VA Healthcare
VA Healthcare is a government / military health plan. For an ASC, what matters isn't the logo. It's how VA Healthcare pays: where it runs rich, where it runs thin, and how its reimbursement compares with peer plans for the same procedures.
Pilot Analysis
Get the complete VA Healthcare analysis
Tell us where to send it. Our team will prepare an analysis of VA Healthcare covering rates by code, market position, and underpaid areas, and email it to you within 5-10 business days. Need it faster? Book a demo.
What Insights reveals
How VA Healthcare pays
See how VA Healthcare reimburses across procedures and markets, benchmarked against the peer plans competing for the same cases. Not a raw rate sheet, a read on where it sits.
Geographic footprint
See where VA Healthcare concentrates and how its presence shapes the markets you compete in.
Peer position
Put your own position next to the benchmark for VA Healthcare and bring the gap to your next contract conversation.
Specialty mix
Understand which procedures and specialties drive VA Healthcare's volume, so you know where a rate change moves the needle.
Whether you're an ASC benchmarking a contract or a provider team looking VA Healthcare up, DataLily AI maps how it reimburses across procedures and markets, and where your own rates sit against the peer benchmark.
Reference
Working with VA Healthcare
- Payer ID
- Z96272 is the EDI identifier used to route electronic eligibility checks (270/271), claim-status inquiries (276/277), and claims to VA Healthcare through a clearinghouse.
- Eligibility verification
- Coverage and benefits for VA Healthcare members are verified before the date of service, through a clearinghouse using payer ID Z96272or through the payer's provider portal.
- Prior authorization
- Requirements are set per plan and per procedure. Confirm whether an authorization is required with VA Healthcare directly before the date of service.
Book a demo: pick a time
A 15-minute walkthrough of VA Healthcare the way it pays.
- What is VA Healthcare's payer ID?
- VA Healthcare's electronic payer ID is Z96272. ASC billing teams use it to route eligibility checks (270/271), claim-status inquiries (276/277), and electronic claims to VA Healthcare through a clearinghouse.
- How do ASCs verify eligibility for VA Healthcare members?
- Eligibility and benefits for VA Healthcare members are verified before the date of service, either electronically through a clearinghouse (a 270/271 transaction using payer ID Z96272) or through the payer's provider portal.
- Does VA Healthcare require prior authorization for ASC procedures?
- Prior-authorization requirements for VA Healthcare are set per plan and per procedure. Confirm whether an authorization is required with VA Healthcare directly before the date of service.
- What type of payer is VA Healthcare?
- VA Healthcare is a government / military health plan.
- How does VA Healthcare compare with other payers for ASC procedures?
- Ask Rose and you get a plain-language read on where VA Healthcare pays above or below peer plans for your top procedures, charted, and ending in a recommendation you can take into a contract conversation.
- Is VA Healthcare paying my ASC below market?
- Put your own VA Healthcare contract next to the peer benchmark in DataLily AI and you'll see the gap by procedure and market, the fastest way to know whether you're leaving money on the table.