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Non Va Physicians Ordering Tests


foleyj
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Question

I have a Non Va Physician that I see for a SCD and this Non Va Physician wants me to get an MRI, can take the order or Rx that he gave me to get this MRI to a VAMC and have it done there?

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You will more likely than not need a VAMC - PCP to order it if you want VA to pay for it.

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Thanks for the reply. The funny thing is when I go to the VAMC for treatment for my SCD they still bill my insurance company and they pay them. The reason I would want to get it done there is because I wouldn't have to pay the copay for my private insurance which is like 300 dollars every time I get an MRI.

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Call the telephone care at your VA. Ask the poeson on the other end of the line to make you an appointment with your PCP. Explain the situation to the provider and get them to request it for you.

That is how it is done.

J

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The VA is not supposed to bill your private insurance for treatment of service connected disabilities. However, if they have found a workaround of sorts. If you see the VA for your (example) service connected knee, but the doc orders lab or imaging for non-SC conditions, they can bill for the non-SC treatment.

Get with your insurance company and obtain a copy of the explanation of benefits from when the VA treated your SC conditions and billed insurance. Usually you to log onto the insurance company web site and get them. Take a few of them to the VA business office and tell them what's going on. They will enter a request in their computer and tell you it will be a few weeks or months before the audit is complete.

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