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Ebenefits Shows Two Claims In "authorization" One In "administrative Review"


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9 replies to this topic

#1 justrluk

 
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Posted 02 September 2010 - 07:16 AM

I noticed this morning that changes happened to 3 claims marked "Closed" on eBenefits:
2 have a status of "Authorization Review" with no Appeal possible
1 has a status of "Administrative Review" with Appeal possible

I have one claim in Appeals which may represent one of these, but I can't tell from the document listing in the details. Does anyone know what this might mean???

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#2 justrluk

 
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Posted 08 September 2010 - 09:26 AM

Has anyone had a chance to take a look at this?? I would really appreciate any feedback...

I noticed this morning that changes happened to 3 claims marked "Closed" on eBenefits:
2 have a status of "Authorization Review" with no Appeal possible
1 has a status of "Administrative Review" with Appeal possible

I have one claim in Appeals which may represent one of these, but I can't tell from the document listing in the details. Does anyone know what this might mean???



#3 JustPLS

 
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Posted 08 September 2010 - 04:15 PM

I'm not able to offer any explanation, but I can tell you that you are not alone. Ebenefits appears to be a good idea that is still in development. I have asked questions like yours through IRIS and have received no good answers.

I have had claims go from development to authorization and back again within a couple of days on Ebenefits. When my IRIS was answered, they said that it was still a work in progress, and promised it will get better.

There is a separate item on the dashboard to get information on appeals. Appeals are not included with your claims.

I think it also depends on whether or not your VARO updates information regularly.

Edited by JustPLS, 08 September 2010 - 04:18 PM.


#4 justrluk

 
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Posted 01 October 2010 - 07:09 AM

Saw another claim move to the Decision Phase in eBenefits. They say on the site their average is +/- 28 days to notification. Let's see how they perform...



#5 stillhere

 
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Posted 01 October 2010 - 09:08 AM

Wish I could help but this ebenefits stuff is still Greek to me.

While I use and am authenticated by My Health evet I have not been able to get that set up on the ebenefits site.

#6 carlie

 
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Posted 01 October 2010 - 09:16 AM

People, people, people -

Whether it's the 800 #, Iris, My HealtheVet or ebenefits -
we simply are still not going to be able to track each and every step of our claim issues.

It just isn't possible.

They would literally need to put a GPS device on our file and a log in device at each station,
to accept recognition of the GPS device.

#7 justrluk

 
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Posted 01 October 2010 - 10:21 AM

Noted - not hoping to track each and every step, but seeing some change in status does provide some hope that this issue is at least in motion Since my VSO seems to be MIA for the last month or so, it's the only contact I have with the system. True or not, it at least satisfies my OCD re: knowing where things are, and what I could be doing in support of the claim.

Edited by justrluk, 01 October 2010 - 10:24 AM.


#8 Teac

 
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Posted 02 October 2010 - 11:03 PM

I don't think anyone expects to track a clam and certainally not by using iris, phone or ebenefits... However it would be wonderful if just once we could use these tools and receive acurate informaton concerning any claim in the system.
It seems the more options we are afforded, the less accurate the information is. I remember when you could call the 1800 number, and someone in your states regional office answered the phone, normally in most cases the information was accurate and the people on the other end were helpful.. Today, the folks at the 1800 number can't spell their own names,, ok so may be that is a little harsh, but they damn sure can't provide accurate information and it is proven time and again simply by calling more than once, and it is likely fhat for every call you make, you receive a different answer to the same question. Now as to iris, I guess it depends on rather the va employee can read English or not , I know the Houston office has a problem, because somehow the equate a request for a EED for my sinusitis as a new claim for allergic rhitinis, and my request to reinstate my 10% for hemorriods , (after a reduction, without any previous letter, or warning, ie no due process) as a new claim for hemorriods.....And when it comes to the ebenifits, well it isn't updated in real time, and the informatin that is provided is not always self explainable.. ie, authorizition review? what does that mean, or and what claim are they even talking about, what about the YES, appeal possible, is this a heads up that a claim was completed and disapproved and the va expects you to appeal.. If that is the case, why has it been over a month and still no letter.... Bottom line, the lack of communication between the veteran and the VA is a serious problem. In a perfect world, We should be able to pick up the phone and speak to a represenative in our own state about our claim....and this simply isn't possible and the only rason in my mind is that the va does not want us to contact them concerning our claims, because they don't want to be bothered.

#9 carlie

 
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Posted 03 October 2010 - 11:03 AM

In my opinion, the real reason there can not be accurate tracking of claims
would be something like this:

Your claim is with the Rating Board (decision maker) awaiting a decision.
The decision maker now request additional development
on an issue - which could be many things such as some kind
of information requested from the claimant is not of record yet,
(a completed ROI form for private treatment or SSA records)
an additional C&P gets ordered or the decision maker feels the
C&P that was done is inadequate for rating purposes or the
examiner negated to provide an opinion.
Perhaps the pre-determination team did not send out a VCAA letter
and this still needs to be done.

This would apply to all the different teams / levels.

#10 john999

 
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Posted 03 October 2010 - 01:01 PM

I am not really sure the VA wants a vet to be able to see into the claims process. What would they find: mistakes, errors, delays, incompetence on vast level. As long as the process is in a black box we can't see it and know how bad the process. My initial claims usually look like a 6 year old did them when I get the rating back. My doctor can't understand it. I can't understand it, and my lawyer can't understand how they got the end product.




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