Champva Strikes Again

[purple]

Many weeks ago, I was told my ChampVA that my son's oral surgery would be covered because it wasn't a dental procedure...it was a medical procedure. He had to have a bone graft. Sounds simple right?

LMFAO.

Just got the EOB today. Claim DENIED. $857.00

Their reason? "Required preauthoization was not obtained"

The phone call tomorrow will be beyond ugly folks.

[sharon]

Am I glad I don't work for CHAMPVA? Yes I am! Give them HELL

Edited April 7, 2009 by sharon

[jbasser]

We are here to help. As they often say. Let them have it Purple.

A New Spoanis word comes to mind. It is SI Mon Pronoinced (see moan) which means "yeah right".

I go round and round with them also.

I record every pohone conversation and play it back to type it out so I can have a record.

Narrator is a great tool.

J

[Berta]

I noticed they spend alot of time on mail (CHAMPVA)

I got what seems to be a bill on a biopsy I had done.I am not used to CHAMPVA stuff and wondered why my Medicare didnt pay it instead.

Then I got a notice from CHAMPVA a few days later that looks like they paid it.(Maybe Medicare did)

I wonder how much mail I will get on another biopsy they did?

These were only skin biopsys-minor stuff but my docs are very concerned about potential skin cancers.I think all docs should be.

[Pete53]

ChampVA waits till Medicare pays and than pays fairly quickly. By law Medicare and ChampVA are all that can be charged unless you have not met your copays.

[Berta]

Thanks Pete -now I get that-

Question- I have never had a prescription until recently (except for antibiotics)

I am thank God always in great health.

I get this prescription refilled at TOPs where I food shop and they use my CHAMPVA for the payment.

The receipt says CHAMPVA co pay 25 % but I always get charges for about 50 % of the med's price.

Do I have some sort of annual prescription deductible I have to meet before I get the 25% co pay fee?

I tried to read the CHAMPVA booklet but I am so involved in VAOLA in different ways that I cannot seem to comprehend what the booklet says.

Last time I called CHAMPVA (which I hesitate to do) they checked with the RO for some reason and the &^%$ing VARO told them I WASNT eligible for CHAMPVA at all.

After 3 weeks of raising hell that was sure squared away-I have been eligible with award letter since 1991 for CHAMPVA.

I might have to pay for the second biopsy myself-

the docs had always said not to worry about a cyst on my back.

After my other doc got worried about a cyst on my hand, I had the back cyst removed too

I think maybe they would consider this a cosmetic surgery-dont know for sure.

I told the doc who removed it that it didnt hurt a bit and now I can chase men again with that ugly cyst gone.

Gosh I was kidding-hope he didnt put that in my med recs.

I also told him I liked him so much maybe I could find something else he could cut off.

Gee-hope THAT isnt in my records either.

[Pete53]

Berta:

Although you are required to pay 25% copay your first prescriptions are charged full price till your 50 dollar deductible is made. In other words the pharmacy collects your deductible but never more than full price for the med. Once your deductible is met you should be at 25%.

Always check to make sure that the pharmacy has charged insurance. SOmetimes they don't. My pharmacy has a box with a Y in it if Insurance was charged.