Noteboom The Law Firm

VA Changing Billing Process For Third Party Prescriptions

The Department of Veterans Affairs (VA) is changing the billing process they use for those veterans using third party pharmacy prescriptions. The new process affects how the VA charges third party insurers for those outpatient medications prescribed to veterans. This process, however, only affects those prescriptions written for conditions not service-related.

The new billing process began in March. The VA now charges any third-party insurer used by the veterans the full cost in addition to a $11.40 administrative fee. Prior, the third parties were charged a $51 flat rate. This is a very similar process to how private sector health providers bill third parities for prescriptions. This new process will aid the VA in providing the best health care available to every veteran who has earned it through his or her service with the military.

By using this program, the VA will recover costs from the insurance companies in the amount of what the VA spends to provide the prescriptions themselves. This differs from the flat fee they were charging; an amount decided upon by averaging the costs of all provided prescription medications.

Veterans written 30-day prescriptions from VA physicians for conditions or disabilities not service-connected do not pay more than $9 in co-pay, and many veterans have no co-pay. This new billing process will not affect the veterans' current co-pay arrangement.