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How Do I Contact The Va During An Emergency

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captain soggy

Question

example: Let' say I have an illness that requires me to go to a civilian hospital ER. How do I contact the VA to let them know I went to the ER and I am being admitted to the hospital for an emergence surgery. I know I am suppose to contact them as soon as possible but what department do I call?

Also should I call the finance dept.so they know they are going to get a billing from the hospital as my only insurance is the VA?

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I am presently fighting the fee basis program. I am anaphylactic to wasps, hornets, and yellow jackets. July 2, 2010, I was stung. The closest VA Hospital to me is 2 hours away (one way). My daughter rushed me over to the hospital on Post, and now the VA doesn't want to pay. The three requirements the VA listed were 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. Ok, I'm 100% P&T, I'm anaphylactic to the stings, the friggin VA hospital is 2 hours away, and a military hospital IS a federal facility! I've been using the same VA Hospital for 17 years (been 100% since 1993, reaching that 20 year mark), and now all of a sudden, they don't have my 100% listed?!

Just a little side-note.... I have been getting my venom shots (fee based allergist prescribed them) from the VA for the past 3 years. The VA clinic, on Post, has been administering them for almost a year, and when I went to get my shot, last week, I was informed I couldn't get them there. I called the fee basis office up.... I was informed that the "audit team" just happened to pick MY file (I'm Cueing 100% PLUS 60%) to audit and disapproved it. It was stated to me that such things (the venom) has to be from an approved VA provider..... Gee, the VA were the ones that picked out the Allergist, they've been paying her for 3 years, and they don't know that she's an approved VA provider???? Needless to say, I fought that, and they have to administer my venom shots.

I actually have to file a NOD to get them to pay for my treatment at the military hospital!

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  • HadIt.com Elder

Wac

That is VA cheapness at its worst. Of course, they should pay for a wasp sting in your case. That is a real emergency. You can't wait two hours and I bet if you called an ambulance you would have a real hard time getting the VA to pay for a two hour ride. Do you have other insurance? If you do then the VA really does not want to pay, regardless. You have to do what is best for yourself.

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Wac

That is VA cheapness at its worst. Of course, they should pay for a wasp sting in your case. That is a real emergency. You can't wait two hours and I bet if you called an ambulance you would have a real hard time getting the VA to pay for a two hour ride. Do you have other insurance? If you do then the VA really does not want to pay, regardless. You have to do what is best for yourself.

I have no other insurance.... The VA has no choice, they have to pay, according to their own regulations (that they sent in their letter of denial!). I do find it interesting that since I filed my CUE (100% plus 60%), I just happened to be the file that the audit team picked, especially since I"m approaching the 20 year mark. I have no worry, as my condition is permanent, won't get better, and now I have even more additional disabilities (and more CUEs) to include A&A.

I guess the audit team picked the wrong file/Veteran, to send through the mill..... I not only make the grade, it would be impossible for them to find fault in it, according to the laws/regulations.

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I have no other insurance.... The VA has no choice, they have to pay, according to their own regulations (that they sent in their letter of denial!). I do find it interesting that since I filed my CUE (100% plus 60%), I just happened to be the file that the audit team picked, especially since I"m approaching the 20 year mark. I have no worry, as my condition is permanent, won't get better, and now I have even more additional disabilities (and more CUEs) to include A&A.

I guess the audit team picked the wrong file/Veteran, to send through the mill..... I not only make the grade, it would be impossible for them to find fault in it, according to the laws/regulations.

Well I guess the audit team picked the wrong file to mess with. Good luck and keep fighting them.

68mustang

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  • HadIt.com Elder

Unfortunately, such things often happen when the VAMC in my area has no one available to authorize fee based services. In fact, during the normal business day, it's even difficult to impossible to get approval before the fact.

Standard answer seems to be something along the lines of "we'll think about it", get done what needs to be done. Don't forget to contact us as soon as the "emergency" is mitigated, etc.

Indeed, the famous don't come here with an emergency message is the first thing you will hear from the VA number, even during normal working hours, and in spite of the same VAMC supposedly having an emergency room.

(Evidently emergency room yes, emergency room staff, No?) Since the VAMC is about two hours away ~64 miles down the interstate, only the local community hospital (~5 miles), or the area regional hospital (~15 miles away) is appropriate for true emergency care.

The regional hospital is an open heart surgery hospital, as well as a transplant facility. The community hospital can and does provide good emergency care for heart related problems, but is limited to using techniques appropriate to a hospital that cannot do open heart surgery. Use of "The Clot Buster" (TCB) is a common emergency treatment.

About 2 years ago, I thought I was having a heart attack. Wife called VAMC. They said they were "diverting patients" because they were full. They authorized "fee basis" care, right then and there. I did not have a problem getting them to pay.

Therefore:

I recommend: Get an authorization from your VAMC BEFORE you do fee basis...even in an emergency, your wife can give them a call WHILE SHE IS DRIVING YOU TO THE HOSPITAL. THEN GET THE NAME AND PHONE NUMBER OF THE PERSON AUTHORIZING IT. (BECAUSE YOU KNOW THE va IS GOING TO TRY TO WEASEL OUT OF IT..THEY ALWAYS DO)

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  • HadIt.com Elder

The VA doesn't have to pay the military hospital. I agree that you should not either! The military hospital might try getting you to pay a co-payment.

I am presently fighting the fee basis program. I am anaphylactic to wasps, hornets, and yellow jackets. July 2, 2010, I was stung. The closest VA Hospital to me is 2 hours away (one way). My daughter rushed me over to the hospital on Post, and now the VA doesn't want to pay. The three requirements the VA listed were 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. Ok, I'm 100% P&T, I'm anaphylactic to the stings, the friggin VA hospital is 2 hours away, and a military hospital IS a federal facility! I've been using the same VA Hospital for 17 years (been 100% since 1993, reaching that 20 year mark), and now all of a sudden, they don't have my 100% listed?!

Just a little side-note.... I have been getting my venom shots (fee based allergist prescribed them) from the VA for the past 3 years. The VA clinic, on Post, has been administering them for almost a year, and when I went to get my shot, last week, I was informed I couldn't get them there. I called the fee basis office up.... I was informed that the "audit team" just happened to pick MY file (I'm Cueing 100% PLUS 60%) to audit and disapproved it. It was stated to me that such things (the venom) has to be from an approved VA provider..... Gee, the VA were the ones that picked out the Allergist, they've been paying her for 3 years, and they don't know that she's an approved VA provider???? Needless to say, I fought that, and they have to administer my venom shots.

I actually have to file a NOD to get them to pay for my treatment at the military hospital!

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