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Getting Your Medical Bills Reimbursed

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I was awarded 70% sc after 28 months. I was being treated at a VAMC and was reimbursed for my co pays by the VA. But the VAMC sent me to a teaching hospital for treatment for some reason. There I am covered under my wife's medical insurance and have to pay co pays under her policy, also scrips have to go to CVS instead of to the VA. My question is how do I get the VA to reimburse me?

Thank you for your time, and I thank God for this website I would never have won my claim if not for what I learned here

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  • Content Curator/HadIt.com Elder

Call the VAMC business office. They are not supposed to charge your private insurance for SC treatment/meds. If they sent you to a non-VA facility for treatment of SC conditions, they are supposed to eat the costs for that too. I had some advanced imaging done at a neighboring university hospital and no charges occurred to me or my insurance.

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  • HadIt.com Elder

You know I had dental work done while waiting for an appeal for IU. When I got my IU I put in for compensation for the dental work I had done while waiting. I got paid. It was significant.

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I went to ER in Aug 09 with rectal bleeding. I had radiation for prostate cancer in 08. Nobody told me about the possibility of rectal bleeding after radiation. I was on Plavix for a heart attack I had while going through the radiation. I freaked out. I thought I was going to bleed to death. I went to the nearest ER. I have insurance because I'm still dragging my tired old butt to work because I need the insurance. My wife has MS. I tried to get the VA to pay the bills once they determined it was radiation proctitis. My ins. paid then they found out I filed with the VA. They said they would not pay. The VA has refused to pay because I had insurance. The reason I filed with the VA was, even if my ins. paid I was still going to be billed about $2000.00. It cost me $8000.00 to be in the hospital less than 24 hours. Sorry I got long winded... I sure could use some help with my claims I have been fighting the VA for the last 10 years on my own...

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  • 3 weeks later...

Contact the Business Office closest to you or at the treating VA Medical Center. They can authorize payments, (if they want to), to cover an emergency item such as this. But always try to talk to the Chief of the Business Service (sometimes MAS (old name) Medical Administrative Services). Call the operator and find out who the Chief of the Business Office is. Alot of times you will talk to a clerk and they will just say "no" because they may have to do some work. If you have to be treated at another facility (besides an emergency) request prior approval at the VA Medical Center and a "Fee" Basis Card so the VA will pay for the item. Also, always remember you get more done with honey than vinager. It other words be as nice as you possibly can be. If all else fails then you will have to write your Senator and be prepared for a standard answer when you do.

One other item. If you get prior approval with a "Fee" Basis Card then take the prescriptions to the VA to be filled. Make sure this is included when getting the "Fee" Basis Card!

BigDan.

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