Lankford Sounds Alarm on Major Delays in New Veterans Affairs Program

WASHINGTON, DC – Senator James Lankford (R-OK) sent Department of Veterans Affairs (VA) Secretary Denis McDonough a letter raising concern about extended delays veterans are experiencing in processing times and reimbursements from travel expenses as a result of the transition to the Beneficiary Travel Self Service System (BTSSS).

“I write with concern regarding the transition from VISTA to Beneficiary Travel Self Service System (BTSSS) carried out by the Department of Veterans Affairs (VA). While the intended goal of switching to BTSSS was to provide quicker and more efficient reimbursements for veterans’ travel expenses, the transition has resulted in much slower processing times due to system issues that require increased manual attention. Unfortunately, the transition has burdened our nation’s veterans and the VHA employees who are diligently working to serve them,” wrote Lankford.

Read the full letter here or below.

Dear Secretary McDonough,

I write with concern regarding the transition from VISTA to Beneficiary Travel Self Service System (BTSSS) carried out by the Department of Veterans Affairs (VA). While the intended goal of switching to BTSSS was to provide quicker and more efficient reimbursements for veterans’ travel expenses, the transition has resulted in much slower processing times due to system issues that require increased manual attention. Unfortunately, the transition has burdened our nation’s veterans and the VHA employees who are diligently working to serve them.

We have identified several issues within BTSSS that, if resolved, would result in faster processing times for veterans’ claims.

1. When VISTA switched over to BTSSS, BTSSS was not adequately compatible with VISTA, resulting in every appointment a veteran could file for to appear. If they filed and paid for their appointments in VISTA, BTSSS should never have allowed those paid appointments to carry over. When veterans see these appointments in the new system and file for them, the employees have to manually resolve each issue. After employees manually review the claim, see that it was paid in VISTA, deny the claim in BTSSS, write a letter of denial, and then mail the denial, veterans may appeal, which creates another long process.

I recommend that in order to reduce the need for VHA employees to manually eliminate claims that should have never transferred over, BTSSS should have a mechanism to prevent duplicate claims whether submitted in VISTA or BTSSS.

2. BTSSS shows every appointment that veterans have at the VHA and allow them to file on all of those appointments. For example, if appointments are completed at 10 am, 11 am, and 12 pm on the same date and same location, the Veteran can file for each claim. Regardless of whether the distance from a Veteran’s home to the VHA location is enough time to go home between appointments, the system will allow the veteran to file for all 3 appointments. However, by policy, due to the proximity of those appointments, only one round trip appointment may be paid for if they occurred within a certain time frame at the same location. If BTSSS recognized the distance from a veteran’s home to the VHA and assessed that there is enough time to go home between appointments, then it would allow them to file for travel pay. Once again, a human has to manually review the claim, deny the claim in BTSSS, write a letter of denial, and then mail the denial. The veteran is once again allowed to appeal, further drawing out the process.

I recommend BTSSS only allow one claim to be filed per location when multiple appointments occur within a reasonable time frame, and thus prevent claims on the other appointments. This will reduce duplicate claims processing and would allow the team to process claims faster.

3. In BTSSS, if the Veteran or the VHA cancels or no-shows the appointment, the system still allows them to file a travel claim on that appointment. Because veterans file these claims, a human must manually review the claim, deny the claim in BTSSS, write a letter of denial, and then mail the denial.

I recommend BTSSS immediately connect with Computerized Patient Record System (CPRS) and see the appointment was cancelled, which ensures the Veteran is not allowed to file on that travel claim. Alternatively, logic could be built into BTSSS to auto- adjudicate by denial any claims associated to cancelled appointments or no-show appointments. 

4. If a Veteran submits a claim for an unscheduled visit and is eligible for travel pay, he/ she is only eligible for one-way travel by regulation. In BTSSS, unscheduled visits are not recognized and must be manually identified by a processing clerk based solely on the name of the clinic or by cross referencing the appointment type from CPRS. This potentially leads to overpayments due to inappropriate round-trip reimbursement. The issue could potentially be addressed through auto-adjudication or a flagging system to alert processing staff that the claims is associated with an unscheduled visit type. I recommend BTSSS either flags unscheduled visit types as one-way reimbursement eligible only or, preferably, create logic in BTSSS to auto-adjudicate one-way payments only for claims associated with unscheduled appointment types. This would reduce processing time for these claims and reduce occurrence of overpayments to Veterans. 

5. The number one complaint received by VAMC staff over the past year has been the removal of the touchscreen kiosks stationed at the medical center and clinics around the state. These provided a user-friendly means for patients to electronically submit their claims regardless of what technology they possessed at home or on their phone. The kiosks required minimal staffing support due to ease of use. Additionally, only appointments within the last thirty days were populated to submit for reimbursement, eliminating claims ineligible for reimbursement due to timely filing requirements. The health care system has installed computers that access the BTSSS patient submission website at several locations. These are helpful for some, but not all Veterans are willing to or can effectively type or use a computer without significant support from VHA staff. Implementation of improved kiosks with similar technology as previously described would improve processing time, reduce submission of ineligible claims and restore a component of the travel program that patients appreciated.
   I recommend installation of new patient, friendly kiosks similar to those installed at the facilities until December 2022 to improve processing of travel claims.

Thank you for your attention to these matters. I look forward to working with you on how we can provide a more efficient system for our dedicated VHA workers to serve our nation’s veterans.

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