Help Please

[Speaking Out]

I had spoken to all of my doctors at the VA, PC, mental health, Gyn and asked them to write a request for me to be seen by outside physicians due to my experience at this VA and they all agreed that it would be good for me to receive my care outside of that VA hospital. I was told previously that the PC portion had been approved. This morning at 0745 I got a phone call from Jenny Gatchel the manager of fee services and she informed me that the chief of staff Dr. Conti denied the requests, but gave no reason. I can write a letter to appeal the decision. If requests from my treating physicians aren't enough what is it that I can say in a letter that will change this doctor's mind? I am so upset. I have been waiting to go to the doctor until I didn't have to go to the VA again because I was lead to believe that with my history and my doctors saying it would be best for me that it would get approved. I sit here is so much pain that I just have to live with and I am so sick of fighting this system. What should I do?

[iraqx2]

I don't honest what opinion to give you. I feel bad on what you are going through but please do whatever is needed to get help, regardless of the VA system. Best of luck to you.

[carlie]

SO,

This is only my opinion:

Since all of the docs were agreed I would let them know fee basis had been denied and ask them to re-support my request with stronger language, in medical terms as to why they feel this is necessary.

jmho,

carlie

[Pete53]

Actually you can write a letter to appeal and ask for a hearing with at least a Doctor on the panel to help with medical issues. This puts them on the spot cause almost no Doctor is going to take the VA line that you can get all the help that you need at your local VA.

Good Luck

Watch your time limit you have 30 days from date of notice.

[Speaking Out]

Thank you all for your replies. I just got back from my local ER. I was given morphine and checked out thoroughly. A patient advocate at the VA told me he was going to take the denial letter to the chief of staff who has to review and sign it and he may over rule Dr. Conti who is not the chief of staff like the lady from fee services had told me. The patient advocate also told me that I can appeal the decision if the chief of staff doesn't over rule the denial. The chief of staff approved for me to go to my local ER because if I came into the VA they would just have to send me over to IU because there was not a gyn doctor at the VA. While I was in the ER a nurse from the women's clinic called my husband to get the fax number for the billing department at my local ER and she told my husband that I am approved to receive gyn care outside of the VA and the VA would pay for it. My husband explained that I was told just this morning that it was denied. I am waiting for something in writing and then go from there. Thank you all for your support and as mad as I am I will NEVER give up. When I get this settled for me, I plan to help other Veterans in any way I can.

While reviewing this post, I got a call from Susan, the nurse for my PC doctor, asking me for the name of the PC doctor that I am wanting to see outside of the VA. I expalined to her that I was confused because I had gotten a call this morning from the fee services supervisor telling me my requests to be seen outside of the VA were denied. I told her I didn't have a PC doctor picked out because I was told that I first have to get approval and then I have to find a doctor that will accept payment from the VA. I am more confused now than ever. Thankfully, the morphine is helping to keep me calm. Any thoughts?

[sixthscents]

They send a letter stating either approval or denial and the reasons. Personally I would fight this tooth and nail. Its some hack trying to save a dime and I wouldn't stand for it. Your doing the right thing by going thru the patient advocate, just follow that path and see if it gets what you need and if not I'd be contesting it and contacting my senator.

OH and the 30 days mentioned below is from the date of the denial letter, not the phone call.

[Ricky]

Speaking Out - As with any VA decision comes a boat load of confusion. It makes no difference if it is a favorable one or one of insaneness. You seem to be on the right track. Just sit back and relax for a bit while this situation unscrambles. For if the end result is unfavorable you will need a clear mind to attack the issue. Your health is of the utmost inportance so this fee basis issue has to get resolved in your favor before you tackle anything else with the VA. Once this is done and your mind is cleared of it then you can restart the battle with the big VA hahahaha. Hang in there all should be resolved shortly even if you have to appeal the issue. With so many favorable comments comming from the Doc's just today, maybe just maybe it is a good sign and the anger they caused you is for nothing. My fingers are crossed for ya.

Edited January 5, 2008 by Ricky