Up. VHA prioritizes safety and trusts its staff members to have a voice in safety decisions. This month’s HRO theme, Duty to Speak Up, emphasizes how VHA is committed to cultivating a safe and supportive culture in which all staff members feel empowered to speak up. Here in Payment Operations, we know that speaking up about an issue in a timely manner can make a real difference to the Veterans we serve as we execute and administer claims processing functions on their behalf.
To learn more about October's Theme of the Month, please explore the resources below.
Links
HRO Theme of the Month
Duty to Speak Up overview video
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Pulled on 9/6/2022
Pulled on 9/27/2022
These graphs above depict the workload for Payment Authority 1703. Each one shows the number of notifications going to the clinical team for review over the past 30 days from the date pulled. They also demonstrate how quickly we are moving through the reviews, with the average turn around time improving from 2 days in August to 1.8 days in September!
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Congratulations and thank you to all these staff celebrating milestones in October. We are lucky to have you!
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CONGRATULATIONS MELINDA!
Melinda Van Hoomissen received the VISN 20 Employee Spotlight Award! This award is used by the Patient Advocate and Veteran Experience teams to nominate staff at their medical centers and CBOCs who have gone above and beyond to help Veterans with complaint resolution and service recovery. Melinda was recognized at the VISN wide virtual awards ceremony in September.
Thank you, Melinda, for your tireless efforts in support of our Veterans! Congratulations again!
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FY22 Highlights from CAEC, Customer Service and Claims Processing |
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CAEC – CAEC has evolved greatly over FY22 to include moving from the SharePoint Emergency Care Authorization Tool (ECAT) to web based Emergency Care Reporting (ECR) in April. Over 1.9 million notifications were received during the fiscal year with more than 1.3 million approved under 38 USC 1703. The CAEC team continues to work on building requirements and user acceptance testing for a new program authority known as the Compact Act. Compact Act will allow for care to be authorized when an eligible individual is in an Acute Suicidal Crisis and will make its debut in the first quarter of FY23.
Customer Service – Throughout FY22, PO resolved over 110,000 CRM requests and closed the loop on over 9,500 ACR requests. Not only did the PO team continue to work down request inventory to a current sustainment level, but the average number of days to resolve also improved significantly over the course of the fiscal year. CRM requests went from being resolved in an average of 37 days in 2nd quarter to 8 days in the 4th and ACR resolutions resolved in an average of 68 days in the 2nd quarter to 32 days in the 4th.
Claims Processing – In FY22, PO received over 4.7 million community care claims in eCAMS and processed more than 4.8 million. 94.4% of those claims were processed within 30 days and 51% of them were auto adjudicated. In March, VA won its appeal on the Wolfe Case which led to a brief pause in secondary processing to work with policy and OGC to determine a path forward for secondary claims processing. This led to a hold of 13k+ claims until leadership and claims processing staff could work together to develop and provide training on updated secondary claims adjudications. Training began in late June, and since that time the aged inventory of held “Wolfe Claims” has been virtually eliminated. eCAMS enhancements occurred throughout the year in a continued effort to increase efficiency and accuracy.
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Workgroup Meeting in Largo, FL!
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A multidisciplinary committee was established to review and update Payment Operations' position descriptions and performance plans. This group, comprised of supervisors, provider relations specialists, deputy area managers and area managers, met at the payment center in Largo, Florida, from September 13 - 15. Tracy Shewmake and Christina Lux are the Committee Co-Chairs.
From left to right: Brandon Gard, Brandy Martin, Charles Landis, Jesus Murrieta, Eric Williams, Lisa Stanglin, Shirley Sweetland, La Faye Hightower; Kneeling: David Digiacomo
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Have You Completed the PACT Act TMS Overview Training?
Join the thousands of VHA employees who have already taken the PACT Act TMS Overview Training! It’s available 24/7 via a computer with access to TMS. Access the training here: PACT 101 Overview Training (TMS #131004853)
The training provides an overview of the PACT Act, toxic exposure, key dates, and how Veterans and their caregivers can receive information and support on the benefits and services provided by the law.
If you’ve already taken the training, please share with your co-workers.
Payment Operations Training Schedule
For the Payment Operations training schedule, please be sure to reference our training calendar: Trainer Calendar - Calendar (sharepoint.com). For training requests, please email VHA104PInternalICSupervisors@va.gov
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Did you enjoy reading this newsletter? Did your work on your high school newspaper? Then get INVOLVED! There is opportunity to support the monthly drafting process for the 104P Newsletter to ensure that the information is relevant and interesting to all staff. We'd love to get your input, so if you're interested, please reach out to Emma.Podkul@va.gov. |
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