VA Taps Xerox For Healthcare Claims Pricing


The Department of Veterans Affairs (VA), Veteran’s Health Administration (VHA) is moving forward on at least one piece of its slow slog toward modernization. The Department has tapped Xerox for work on improving their strategy to provide veterans with timely access to quality healthcare services from non-VA healthcare providers. Xerox will help the VHA meet new Federal guidelines for non-contracted home health and hospice services provided by non-VA medical providers. Previously, VHA did not have the capabilities to price non-contracted home health and hospice claims under the new Medicare pricing methodologies.

VHA will use an electronic home health and hospice pricing solution to key claims data into the system and get a Medicare price in return. The work will be conducted through a web portal pricing tool.

Xerox’s previous 2-year contract with the VHA for purchased care claims was similar to the new contract in that it priced anesthesia, outpatient, end stage renal disease and ambulatory surgery center claims under Medicare rates instead of under VHA rates.

The VA has been working with DoD and several contractors on modernizing its out of date healthcare system, and significant backlog of veterans claims. Efforts on this initiative have already reached the billions of dollars with limited success. DoD and VA are running up against a 2016 deadline for modernized electronic health records. Continued funding for that work was included in the recent national defense authorization act.