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LSGi
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Posts posted by LSGi
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On 12/19/2018 at 12:21 PM, acesup said:
It is SOP nowadays. Back in the old days, VA never asked an SC disabled vet for such info; if you met the qualifications, VA covered all costs of your medical care, prescriptions, whatever (as long as treatment was by VA, that is, or approved for "Fee Basis" or something like that.
I went for a long time where I only used private medical care, since I had a "Cadillac" plan through my former employer. When I started going back to VA for some treatments and other things, including prescriptions, starting in 2009, they began billing my Medicare and my secondary insurer for anything and everything. Some change in the law over they years allows VA to bill insurers, even if you're 100%. However, there has never been a deductible for anything I've received from VA. The deal is, if your SC disabilities qualify you for free care, it will still cost YOU nothing.
i'm curious,did your medicare of secondary insurer ever deny payment, i.e., they figured VA should have paid for some things that VA billed them for?
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20 hours ago, Buck52 said:
If your not sure what to do check with your Hospital Director Office The person at the desk should be able to clear this up..this is what I did what I did when I got on medicare...they take your medicare card and run it through a machine that detects the code on these new medicare cards, also each clinic you report to show them your medicare card and any supplement cards you have.
After that I am not sure how they charge each other but I think VA pays Most of your health care if done at the VA, They do charge medicare a certain % its pretty low I think but its just to help offset the high cost from the VA. (JMO)
i'm all for offsetting the high cost Americans/Veterans pay for healthcare in this country so every citizen gets a fair shake for quality healthcare...just some of this billing is just hard to wrap my head around. i'll check with that office, good idea, thanks.
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14 hours ago, Vync said:
Back when I was exploring this, I was told the VA typically will try to bill private health insurance companies. However, they are not supposed to bill for treatment of SC disabilities.
Earlier this year, I was sent by the VA via the choice program to a non-VA doctor to have a procedure performed. The VA paid the bill for the doctor. However, they did not pay for the CRNA and anesthesiologist bills. I just got those in the mail the other day. I had to call my VAMC's community care office and they are going to look into it. I also called the billing agency and let them know so I would not receive any nastygrams in the mail. It will probably take them forever to get it all sorted out.
the VA person that called wanting the info said the same, i.e., they only bill for non-SC disabilities. like you, i asked twice and asked another person at VA and they came back with the same statement.
Yet, we all know the VA, good & bad, and in your case, that's what i'm trying to preempt...the huge bills that we shouldn't be getting and along with that the non-stop calls from medical bill collection outfits.
though the paperwork for my recent Choice appt states all of it was approved and no copay or such was mentioned and the center that did the procedures didn't ask for any dough upfront i'm always leery that in the mailbox will be those unforeseen bills. and as you say, they(VA) often takes forever. plenty of these stories abound out there from many veterans so leery is a bit warranted for all of us.
i'll keep my fingers crossed. appreciate your reply and hope they sort it out for you soon with positive outcome.
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3 hours ago, doc25 said:
I use my health insurance. I figured if I have employer health insurance, the least I could do, is use it so my insurance can pay some of the VA services. VA can take care of another veteran that is homeless and unemployed that doesn't have insurance.
But, that's just me.
makes sense and i agree to some degree. i guess what gets me a bit, is the god awful amount of money & time va spends to NOT pay compensation when verifiable evidence is presented. then after a lifetime fighting for that, you get it, then you can afford a monthly premium, and they want to jump on that and use it to save them money.
i'm replying to everyone but for some reason i don't see my replies...
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3 hours ago, Buck52 said:
We have to report any health insurance we get to the VA and that includes medicare, They will bill them a part but not all I think VA foots most of the health bill but the others pay a part too. ..I don't know why.....I drop my supplemental I had after I got on medicare...I may pick it back up if my health gets worse like Heart problems or any VA Specialty clinics b/c I want private care for that.
so we "have to" report this? i didn't know. if not for medicare supplement i'd still be told by va they don't see my problems but "something" is there. civilian docs diagnosed it in no time. glad i got the supplement as va really doesn't want to treat/pay for incurable service connected things as they tend to cost more as we get older. most times i feel like the can that gets kicked down the road after va visits. residuals from dealing with them over the years i guess. thanks for reply and letting me know.
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5 hours ago, Sgt. Wilky said:
I always thought it was immoral for the VA to bill medicare or my private insurance for ailments. They owe, they should pay. "Big Insurance" or not, the VA is good at passing the buck, and this is another prime example of them not taking responsibility for their promises.
Sgt. Wilky
this is why i posted my question as i have similar thoughts. i don't see how my medicare supplement would be willing to pay for my VA SC issues when i see VA. i see why when i go to a civilian doctor or civilian treatment but not when i go to VA. recently had to use Choice. and now they want this info. just seems like a round-robin pay shuffle game. since its a medicare supplement i guess somewhere there is a rule/law the company will pay but i don't see how they could keep their books straight or make a profit. i pay the premiums, seems VA has a way to piggyback on that.
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8 hours ago, acesup said:
It is SOP nowadays. Back in the old days, VA never asked an SC disabled vet for such info; if you met the qualifications, VA covered all costs of your medical care, prescriptions, whatever (as long as treatment was by VA, that is, or approved for "Fee Basis" or something like that.
I went for a long time where I only used private medical care, since I had a "Cadillac" plan through my former employer. When I started going back to VA for some treatments and other things, including prescriptions, starting in 2009, they began billing my Medicare and my secondary insurer for anything and everything. Some change in the law over they years allows VA to bill insurers, even if you're 100%. However, there has never been a deductible for anything I've received from VA. The deal is, if your SC disabilities qualify you for free care, it will still cost YOU nothing.
appreciate your reply & insights. i guess the feds somewhere in this equation pays the priv insurer.
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On 11/7/2018 at 7:44 AM, Buck52 said:
I think the VA Id cards are useless..I've never had to use mine they always ask me my last 4..eh!
i have same experience. odd but it is the va/gov
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On 11/7/2018 at 5:43 AM, SgtStelmo said:
Broncovet,
I agree with your excellent advice. As I read your advice I was reminded of another of my pet peeve's. I do not remember exactly when, but it certainly was years ago that the VA decided to issue new VA ID cards. At that time, their stated reason was to provide each Veteran with an identification number such that they could discontinue using SSN's.
Well I have the new card and the ID number on it. But after spending all that money the VA still uses one's SSN. Not one time have I ever needed to use my VA assigned ID number.
me neither. but they sure want veteran's priv insurance card number too these days. am i the only one that thinks that odd if one is 100+ SC?d. i posted this question in new thread.
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On 11/6/2018 at 12:25 PM, Vync said:
Good advice from Broncovet about being on the lookout for phone scammers. If you encounter any, be sure to go to FCC's web site and report them: https://consumercomplaints.fcc.gov/hc/en-us Adding your number to the "do not call" registry can also help: https://donotcall.gov
I haven't got any calls from the VA pharmacy about my medications. When the VA succumbed to the red tape, my primary care doc simply said they could not refill any. Instead, I had to go through the VA pain clinic.
thanks. i put my phone on that donotcall list. helps some. the VA now sends out narcan to those on pain meds. i felt dirty when i got that in the mail. don't know why, but i did.
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On 11/6/2018 at 6:37 AM, broncovet said:
Of course, what Sgt Stelmo says is true. However, scammers integrate their "scams" into current issues like this, so you have to exercise caution, especially if they ask your SSN. The VA usually asks for your last 4, scammers want everything. Best is if you call them, then you know who you are speaking with. When they call you, they can "spoof" the caller id and make it appear they are with the VA when they are not. Vets and seniors are targets of scammers, and, usually if something is "odd" then there is a good reason. The VA cut me off opiates, but I got no phone calls, the doc simply said no more.
I can not say this is/is not a scam, but I get several calls a month from people claiming to be with "Windows", IRS, etc.etc. "Microsoft" does not call its users to tell the of a malware infection, so this is always a scam. Likewise, va does not call you and ask for your ssn, etc. They may ask for your "last 4", however. The last 4 wont help a scammer, but will help VA identify you.
they asked for last 4. the call was logged into my file as my primary and nurse at my va clinic knew of it and the pharmacist's name. pretty sure the call was legit this time. thanks for the info. the scam calls we all get is off the charts these days.
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On 11/6/2018 at 1:16 AM, LSGi said:
i'll see what they say via phone first, it may be nothing, but then again, it just seems odd to me. and you too i see. i'll check back after call
sorry for being so late.
it was a new standard for VA pharm's to call pt's who are/have been on long term pain meds. want to know how its working, what other things i do to help with pain, (i.e., exercise, meditation, what foods i eat, any adverse reactions to meds, those kind of things.). same type of questions my primary has asked over the years. primary has a medical degree and years of experience seeing me and talking with me, versus, i've never met anyone from a VA pharm in my life that i know of.
we all know now, the CDC & how political it is, lumped all the opioid deaths in with legit chronic diseased/injury longterm use patients who have had little to no neg issues with their pain meds over the years. so the media and politicians knee-jerk out opines and bad policies. politicians, media, big pharm don't want to take on nation actors(you know who they are) who are and have been flooding this country with fentanyl/meth, and the like, so they side step that, and the patients who hadn't had any issues get slammed dunked by these policies. and of course, more population control as all of us legit patients got tossed into a national database and telling pharmacists they know better than a patient's doctor.
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On 11/6/2018 at 4:53 AM, SgtStelmo said:
I have an answer here. You have heard of the 'opioid epidemic' this country is experiencing. As such, the government is tracking down on these and other addictive drugs. (i.e. benzopyrenes). This is not necessarily the doing of the VA, but what is required pursuant to collateral government bureaucracy. And so when you identify the drug as 'pain med' I am sure this is but the first step of their changing your routine.
Sadly our government (not just the VA) tends to overreact. And that is what is going on now. My dad was dying. The doctor wrote out a script and gave it to me. She said right from the start, good luck getting this filled. It is almost next to impossible. I lucked out and after a half dozen pharmacies I found one willing to sell the drug. I do not remember the name but it was an opioid. So the sick pay the price for the criminal actions of others, a really sad outcome.
sorry for delay in reply. yes, it was the VA pharm who called in a phone interview to go over things. sort of odd a pharmacy person calls to discuss my med treatment and not my primary care doctor. interview went ok. just strange but i know why they do it now since i posted this thread/question. non-VA doctor said the same and mentioned it is happening to all his patients now too. mentioned a pharm's have over-ridden him and yet, the pharm's know nothing about the patient or history. thanks
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2 hours ago, Berta said:
Was " she" a real MH doctor?
Have you googled her name to see what qualifications she has to opine on a MH disability?
Yes, you can appeal and go to the BVA or contact a real (non VA) MH doctor for an IMO.
so we can request a non-VA MH doctor to do the C&P MH exam?
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regarding veterans with 100+% SC disabilities, is it ok to give VA one's civilian medical insurance card information when they ask for it? i don't know, which is why i ask. recently made use of the "choice program" for SC procedures/tests that that is covered along with no co-pay. and now i get phone calls from VA to home phone wanting my civilian insurance info. may be a nothing burger, but wanted to get advice/educated on this.
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8 hours ago, broncovet said:
I think you should get to the bottom of this, and visit your local VA pharmacy. This is a great question.
i'll see what they say via phone first, it may be nothing, but then again, it just seems odd to me. and you too i see. i'll check back after call
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recently was called by VA pharm to setup a phone consult with VA pharm to ask questions about the pain med i'm on. (for 10yrs). caller mentioned this is a new protocol for this VA. i've never had this type of call before. usually PCP would generally ask about such things with each visit.
caller mentioned some med, forget the type, something about blood type med. high blood pressure or thinner or something, when i asked what the call was about. i'm not even on that type med that the caller mentioned. can't help but have a sense of suspicion with that reply.
with all the crack down on pain meds in this country, wondering if this is a prelude to them switching gears on me or something. i hear/read these type stories all over the country last few years. anyone else hear about these type VA pharm calls and/or participated in one? what can i expect?
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38 minutes ago, BuddyLoveAK said:
You can submit a question with IRIS here:
https://iris.custhelp.com/app/ask/session/L3RpbWUvMTMzNTM1NTAyOC9zaWQvdmE2Q0R3V2s%3D
And you can check and see what month/year they're working on here:
thanks for the links. the worriesome mind took over and i had forgotten about these. i can see why the attorney might get annoyed with my questions, though he didn't say as much, so i'm projecting a bit.
thanks for the help
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1 minute ago, broncovet said:
Two years, while frustrating, isnt a long time to VA appeals. If it makes you feel better, then call your attorney, check ebenefits, or even call the BVA to check the status.
you're right. i guess its more with me and the "feel better thinking i'm doing something". guess the attorney knew that too. appreciate the advice.
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i have an attorney who filed an appeal about 2 years ago. i asked him recently if he would check with VA on status.
my question is, should the attorney or veteran check on the appeals status periodically or does that just cause issues with the appeals itself? i don't want to keep asking him if that is the wrong protocol, i mean, VA way of things is a bit strange anyway,
tia
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darn, i see i posted twice. brain malfunction with 2 computers. i'll deltet one. its been a rough few months with my ms.
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I don't know the regulation, but common sense says the VA should include private medical records in their medical file on a vet. This does not take a genius to understand. When I got supplies for OSA from VA they relied on my private records. They just lost half of them. The VA wants to "own" your medical care. HA, HA, HA. Yes, and the VA still bills my insurance for everything including SC treatment. If you have DMII that is SC and your doctor does your blood work and glucose testing at the VA how can they bill your private insurance? They do it and dumb insurance pays them because VA knows the insurance company does not want to fight with the VA over small claims. The VA is a lawless organization unless you can hit them over the head and make it hurt.
see, we think alike. whew, good. you already know i'm a little slow in the head, glad we're on the same page.
boggles my mind the billed my priv insurance for SC issues. my concern at the time, when i was able to work, was it affecting work related issues like promotion and security issues. that was my big concern about the priv issues. you understand.
yeah common sense. i mean we [have to] include civilian medical reports to counter VA medical reports in our c-file for claims when such counters are warranted.
for many veterans its life and death...from AO fiasco and including those veterans that died of gastric cancer recently.
i agree, its ventured into the criminal arena on many fronts, from its not answering to Congress nor to veterans, zero accountability, the AO issues, gulf war syndrom which is now called "multi-system illness", denying spouses compensation after veteran dies, etc etc.
i'll keep looking and see i can find a link about VA supposed to acknowledge civilian medical reports thus my question as to whye ROI wouldn't scan it in though they used to.
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If you are 65 or older you can still deduct the medical expenses you paid that exceeded 7.5% of your adjusted gross income. If you are less than 65 you can only deduct the expenses you paid that exceeded 10% of your adjusted gross income. Medical insurance premiums are considered a deductible medical expense in certain situations. Check online with the IRS to determine if your situation permits you to deduct the premiums. I am not sure if IMOs would be deductible or not since this is a report and not a hands on medical exam. I would think an IME would be deductible but you need to check with a tax professional to find out about the IMO and IME.
Georgiapapa...
ok, thanks for the explanation. for my mind, i didn't think of a difference in IMO and IME. if thats an exam i've had those. i'll check the IRS site when my brain clears up a bit. i still ahve to have someone do my taxes even on only disablility income as i find the tax prep a bit much for my brain. i'll file this thread in my tax box for next years. thanks
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I think they would be if you itemize your taxes. I know it went up from 7% of your income to 10% I think before you can get a deduction. Do you know if medical insurance premiums are deductible? Now days you almost have to have a big mortgage to itemize.
i don't know the answer to that. i was just something that crossed my brain. i don't make enough or have such mortgage whereby many deductions are on my radar. the tax preparer at a national chain the other day mentioned medical expenses to me. i mentioned i go to VA and some civilian and he said co-pays, ER visits, hospital stays i could deduct. i never really thought about it. he keep a record for next year. when i got home the thought of IMOs that many of us have paid for (the only way to counter VA) popped up.
VA wanting veterans priv insurance info, is this SOP?
in VA Disability Claims Research
Posted
fully empathize about the burned in the past. they tell me they don't bill for SC issues, nevertheless, trust but verify as they say.