Contract Care

[drichva]

I was sent to a local private medical doctor for a colonoscopy today. I had the pre-procedure Q & A today. At this time I was told by the Secretary there that I would have to give them my insurance card for private coverage. I have none. I was then told that I would have to pay out of pocket if the VA does not pay in a timely manner. Is this true? if so what is a timely maner? I refused to sign the fiscal responsibility form and gave them my VA Service Connected card.

Any Ideas for my follow-up

[Pete53]

The VA will probably not pay timely and they will only pay what Medicare would but you don't have to pay. If you are worried you might visit with Fee Service at you local VA Hospital and see what they have to say.

Good Luck

PS if you were sent the VA should have made some kind of arrangements.

[mssoup1]

My husband is on fee basis outside of the VAMC because they no longer have a dermatology department. He was granted the fee basis and told to find a doctor who would accept him on a fee basis from the VAMC, then call them back and let them know who the doctor was. They then wrote a letter to that doctor, with a copy to my husband, stating that the VAMC was approving the outside care and to bill the VAMC. They also stated the terms of the fee basis visits; i.e., 4 visits within the next 6 months, then further approval would be needed for more visits, if needed. The doctor would have to request the additional visits. The doctor also needs to send regularly to the VAMC a copy of your medical notes from each visit with him. If he fails to do this, then that is where you can get into a lot of problems with the fee basis care.

I would always, at each visit, take your copy of the approval letter with you to the fee basis doctor. This way, the doctors office can not say they did not receive it. Also, if you get the approval for the fee basis visits, never, never give them your personal insurance cards. We really had to fight this one. We told the doctors office that the VAMC would be paying the bill based on the letter they received, therefore, there was no reason for them to have an personal insurance cards he had, including his Medicare card.

Hope this helps.

mssoup

[drichva]

Thank you for your assistance. Knowing the Government I refused to give the MD my medicare card also. I kniow that if the I pay the doctor in any way I will never get re-imbursed. I do not have a referral letter as this is for testing the doctor is supposed to be a contract doctor but the attitude did not seem like it was contract to me.

[tdak]

hi,

Just so you know, in most states, 30 days is a timely manner for paying medical bills. Like Pete said, The VA will probably not pay timely and they will only pay what Medicare would but you don't have to pay. If you are worried you might visit with Fee Service at you local VA Hospital and see what they have to say.

In some cases, if you talk to the billing dept for your doctor, they will allow extra time, just explain the situation, but keep them updated. Believe me I am still fighting my insurance company to pay for my brain surgery from 2005. They approved the procedure, but then tried to bill me for the difference, something like $139,000. I guess they think I can just write them a check....hahaha.

If you do end up paying out of pocket, you should be able to negotiate the amount, because the doctors try to bill us at the full amount, which would be unfair.

Good luck

I was sent to a local private medical doctor for a colonoscopy today. I had the pre-procedure Q & A today. At this time I was told by the Secretary there that I would have to give them my insurance card for private coverage. I have none. I was then told that I would have to pay out of pocket if the VA does not pay in a timely manner. Is this true? if so what is a timely maner? I refused to sign the fiscal responsibility form and gave them my VA Service Connected card.

Any Ideas for my follow-up