Department of Veterans Affairs overview

You may know that Medicare processes claims for health providers on behalf of DVA, although sometimes using different item numbers and claim rules.

Case Manager enables you to streamline invoice payments from the Department of Veterans Affairs

The process of submitting a DVA claim is similar to a Medicare Bulk Bill claim. You claim the full invoice amount from the DVA and when it is approved it is paid into your account.

DVA claims are made from invoices. Case Manager monitors the status of these claims and the outcome, including when you are paid.

Case Manager utilises a claiming service provider to submit claims. There are additional charges to connect to this service. Please contact your sales team to discuss this charge.

All the other DVA services are free, including validating and monitoring claims, and verifying cards.

Claim life cycle

When you submit a claim from an invoice, the claim is validated to ensure it contains the required information. Then it is sent to DVA and given a Pending Update status. Eventually DVA either accepts and pays the claim or rejects it and give reason(s). Case Manager monitors and reports on this process, recording claim outcome details and giving claims a status of Complete or Failed at the end of the process.

At any time you can check pending claims in Case Manager to find out whether, when and how DVA has resolved them. See Claim life cycle for more details.

Payment transactions

When DVA claims have been successfully completed you can create a payment transaction, as you would for any other direct deposit.

Set up and requirements

Setting up this functionality is reasonably simple. Naturally you need to also make sure that Case Manager contains the information that the DVA requires so that this can be included in the claims, see Setting up for DVA claims.

Service types

The following service types are supported:

• S: Specialist
• O: General
• J: Allied
• K: Psych

The following are not supported:

• G: Dental
• L: Optical
• I: Speech Pathology
• P: Pathology services
• F: Community Nursing

Medicare claims

Naturally the Medicare Claiming service also enables streamlined management of Medicare invoices, see Medicare overview.