Emergency Room Bill

[Butcher2510]

I had an emergency room visit while on vacation last year and have been fighting with the hospital billing company to honor my VA health care for over a year.  How do I go about getting me bill paid for by the VA.  Every few months I get a bill from the hospital saying that they have not received any payment.  I continue to call them and refer them to the VA but nothing seems to happen.  First it may have been my fault as I go to the Portland, OR VA so I referred the bill to them, but was ;later informed that I needed to go through the San Francisco VA as that is the region where I received treatment.  I am at a loss as to where to go from here.  Any help would be great. Thanks.

[Tbird]

I found the following phone numbers that may help - my personal experience is that it takes forever to get them to pay, you have to follow up a lot and watch your credit report -

Billing Office 
(866) 347-2353

Also you may want to try County Veterans Service Officer (San Francisco) 
(415) 379-5613/(415) 503-2000 and see if they can tell you how you need to contact.

[Gastone]

Could be wrong, I think your chances are slim and maybe none. It appears that you didn't follow the VA Rules regarding Emergency Room Visits to non-VMC Hospitals. The fact that you got billed by the non VA Hospital, for anything, indicates you or the Hosp ER Staff, never contacted the VA.

Had you or anyone else that accompanied you to the ER, notified the ER Intake Rep that you were coming in under VA Emergency Coverage, the Bill wouldn't be your problem. Was the VA ever contacted after your admission for Treatment Approval and to set up transport to a VMC, once you were stabilized? The steps for using non VA Emergency care, as to notifying both the VA & the Non VA Hosp, are mandatory, not optional.

If the nearest VMC doesn't have a Bed or a Dr to treat you, the VMC MFIC can authorize your continued care at the non VA Hosp, after you've been stabilized. All contacts with the VA at time of admission, when requesting ER Coverage has to be documented.

When was your 1st VA contact, after you got billed?

Semper Fi

[armorer]

3 hours ago, Gastone said:

Could be wrong, I think your chances are slim and maybe none. It appears that you didn't follow the VA Rules regarding Emergency Room Visits to non-VMC Hospitals. The fact that you got billed by the non VA Hospital, for anything, indicates you or the Hosp ER Staff, never contacted the VA.

Had you or anyone else that accompanied you to the ER, notified the ER Intake Rep that you were coming in under VA Emergency Coverage, the Bill wouldn't be your problem. Was the VA ever contacted after your admission for Treatment Approval and to set up transport to a VMC, once you were stabilized? The steps for using non VA Emergency care, as to notifying both the VA & the Non VA Hosp, are mandatory, not optional.

If the nearest VMC doesn't have a Bed or a Dr to treat you, the VMC MFIC can authorize your continued care at the non VA Hosp, after you've been stabilized. All contacts with the VA at time of admission, when requesting ER Coverage has to be documented.

When was your 1st VA contact, after you got billed?

Semper Fi

Thanks for the education! I aways grab my card if I have a dental antibiotic drugs at Walmart, but so far it hasn't done anything but waste my time, so I pay the Walmart $4/drug charge (and I hear VA drugs where I'm at are cheap substitutes with many side-effects.) I don't think any medical service would opt to work with the VA's paperwork, delays, and incompetence: but I don't know for a fact. But some health care providers I have heard will give you free services if you don't make them work with the VA, ha ha.

[Gastone]

Armorer, I hear ya, many Vets have that same initial opinion. The VA, like most Private RX Ins Providers, has an RX Formulary, that they use. I was on Lipitor (01/2006) back in 09, when I 1st got hooked up with VA. VA's Formulary called for Simvastatin and my Private Dr didn't stipulate, Lipitor only.

So I tried the Simvastatin. for about 1 yr, kept the Cholesterol #'s in check but started getting hell-latios Charley-horses late at night, in my thighs. Contacted my VA PCP, within 1 week, I started receiving the non-formulary Lipitor.

The VA can and will supply you with any RX that you need, even if it's not on the VA Formulary. You can understand them, like all RX providers, preferring to use the most cost effective drug available.

Just about all Rx's have some type of possible side-affect. the VA doesn't lock you into the (1) drug.

As to Butcher's situation. You know, all Private Hospital ER's must treat you, right. It doesn't matter what your Insurance situation is, Private, VA or Uninsured. Hospitals, unlike Private Dr's, can not refuse a Vet using the VA Emergency Room coverage. I don't think that is Butcher's problem.

VA regulations covering Non-VA Hospital ER coverage requires the Vet, Hospital ER Staff and/or the Vet's next Of-Kin, to notify the nearest VMC almost immediately, regarding the Non-VMC ER Admission.  Doing so gets the entire ER Bill covered, not doing so puts you in a real Trick Bag. Given the option, Private Hospitals will go to the fastest and most lucrative payer, Insurance Companies, private Individual and lastly the VA. If the VMC doesn't have a bed or Care required by the Vet's ER Condition, the VMC Chief can authorize continued care after the the Vet is Stabilized. Otherwise, the VMC will arrange Ambulance transfer to the VMC after the VEt is stabilized.

The Rule of Thumb for Vet's, present your VA ID and request the ER Staff contact the nearest VMC. Keep your Medicare or other Medical Insurance card, hidden in your wallet (Don't mention your other Ins coverage), incase your unconscious and not accompanied by a knowledgeable family member. Both Medicare and Private Insurance companies have a sizable co-pays, 20% of $100K, would definitely FU your Day. Don't take the chance, follow the VA Rules, much easier and less stress.

Semper Fi

[armorer]

Well that is locked and loaded now :) I think the secret to any VA hospital is to know where the 'pockets' of competence are at. I hope I never find out about entering a VA hospital unconscious. I don't think I'd make it through the night on IV's with anti-freeze mixed in them. I do not have any drug resistance built up, and I probably need one of those bright colored silicone wrist bands with a warning. I was in a comma for 2 weeks once, and wonder if it was delayed due to an IV drug side-effect. 

Thanks for the VA hospital instructions! I may put easy 1-2-3 instructions, front and center, in my wallet to help hospitals out just in case. You just never know when you should have changed your underwear :D

[Buck52]

Butcher2510  Everyone has good information here.

Here is some regulation on this that might make it easier to understand.

http://www.tampa.va.gov/patients/emergency-care.asp

 

........................Buck