Basser Is Real Mad

[hedgey]

Well aside from the VA stealing from the insurance companies and causing the costs to rise for all insured people, on a personal note we are seeing it this way:

On the up side, it made us hit our yearly deductible with BCBS before the end of March. This made it feasible for me to get some tests done that the VA wouldn't give me vouchers for, even though my psychiatrist said I shouldn't have to go to the VAMC overnight to endure it, especially with the travel involved.

On the down side, my podiatrist is pushing me to get more PT done on my RSD feet. She doesn't know how to write the order or maybe the VA won't approve it, but she keeps writing me scripts to take to the PT & pay through BCBS. Now BCBS will only pay a portion of PT, regardless of the deductible being met. I figure this will amount to a couple, three hundred dollars or more, not including traveleing 1/2 hour each way to PT.

So because she knows I have insurance, she's on the verge of calling me a Non-Compliant Patient because (long story, not for here) I can't do the PT. Part of it is the money, part of it is the principle. My foot problems are SC.

She has also remarked that since I'm 100%, I can afford it. (this really p'd me off. She knows nothing of our financial situation).

Can she rightfully write in my notes that I'm non-compliant if I'm avoiding NON-VA care? I did go when the VA was paid for it. I go to all my appointments with her.......

[Capt.]

Hello Jbasser , This is such a rip off. I can't afford insurance and with the problems I have there is no insurance company that would touch me unless I could afford the adjusted high risk policies. If you try and tell them you don't have insurance , which is really none of their business as the VA was not started with that stipulation in mind, then they may be entitled to VA paying for it all. But somewhere down the line, it was one of those loopholes that someone in VA decided to go thru and noone really complained enough. Nor did enough congressmen get involved early on to stop it. Now it is a monster. Its ok for the VA to break the law.......they do that every day. But let the Veteran deny he or she has insurance and then the Vet is a lawbreaker. Something wrong here folks.

Also Hedgey, If your doctor turns you in as noncompliant patient then your only recourse that I can see is get to your Patient Advocate and try and get that stricken from your records. It is not easy but I have done it on another doctor that was beligerant. It will require you to build a strong case of reasons, and the Patient Advocate will have to decide your complaint. If they rule in your favor , they will not only strike the statement from your record but can also tell the Director of VAMC there that they are to correct or stop that beligerance. In your case it is going to be a battle but not unattainable if you can show the doctor as being beligerant and insensitive. As always NEVER GIVE UP. God Bless, C.C.

Edited December 9, 2011 by Capt.Contaminate

[hedgey]

Thanks, Capt. I'm hoping it won't come to that.

I'm thinking that if she puts that in my record, my argument would be that I refused or was non-compliant with her private, off the VA record prescriptions. She's said she didn't know how to make the VA set up PT the way she wants it done, and so she's written prescriptions on her personal script pad. So as I see it, they are not official VA orders for treatment that I'm refusing.

But to go back to JBasser's OP, sort of, isn't it wrong for them to bill the insurance for any care you receive? I mean, if you're on the VA healthcare system rolls, and they will treat you for your headache, back strain, whatever, regardless of SC, and they would have no one to charge if you didn't have insurance, why can they bill?

It's kind of a catch-22, isn't it. If they bill the insurance company, the premiums go up and the coverage goes down for all. If they don't bill the insurance, the taxpayers foot the bill, and we all end up paying in just a different way.

I just really don't like the fraudulent behavior of the "you better have your ducks in a row!" VA.

[Capt.]

Hello Hedgey, The VA now will ask enrollees if they have health insurance from employer or other entities. Also being in the Group system may also have an effect upon what your insurance pays or does not pay. This was not the original intent of the VA health care system but as Congress squeezed the budgets over the years that the Veteran and alter saving and cost cutting efforts soon were established. Do I see the problem getting better or the Veteran becoming exempt from copay or billing insurance companies. Not anytime in our lifetime . The door of billing the Veteran and billing insurance companies is now open and they are not going to close it and cut off the millions, probably billions of dollars that pour in from this cash cow they created. This is one problem that is distasteful to all of us. But the giant wheel of government and insurance companies(which are silent) keep right on turning. NEVER GIVE UP . God Bless, C.C.

Edited December 9, 2011 by Capt.Contaminate