AUDIT OF FEE BASIS CLAIM PAYMENTS, DEPARTMENT OF VETERANS AFFAIRS MEDICAL CENTER LONG BEACH, CALIFORNIA

Audit of Fee Basis Claim PaymentsDepartment of Veterans Affairs Medical CenterLong Beach, CaliforniaOverall, the fee program wasoperating satisfactorily. Someimprovements related to insurancebillings, authorizations, coding,and pricing will help avoidoverpayments.Report No. 99-00180-85Date: June 7, 2000Office of Inspector GeneralWashington DC 20420DEPARTMENT OF VETERANS AFFAIRSOffice of Inspector GeneralWashington, DC 20420Memorandum to the Director, Department of Veterans Affairs (VA)Medical Center, Long Beach, CaliforniaAudit of Fee Basis Claim Payments1. The Office of Inspector General audited VA Fee Basis Claim Payments for FiscalYear (FY) 1998 at VA Medical Center (VAMC) Long Beach, California. We performedthe audit as part of a national audit of Fee Basis Claim Payments. The purpose of theaudit was to determine whether fee payments made for outpatient and inpatient medicalcare were appropriate. Specifically, the audit objectives were to determine whether (i)veterans receiving fee care were eligible for fee care, (ii) amounts paid for fee care wereappropriate, and (iii) fee care was the best alternative for providing medical services. Wealso evaluated whether third party billings were made when appropriate. Our universe ofFY 1998 fee payments at VAMC Long Beach totaled $2,091,269.2. Overall, the fee program at VAMC Long Beach was operating satisfactorily.Veterans who received fee care were eligible. While some payment errors ...