VETERANS AFFAIRS

VA claims recovery is the process of managing billing, follow-up, denial resolution, and reimbursement for care provided to veterans and military beneficiaries. This includes claims involving the Department of Veterans Affairs (VA), TRICARE, TriWest, Optum, and CHAMPVA programs. These claims often have unique authorization, eligibility, and billing requirements that differ from commercial and government health plans.

ElevatePFS specializes in complex government payer accounts and brings more than 30 years of experience managing VA-related claims. Dedicated teams with VA expertise, including team members with military backgrounds, help healthcare organizations navigate authorization requirements, billing protocols, appeals, and payer-specific processes that can be difficult to manage internally. By combining specialized expertise, established VISN relationships, and technology-driven workflows, ElevatePFS helps hospitals improve reimbursement outcomes, reduce claim aging, and accelerate resolution.

ElevatePFS manages the entire claim lifecycle, from eligibility verification and claim submission to follow-up, underpayment reviews, and appeals. The team also performs coordination-of-benefits reviews to identify additional payer sources and ensure claims are billed correctly. This comprehensive approach helps reduce reimbursement delays, resolve claim backlogs, and maximize recoveries.

ElevatePFS uses specialized teams with deep knowledge of VA billing requirements, authorization processes, and regional VA networks (VISNs). These specialists ensure that claims include the required documentation, medical records, and billing forms while proactively addressing issues that could delay reimbursement or result in denials.

ElevatePFS uses a proprietary platform to manage complex VA claims through automated workflows, real-time claim tracking, and performance reporting. The platform helps prioritize accounts, monitor filing deadlines, identify secondary payer opportunities, and provide visibility into claim status, denials, aging trends, and reimbursement outcomes. This data-driven approach helps accelerate resolution and improve revenue cycle performance.