ptsd Va Reimbursement For Medicare Deductible Emergency Room

[Tbird]

long story short friday i called va emergency room rectal bleeding sever pain to the point of passing out, emergency room nurse says va is diverting they have no beds, but she doesn't know if they va pays or not. i call 911 they check their system the va has not put it in the emt system that they were on diversion, so the emt called the va and they told him they were on diversion, there was some back and forth about it needs to be in their system. and then they took me to a civilian hospital slu saint louis university hospital, we'll just call it slu. so my colon is inflamed and swollen and the bleeding was not stopping. they check me into the hospital on friday and i check out on wed, diagnosis ulcerative colitis. when i got to the emergency room on friday they asked what my insurance was we gave them my va card and stated it was my primary and we gave them my medicare card.

so's the civilian hospital slu wants me to pay the medicare deductible and i says the va needs to pay it, they need to bill va, they says they don't bill va, because va won't pay the deductible. i call fee basis at the va and they say slu bills us all the time call them back, so's i call slu back and tell's 'em what the guy at fee basis say and they say again that they won't bill va for medicare deductible because the va won't pay it. so's i call the patient advocate and she say's the va can't legally pay the medicare deductible, but i say you guys diverted me and i'm a 100% veteran. and she says that's the problem with giving them your medicare card and i says do you want me to lie and she says no i am in no way telling you to lie, but what should i do then and we just go round and round till she tells me when i get the bill to submit it to fee basis and a determination will be made by them.

what kind of crap is this? i says to the lady this sounds like a scam, it sounds like you understaff your er, so vets get diverted to civilian hospitals and you don't have to pay those bills, she assured me this was not the case. but i'm just suspicious that way, too many years in the system, ptsd, maybe a combination of both.

so waiting for the bill for the medicare deductible which i will take to fee basis and make the claim.

the doc wants to come back in two weeks for a follow up but i can't afford that.

any advice would be welcome.

[Tbird]

i'm having the va pull the hospital bills and do the claim for me. but i am telling you hospital is insistent on the fact that they don't bill the va for the medicare deductible, see that's the catch - the va can not and will not pay the medicare deductible, so i told the va to pull the records and i put in a claim for the whole hospital stay, since they diverted me and in theory they should have to pay for the whole thing, there by getting rid of my medicare deductible. it's all about the medicare deductible.

of course the catch with this is they may only pay till i was stabilized at which time they say i should have been transfered to the va, like this is my fault.

so i'm suppose to call the fee basis office in a week and see if they received my hospital records and how the claim is processing. t4his seems to be the only way.

also apply for aid and attendance, already housebound, going to ask for an increase in ibs rated 0% changed to ibd ulcerative colitis and see if it can give me a higher rate.

this started in service these attacks, but never so severe as to cause bleeding that i can remember. also i think it could be connected to my ptsd at least in exacerbation of existing condition.

have several trips to the bathroom a day, a bad day i lay on the floor severe cramping about every other week or so, between this and my ptsd i need help remembering to take my meds, rides to appointments, help with the shower, sometimes i fall, arthritis in knee, loose track of days and showers. forget to eat, and more. back pain and back aches which it turns out is related to the ulcerative colitis as well as the arthritis.

so trying to get my ducks in a row, thank goodness my niece is helping me,

[Tbird]

i'm having the va pull the hospital bills and do the claim for me. but i am telling you hospital is insistent on the fact that they don't bill the va for the medicare deductible, see that's the catch - the va can not and will not pay the medicare deductible, so i told the va to pull the records and i put in a claim for the whole hospital stay, since they diverted me and in theory they should have to pay for the whole thing, there by getting rid of my medicare deductible. it's all about the medicare deductible.

of course the catch with this is they may only pay till i was stabilized at which time they say i should have been transfered to the va, like this is my fault.

so i'm suppose to call the fee basis office in a week and see if they received my hospital records and how the claim is processing. t4his seems to be the only way.

also apply for aid and attendance, already housebound, going to ask for an increase in ibs rated 0% changed to ibd ulcerative colitis and see if it can give me a higher rate.

this started in service these attacks, but never so severe as to cause bleeding that i can remember. also i think it could be connected to my ptsd at least in exacerbation of existing condition.

have several trips to the bathroom a day, a bad day i lay on the floor severe cramping about every other week or so, between this and my ptsd i need help remembering to take my meds, rides to appointments, help with the shower, sometimes i fall, arthritis in knee, loose track of days and showers. forget to eat, and more. back pain and back aches which it turns out is related to the ulcerative colitis as well as the arthritis.

so trying to get my ducks in a row, thank goodness my niece is helping me,

and frankly i don't trust the va, those unsterilized colon scopes and such have really put me off them, plus for years they've told me i don't have a hernia, it's just the way the military doc sewed me up after my last surgery, but while in the hospital they say oh year that's a hernia, the left side of my stomach sticks way out, which is not causing any health concerns, well other than one of the signs of toxic megacolon is swelling on the left side, but i won't be able to tell, the rest of the symptoms seem to be the same as the flare up, and last year i got saw at triage who told me my tonsils were infected, i told her i didn't have tonsils and she said you sure do and they infected, she sent me to the next gal who was a doc, i says doc humor me and look down my throat and tell me if have tonsils, she looks and nope no tonsils, she gives me meds for thrush, and the ulcerative colitis may be linked to this also.

[Philip Rogers]

Tbird - you'll probably have to contact Medicare and tell them that the VA was supposed to be billed and not Medicare. Request Medicare rescind/recover the payment to SLU. I think you'll have problems getting the VA to pay, while there exists a Medicare payment. Also, the hospital is required to notify the VA when a VA patient becomes a patient there, so that the VA knows and has to option to transfer a patient, once the patient is stabilized. Unless you're planning on paying your own bill, it is best you never give them Medicare info or sign any document that allows them to bill Medicare. Good luck!! jmo

pr

[Pete53]

SLU I believe is St Louis University or the name of the Hospital.

When the VA pays for a Veteran there is no deductible they pay everything

[Philip Rogers]

TiredVeteran - I believe SLU stands for St Louis University hospital, a teaching hospital, probably affiliated w/the VA. jmo

pr

Pete,

When Fee Basis states they pay the same as Medicare, isn't that minus the deductible? Or do they also pay the amount of the deductible?

Maybe I have been wrong all this time, if so I am so sorry

Excuse my slowness, what is SLU?

Debbie

[LarryJ]

t, I don't know all the rules and regs concerning your predicu----er, predickyou-----ah, perdicum-----ah shit, your situation.

I do know that you're 100% and 100%'s don't have to pay for VA care..........and if VA sends you elsewhere......it was them, sending you from 100% care, to somewhere else where the prices, total amounts of charges, etc., were totally out of your control.

VA pays, else they get all kinda embare-assin 'phone calls from Congress Critters........heck, I even voted for my old buddy Obama and he can call 'em too.

I ain't PROUD!