Errors result in improper billing for victims of military sexual trauma

Some veterans receiving treatment for military sexual trauma were billed incorrectly for services in fiscal 2009, according to a new report from the inspector general of the Veterans Affairs Department.

The IG discovered a lag time between when a patient received treatment and when the proper information was entered into the automated system, as well as manual edits to designations that caused incorrect co-payment charges. The lack of systematic reporting for MST services also contributed to the erroneous billing and limited data available for the study. As a result, VA recommended the "implementation of a method specifically designated to track MST-related care at all VHA medical facilities so that MST treatment data are readily accessible across the VA system."

Military sexual trauma includes sexual harassment and assault that occur during military service; victims can suffer from negative physical and mental health effects for years. VA provides free counseling and treatment for veterans who've experienced MST on active duty.

Hawaii Democrat Daniel Akaka, chairman of the Senate Veterans' Affairs Committee, called for an investigation into the billing practice after a veteran complained about erroneous charges at the Austin Outpatient Clinic in the Central Texas Veterans Health Care System. The Austin OPC treated 250 veterans for MST in calendar year 2008; 86 rendered services flagged as related to MST were billed.

The IG also recommended requiring staff to review all MST services before adding co-payment charges. Adding system checks, such as a confirmation screen or requiring supervisory acceptance for manual changes can prevent future mistakes by facility staff.

A health care provider must designate treatment for MST but a diagnosis of trauma is not always immediately evident, leading to another possible cause for improper billing, the report said. The IG recommended incorporating a billing delay to avoid this type of error in the future.

The director of the Central Texas Veterans Health Care System generally agreed with the IG's findings. VA canceled all erroneous charges at the Austin clinic and educated the facility's staff on proper billing procedures. VA is implementing more programs to improve the reporting of MST treatment departmentwide.