Service 02 · Billing and collections

Federal Payer Billing & Collection Services

Your DCSP posts every remit, works every denial and collects every patient balance. Billing and collections is its own service with its own desk, beside Workflow — not a module inside it. DutyPath is the software; it never bills a veteran, never touches patient money and never performs collections itself.

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The claim side

Every 835 is posted against the claim it belongs to, keyed on the patient control number and the payer's claim control number. Payments post, contractual adjustments post, and every denial is routed by its reason code to a task with the next action already written: re-route, attach the referral, reconsider, correct and resubmit, dispute the coordination of benefits.

Misroutes are caught before the payer says so. A VA community care claim heading to TRICARE because TRICARE was on the patient's card is stopped at scrub; a CO-109 that slipped through becomes a re-route task naming the gateway on the referral, with the 180-day clock checked first.

Timely filing, reconsideration and corrected-claim windows tracked per gateway — Optum Serve, TriWest, VA FSC, TRICARE East and West, CHAMPVA, Medicare, Medicaid, commercial.
Underpayments checked against the fee schedule; the variance becomes a reprocessing request with the citation attached.
Secondary coverage billed before the patient sees a balance.
Follow-up at 21 days with no remit; deadline alerts 30 days out with the dollars at risk.

The patient side

A statement goes out only after the payer adjudicates, only for the share the remit assigned to the patient, and every statement is itemized. TRICARE and CHAMPVA cost-shares are quoted exactly as the explanation of benefits shows them. Self-pay statements carry the Good Faith Estimate.

Collections run on a published sequence — three statements, a courtesy call, a final notice, a review — and a dispute pauses the account the day it is raised. Interest-free payment plans are always available. No interest, no late fees, no credit reporting unless the practice turns them on with its counsel.

The veteran guard

Under VA community care the veteran is never billed by the practice. Any patient responsibility a payer marks on a VA episode is held in insurance A/R and becomes a payer inquiry, not a statement. The rule is enforced three times: in the software the DCSP sees, in the server that produces the statement, and in the database that refuses to post the balance. The counter on the board reads zero and stays there.

What the practice gets

Never a bill to a veteran.
Statements only after adjudication, always itemized.
Your own processor account — DutyPath never holds patient money.
Every posting, statement, payment and hold in a tamper-evident ledger.

Bills sent to veterans. Enforced in the software, the server and the database.

Worked by your DCSP · Bills sent to veterans: 0 — enforced in the software, the server and the database

Also for practices

DutyPath is software. Billing and collections work is performed by DCSP members for the practices they serve; DutyPath never bills a veteran, never holds patient money and never performs collections itself. The Professional Training Program issues a certificate of completion; it is not a credential.