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Tip: Going to a non-VA ER and transferring to the VA


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Hello everyone,
I wanted to share an interesting experience and some tips if you seek care in a non-VA emergency room or are admitted there. First, I qualify for non-VA emergency care because I am 100% P&T, so this information unfortunately will not apply to all veterans.

You have 72 hours from the time of the emergency room visit to contact your VAMC community care or business office. In my case, I went to the ER and was admitted on a Saturday, so both of those departments were closed. After the non-VA hospital saved my life, I recall a financial counselor lady visiting. She indicated the VA would be covering the care costs (as I was previously admitted). She had me sign a form provided by the VA where you could chose to transfer to the VAMC (if a bed becomes available) or if you would prefer to stay in the facility. The form may vary based on the VISN network of your VAMC, but mine goes like this:

It gives you two choices to check:

Quote

If a Birmingham VA bed becomes available, would you like to transfer into our facility?
__ I chose to transfer to a VA health care facility. I understand that payment for transfer  costs will be dependent on my VA eligibility
__ I choose not to transfer to a VA health care facility. I understand that the VA is prohibited from paying any insurance copayment, deductibles, and balances.

If you choose NOT to transfer, there are a couple of more choices to explain why (private insurance or Medicare/Medicaid)

 

Keep in mind that your doctor CAN override transferring to the VA if he feels your health would be at risk. He would need to provide adequate medical justification and keep you there.

 

In my case, I signed the form and checked the choice to transfer. I called the VAMC business office today to ask some questions and the agent said I signed the other box and the VA would not pay for anything. He did not have a digital copy of the actual form in front of him, but was looking at what was put into the medical transcript. He advised I go back to the hospital where I was treated and talk with their business office. I did that and the financial counselor printed out the form I signed. I was very surprised to find that I did check the box for transfer. I called the VA business office and they said I could just mail, fax, or drop off the form.

Moral of the story: Always double-check everything!

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I think if a Veteran or his spouse/Dr can call the VA and let the person on the phone know at the VA know that you had to go to the E. R. .just letting the VA  know you had to use the E.R. should get the Veteran off the hook to pay the medical Bill  or Ambulance  Bill..as long as you let the VA know.

I think you need to be 100% P&T as Vync mention above,,,not sure about veterans under this rating but in an emergency situation the VA will pay if you make that phone call.

Remember all calls into the VA are monitored/recorded and they can go back to see if you called it in or not.

My spouse called in for me one time that I had to use the E.R. Because I could not breathe on my own and its a 30 minute run  to the VA vs  a 5 minute run to the ER..Anyway the person that answered the phone at the VA said yes take him to the nearest E.R. so we went to the E.R.

After I found out I was not going to die and the bills stated coming in  we took them to the VA Bill paying Managers office.at mt VAMC..she was very nice and ask if we called  VA before going to the E.R. or from the E.R   we said yes my spouse called from the  E R  ..We mention the date we called the VA for this reason and she check the phone record and it was on there that the person at the VA said yes take him to the nearest VA.....the Bill pay manager ask for the Bills and the VA would pay them....what a relief that was  it was like 7.000.00  

And I lived.

Edited by Buck52 (see edit history)
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