November 2012/ 1300-1415/
A.) Brief was held at the Angeles City VFW Post 2485 and was attended by (02) FOTH Members.
B.) Manila V.A. Service Center Acting Director Nick Pamperin and V.A. Outpatient Clinic Director Vicki Randall gave the briefing update.
A.) V.A. has recently brought a new claims process on line. All claims will be brought in to the following (04) categories. They are as follows:
1.) Fast Track Lane: Those claims that only have one or two disabilities to be rated.
2.) Core Claims: All claims that have multiple disabilities to be rated.
3.) Special Operations: Claims that deal with certain disabilities due to special circumstance i.e. Diving & Parachute duty, Radiation exposure, Diabetes, IU, etc.
4.) Non-Rated: Those claims that will not bear a disability rating.
B.) No Claim submission should take more than 125 days to process vice the normal 190 day standard.
1.) 2011- All Claims processed averaged at 89 days per.
2.) 2012 - Claims processed averaged 192 days.
2.) 2013 - Manila VA OPC goal is no longer than 125 days.
C.) Appeals to Claim Rating not included in the Group of 4
processes. They will continue to be processed as they presently have been.
D.) Ebenefits website and My HealthVet were highly recommended as tools that individual Veterans can utilize.
1.) Ebenefits: Track their claims process. A premium account is needed to do so.
2.) My HealthVet: Order medications online, send messages directly to their primary health provider, etc.
Web address are: https://www.ebenefits.va.gov https://www.myhealth.va.gov/index.html
F.) Any Veteran that shows up to the
G.) All Veterans were reminded that the
H.) A new V.A. Service Director is expected to arrive to
A.) New Pharmacy prescription filling Machine expected to be on line in March 2013. This will increase the number of daily prescriptions from 800 to 1500. Currently, all prescriptions are done by hand individually.
B.) Due to Philippine Drug Enforcement
Agency (P.D.E.A.) controlled substance restrictions. All controlled substance
prescriptions are limited to (30) days from the
C.) New VA OPC Phone system should ease the burden on Clinic’s Pharmacists and Pharmacists Assistants from manually taking information over the phone. It was reiterated that a Veteran should only request to speak with a Pharmacist should that have questions and/or concerns regarding a specific medication. This will allow Pharmacy Staff to focus on filling prescriptions and not be distracted.
D.) Cancellation of Appointments was reiterated. Veterans were asked to cancel and reschedule any medical appointment(s) that they were unable to attend. This will allow resources to be shifted to more supportive means. Appointments that are not cancelled and not attended are a waste of resources that could be used toward another Veteran.
E.) The VA OPC has a No Show rate of 10% and this, as mentioned above, has a huge impact to other Veterans. Based on this, Manila VA OPC is considering for implementation to (03) Strike rule plan for missed clinic appointments. This plan is already in effect in CONUS V.A. facilities. Those Veterans that miss (03) appointments and did not cancel them will face refusal of further V.A. Medical Services. Bottom line- CANCEL ANY APPOINTMENT THAT YOU CANNOT MAKE AS SOON AS YOU DETERMINE YOU CANNOT MAKE IT! Sooner the better.
F.) Across the V.A. beneficiary population regardless of location Fraud has become a real problem. Veterans were reminded that any fraudulent submitted forms, claims, receipts, etc. will face serious repercussions. Cancellation of Benefits and Services could be done as well as criminal prosecution could be faced by those Veteran(s) conducting such activities. The little bit of reward that you might receive from these activities is not worth the penalties that come with being caught doing these shenanigans. Note: One item that was mentioned was Vets that share a ride, but both make a travel claim stating they drove their own vehicle or transportation to the VA OPC.
G.) Last but not least, Clinic Director stressed that no Veteran should come to the Manila VA OPC seeking Emergency Room care. The OPC is not set up for Emergency Room care, they can only triage and have the patient moved to a more suitable Medical Facility. The time that this would take could make a serious difference in a Veteran's outcome during such a medical episode.
H.) The Power Point Attachment covers the same information.