Fee Basis Claims System (FBCS) is designed for exclusive use at the VA Hospitals to improve purchased care claims management and adjudication. It brings efficiencies to the processing of claims as well as provides a knowledge base of information needed to strategically guide the decisions made about Non-VA care. Through the use of Optical Character Recognition (OCR), data from paper claims (CMS-1500 & UB04) is electronically entered into the appropriate fields in the VA’s VistA.

Features:

• Windows GUI interface for VistA Outpatient Authorization package and inpatient payment processing
• istA-integrated GUI Inpatient Authorization management
• Real time match of authorization to claim
• Index and track claims received for processing
• Routine scrubbing of claims against Medicare coding/billing guidelines
• Standardized reporting
• Users can sort their work queues and re-route claims
• Veteran letters automatically generated when claim is processed
• Billable Claims Report
• Windows GUI user interface for Inpatient payment processing

Benefits:

• Reduces handling, storage, duplicate entries, and manual data entry of paper claims
• User friendly, clear presentation of payment information allows for process efficiency
• Provides enhanced customer service to Veterans as well as providers
• Streamlines procedures and processes
• Accurately collect and report claim data

Insurance Capture Buffer (ICB) is designed for exclusive use in the VA Hospitals to reduce data entry errors during the patient registration process. ICB allows users to scan the patient’s insurance card and through the use of optical character recognition technology, the patient’s insurance information is electronically entered into the VA’s insurance buffer file for final verification.>