VAMC Timelines for Pain Treatment

[Vync]

After all the excitement of waiting forever to get my first VA Choice program referral, I had an appointment setup for this Friday. This morning, the doctor's office called and said they regret to inform me that the appointment has been canceled. They explained that contract between the VA and Healthnet is due to expire at the end of the month, so they opted to withdraw from the Choice program entirely. I called the toll-free number for the Choice program and they have not yet been informed about my appointment being canceled or them withdrawing from the program. But on the bright side, I should hear back from a scheduling coordinator within the next five to seven business days to get me setup with another provider.

As of today, I have been waiting 166 days.

[Buck52]

sorry to hear that vync

if you need emergency care  for this area that your appointment was canceled

call your VAMC and talk to the triage Nurse, and tell them your going to the ER b/c its closer to you and you need care now,

As long as they say ok go ahead and go  then it will be recorded on myhealthvet notes that you called and VA will pay the bill

I had an emergency first part of this year Jan  and spouse called the VAMC And ask if we could go to the nearest E.R.   That the VA Hosipital was to long to drive plus she can't drive on the busy freeways here in Dallas and we live just east of Dallas  and the VA is way out South of Dallas.

Anyway I had to get a # to call to see if they would pay the bill and I got that # from the people the VA Billing  (it was in the basement next to the FIOA desk) and I called that # and   so for I guess they paid it  not heard from anyone..yet? They did ask me if I called the VAMC before I went to get the ok to go  I sad yes my wife did.  she said oh ok then your in the system.

I gave her my last 4 and she looked on my Healthvet Notes and said ok here it is I got now that's all she needed.

 

Now I may still get a Bill??  but so for after the ER Billed me  I said the VA will be paying you guys. that was back in April.

[Vync]

It has been 207 days since I embarked on this journey to get my VAMC to provide a lumbar pain block.

In the meantime, I have been working with the Choice program team (Healthnet) and the VAMC Patient Advocate on this problem. Both have dropped the ball more than once.

Healthnet appears to care less if I actually receive treatment.

The Patient Advocate is new and genuinely appears to be trying to help, but when the Healthnet people said my complaint was resolved, they closed my case without verifying it with me. They are "currently working" to get this problem resolved.

Additionally, my VAMC has not had a doctor qualified to perform this treatment for months. No ETA on when they will get one.

 

A couple of weeks back, I finally broke down and paid for a pain block out of my pocket from a non-VA provider. I will need these periodically in the future, but am hoping the VA will actually cover them in a timely manner.

 

What would be the recommended complaint path? Shulkin? IG? Congressman?

 

[caubulldog]

get a private doctor,preferably neorologist.Ihave one right now that got my in and did four injections.They were all paid through Tri West Va contacted them and he jumped on it even with covid shutting down. 

[Vync]

I'm back with an update on the typical red tape. My last lumbar pain injection was in early 2019, a couple of months before my heart attack. I needed another later that year, but cardiology would not release me, so I dealt with it in other ways for the frequent subsequent flare ups.

In early February 2021, I have since been released by cardiology, I had another flare up. I encountered a ton of VA red tape. It was a bunch of internal red tape between primary care and the anesthesiology/pain clinic. Eventually, primary care gave me the extension of the person in the pain clinic. I learned I needed a new MRI and it took a couple of more weeks to get that done. I was told they would likely refer me to community care like was done previously because they were backlogged for several months. I kept having to call and get the status because nobody would call me. Now it was them fussing between each other about which heart meds I needed to come off of before the procedure. They finally got that straightened out. Now, the pain clinic is open and they want to do it themselves because I live just a bit too close to the hospital and they could fit me in within 30 days. I was like, no... I had to go through the patient advocate. They wanted to know why I was requesting this be done via community care. I explained I have been having these injections for 15 years and never through the VA. About five years ago, I finally found a doc who got the job done right every time and I could trust his results. Additionally, VA treatment goofs resulted in me being given overdoses of injections and even resulted in a heart attack. Do I really want someone who has never treated me, likely a trainee, poking needles into my spine? I don't know what happened behind the scenes, but they approved the referral. Got my appointment setup and looking forward to some much needed relief.

Yes, I do have private insurance and previously used to get treatment from the same doc they are referring me to. I am SC for this and should not have to cough up money for deductibles and copays for something the VA should be covering. It's the principle of it. Be persistent and don't give up.

[kanewnut]

4 hours ago, Vync said:

something the VA should be covering. It's the principle of it. Be persistent and don't give up.

I am using Novant in NC. I think my community care approval was for 1 year. Novant told me to call or email when I needed to come back. They said they would work with the VA to get it approved if it is over a year later. 

 

4 hours ago, Vync said:

Do I really want someone who has never treated me, likely a trainee, poking needles into my spine?

They gave to learn some how don't they? Just kidding. I don't like the idea either. Had a nightmare time with Durham VA for shoulder surgery that I eventually declined.