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VA Community Care Recovery

Revecore delivers specialized end-to-end VA Community Care billing — managing federal authorization requirements, eligibility verification, and program-specific compliance that fall well outside standard revenue cycle workflows.

Every VA Dollar Starts with Getting Authorization Right

Revecore verifies service-connected status, confirms authorization numbers, and aligns rev codes and HCPCS before a single claim goes out — connecting directly to Optum Serve, TriWest, TRICARE, and VA Community Care systems so nothing gets misrouted or denied on a technicality.

Performance by the Numbers

Revecore's dedicated VA teams, purpose-built technology, and contingency-based model turn VA claims from a compliance liability into a reliable, fast-paying revenue stream.

96%

Claims closed with payment

24

Avg. days to payment

9

Avg. days to bill submission

VA Claims Done Right the First Time

  1. Identification & Eligibility

    Automated intake via payer class and veteran status indicators routes every claim correctly — with service-connected versus non-service-connected status verified before billing begins.

  2. Compliant Billing & Submission

    Fully electronic VA billing with rev code and HCPCS alignment, medical records attached at submission, and 80,000+ compliance rules enforcing correct first-pass acceptance.

  3. Follow-Up, Validation & Recovery

    Active denial management with payer-specific appeal workflows, daily Epic reconciliation, and payment validated against VA fee schedules before close.

What Sets Revecore Apart

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  1. Dedicated VA specialists — not generalist billers

  2. Direct electronic connectivity to Optum Serve, TriWest, and TRICARE

  3. 80,000+ compliance rules embedded in ReClaim

  4. Attorney-informed escalation workflows for contested or rejected claims

  5. Contingency-based model — no upfront fees, no implementation costs

Case Study: Midwest Health System

  • Challenge

    A six-hospital Midwest health system had built a functioning VA claims program but wanted to push performance further. With $2.6M in annual VA recoveries through their existing vendor, leadership believed the program had more upside — and set out to find a partner who could unlock it.

  • Solution

    The health system transitioned VA claims management to Revecore, prioritizing a partner with direct payer connectivity, compliance-first workflows, and a proven track record. The transition was executed on the same placement volume, making the performance comparison clear and clean from day one.

Results

  1. Monthly recoveries increased from $216K to $540K — a 150% improvement

  2. $3.9M in additional VA revenue recovered in the first 12 months

  3. Same placement volume, materially better outcomes

Revecore has blown our previous firm out of the water when it comes to results. Revecore has far and above exceeded our expectations and baseline measures. The firm is also fast at responding, and they give good feedback, help, and explanations as needed. (Complex Claims, Veterans Affairs)

— Director, January 2025 Collected by KLAS Research

Frequently Asked Questions

How is VA Community Care billing different from commercial billing?

VA claims are governed by federal authorization requirements, program-specific eligibility rules, and documentation standards that fall well outside standard billing workflows. Authorization errors and missed deadlines aren't forgiven — getting it right requires dedicated expertise and purpose-built tools, not a generalist team.

Why do VA claims fail at higher rates with standard billing teams?

Most billing teams lack the tools to verify service-connected status, confirm authorization numbers, and align rev codes and HCPCS before submission. Without those steps completed correctly at intake, preventable denials stack up - and A/R extends on a payer that, managed correctly, pays reliably and fast.

Which VA payer networks does Revecore connect to?

Revecore has direct electronic billing connectivity to Optum Serve, TriWest, TRICARE, and VA Community Care - ensuring claims are routed correctly and submitted electronically for faster processing.

How does Revecore handle service-connected status?

Every account is verified for service-connected status before billing begins. That distinction drives authorization requirements, fee schedule applicability, and routing - and getting it wrong at intake is one of the most common sources of preventable VA denials.

What happens when a VA claim is denied?

Revecore's active denial management workflows include payer-specific appeal processes and deadline tracking. Attorney-informed escalation is built into the workflow for contested or rejected claims - not bolted on after the fact.

Does Revecore integrate with Epic for VA billing?

Yes. Revecore performs daily Epic reconciliation and validates payments against VA fee schedules before claims are closed — ensuring nothing falls through the cracks between billing and posting.

How is Revecore compensated for VA recovery?

Revecore operates on a fully contingency-based model with no upfront fees and no implementation costs. Fees are earned only when VA revenue is successfully recovered on your behalf.

How does Revecore compare to other VA vendors?

96% of VA claims closed with payment, 24-day average to payment, 9-day average from discharge to bill submission. For health systems coming from other vendors, the difference is typically immediate.

Is Your VA Program Performing at This Level?

Connect with Revecore to benchmark your current VA performance and see what a dedicated, compliance-first program can deliver.

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