Admitted Into The Hospital

[Cherie33]

Good Afternoon All,

On Dec. 28, 2007 - I began having chest pains, my blood pressure went up, my chest felt as if someone was sitting on it, I felt hot all over, I was dizzy and felt as if I was going to faint.

To make a long story short, I was very hesitate to call 911, because I wasn't sure what was going on. But because after hours of feeling this way, we decided to call 911. The resue came and told me that they thought that I should go to the hospital. So, I went. The emergency room immediately began running test, and utimately decided to admit me for more test. So, I spent 5 days in the hospital. I was released on Jan. 2, 2008.

While I was there, my mom contacted my VA Primary Care Dr. and he told me to stay in the hospital until they found out what was going on. And that the VA should cover the cost. (Being that the nearest VA Hospital is in Gainesville, FL. Which is about 1 1/2 hours away from me.)He also told me to talk to a Social Worker in the hospital and let them know that I am a disabled vet and to contact the VA in Gainesville. I did speak with a social worker and she said that the VA usually does cover the cost when you are admitted for observasion and additional test.

Well, I received a letter in the mail today from the Gainesville VA stating that and I quote:

Claim has been disapproved.

Payment may be made only if all three of the following criteria are met; (1) Care or services were rendered for an adjudicated service-connected disability or for any condition of a veteran who has been determined to be totally and permanently disabled as a result of a service-connected disability; (2) Care and services were rendered in a medical emergency of such a nature that delay would have been hazardous to life or health; (3) VA or other federal facilities were not feasibly available.

Unquote

They sent me a letter of my appeal rights. I'm not sure of what to do. I do not have any medical insurance besides the VA. And when I saw one of my doctors, she felt as if I had a Panic Attack (which is one of my disabilities)

I need some advice...Please help.

Thanks,

Cherie33

[sixthscents]

Theres been some very GOOD advise on this thread so I'll only make a couple of comments...

As stated take the claim to the fee basis office NOT your CBOC, they cannot help anything.

The VA Should eventually pony up on this, just dont give up.

Phillip - go easy man, we all know the VA is not charity or welfare... right? Oh, I was told you tried to call, give me a yell this week if you can. Tell my housekeeper I said to wake me if I am asleep.

Feel free to "rant"... we all do from time to time... we have to get it off our chests and its only here that others understand. Just try not to rant all the time right?

Good luck and dont give up - also work WITH the hospital so they dont refer the claim to collections, 1. it can show up on your credit report and 2. the collectors are nasty.... Seriously work with them and keep their billing office personally informed of what you are doing ok?

Edited January 31, 2008 by sixthscents

[Cherie33]

Theres been some very GOOD advise on this thread so I'll only make a couple of comments...

As stated take the claim to the fee basis office NOT your CBOC, they cannot help anything.

The VA Should eventually pony up on this, just dont give up.

Phillip - go easy man, we all know the VA is not charity or welfare... right? Oh, I was told you tried to call, give me a yell this week if you can. Tell my housekeeper I said to wake me if I am asleep.

Feel free to "rant"... we all do from time to time... we have to get it off our chests and its only here that others understand. Just try not to rant all the time right?

Good luck and dont give up - also work WITH the hospital so they dont refer the claim to collections, 1. it can show up on your credit report and 2. the collectors are nasty.... Seriously work with them and keep their billing office personally informed of what you are doing ok?

Thanks so much everyone. I will do as advised. I'll keep all of you posted as to each step in this process.

Cherie33