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Can't believe what VA Billed my insurance!


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Since I recently moved to another state I decided to try the VA Primary Care facility near me.  I am 50% service connected for back. 

The PCP wanted to order some blood work for my first visit. I had no health conditions except the back pain.  I assumed this was the basic stuff any doctor would ask for to check cholesterol, etc.   When I went to the VA lab they drew about 6 tubes of blood.  I joked with the nurse and called her a Vampire.  She said your doctor ordered a lot of tests.  When I get the results I was iterated to find out they drug tested me.  I am not a drug user and didn’t pop positive for anything, but I felt a bit misled. 

I logged into my private insurance portal.  They billed my private insurance $8600.00 for the blood tests.  The discounted amount is $4,000 which the insurance company paid.   Luckily my deductible was met for the year.

I noticed my doctor already has lab work scheduled for me again early next year.   With my private doctor I never had more than one per year unless there was a specific problem we were tracking.   Is this how the VA is making money and driving up insurance costs at same time?   I feel like I should be reporting these outrages prices to somebody.

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  • Content Curator/HadIt.com Elder

@USMCVMO If you are SC at 50% and the VA bills your insurance for treatment, you don't have to pay anything. Technically, they are not supposed to bill for treatment of SC conditions, but they frequently do it anyway. Regardless, it can actually help you because it should goes towards your out of pocket and deductible.

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  • HadIt.com Elder

I know the VA can bill our private insurance, we are supposed to let them know if we  GET THE INSURANCE OR have any other insurance  including medicare.(SO THEY CAN BILL THEM A PART OF THE COST)

I remember back when I first started using the VA I HAD TO PAY A SMALL CO-PAY it was not that much so I didn't gripe,  I was 0% S,C,..AND when I got my 50% NO CO PAYS..IF Only I had known at the time I should have saved up all my prescription receipts from the private drug stores like Walgreens   CVS ect,,ect,,,VA will Reimburse you for those.

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  • Content Curator/HadIt.com Elder
9 minutes ago, USMCVMO said:

In my case I don't have a problem with them billing my insurance since this was a check-up bloodwork and not related to my SC.   My grievance is the amount they billed for the blood-draw and lab work.  

It can seem excessive. It comes down to the kind of labs which were ordered because some of them can be expensive.

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  • Content Curator/HadIt.com Elder
1 hour ago, Buck52 said:

I remember back when I first started using the VA I HAD TO PAY A SMALL CO-PAY it was not that much so I didn't gripe,  I was 0% S,C,..AND when I got my 50% NO CO PAYS..IF Only I had known at the time I should have saved up all my prescription receipts from the private drug stores like Walgreens   CVS ect,,ect,,,VA will Reimburse you for those.

It makes you wish the VA would have notified us when we filed our claims initially. All I got was the "it's going to take forever, blah, blah, blah" form letter. I lost about five years of reimbursements because I simply did not know. In fact, it was some years after I won my appeal before I learned the VA could reimburse for copays and travel.

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  • HadIt.com Elder

Vync

Ain't that the truth...eh!

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  • 10 months later...

Believe it or not, but, whether the VA coordinates payment of your care with your private insurance when you also have private insurance and the Veteran is 90%, is or could be dependent on how many employees your place of work has.  Many different thresholds.  Who pays what when is mandated by law, and basically everyone's situation is different.

Two years ago, I was 90% and had private insurance through my employer, and with less than 20 employees.  Also, at this time, my wife was on SS disability.  SSDI paid first, private insurance second in her case.  For me, I never got billed for anything.  In eBenefits, they listed my private insurance.  I am making the assumption, that the VA and my private insurance worked it out.

I have no private insurance now, eBenefits lists none for insurance, and am still 90%.  The VA pays everything, or I should say, I go to the VA for everything.

Now in March, I will go under Tri-Care, and will probably go back to my private doctors.  My private doctors have been more beneficial towards my VA claims versus, my VA PCP.  She is not very progressive in regards to my maladies.  Good enough, etc..

My thoughts,

Hamslice

 

Edited by Hamslice (see edit history)
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  • HadIt.com Elder
9 hours ago, Oceanbound said:

I think you're wrong Buck. If someone is 90% why is the VA billing the insurance at all. What is the point of VA (poor) care then when you'er getting billed for poor service and still not treated.

What part of this I mention is wrong?

I quoted

  I know the VA can bill our private insurance, we are supposed to let them know if we  GET THE INSURANCE OR have any other insurance  including medicare.(SO THEY CAN BILL THEM A PART OF THE COST)

I remember back when I first started using the VA I HAD TO PAY A SMALL CO-PAY it was not that much so I didn't gripe,  I was 0% S,C,..AND when I got my 50% NO CO PAYS..IF Only I had known at the time I should have saved up all my prescription receipts from the private drug stores like Walgreens   CVS ect,,ect,,,VA will Reimburse you for those.

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  • Moderator

You posted:

Quote

 When I get the results I was iterated to find out they drug tested me.  I am not a drug user and didn’t pop positive for anything, but I felt a bit misled. 

From the Veterans point of view, Im not sure that it matters whether or not our insurance is billed "except that" it COULD  (If the VA did a good job money management, which they dont) mean that the VA could serve more Veterans better with that money they receive from insurance.  

   But, Im not crazy about going down for health care, and the doc unknowingly drug tests you.  (They did that to me, too!)  

     The drug test (without your consent) seems to be a much bigger deal than the financial health of VA vs the insurance companies.  

     Apparently, the laws are such that allows VA to bill insurance companies, and I have to assume the insurance companies know what/if they should pay.  

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The VA is only supposed to bill private health insurance for non-service connected medical care, supplies and prescriptions which I have no issue with. But they have in the past billed my private health insurance for my allergy immunotherapy vaccine vials even though I'm service connected for allergies. The only reason I was made aware that they were doing this is because I had a flexible spending account through my job that would automatically reimburse me for copays, etc. and they were giving me reimbursements for the copay costs of the vials.  

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  • 2 years later...

Drug tests - this was common when I was receiving or about to receive pain killers for an ortho problem.  Once I came off the painkillers - I simple refused to allow the drug test.  Ask what they are doing before they do it.  

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  • HadIt.com Elder

The VA drug tests the hell out of me because I get pain meds from VA.  This must cost VA a fortune to see if I smoked a joint last week etc.  They question in detail about any alcohol use.  VA also billed my insurance, but I called my congressman and insurance to tell them not to pay.  I have 8 SC conditions.  How does the VA distinguish between what is and isn't SC?  I don't think VA gives a shit about us.  It is about the money they have to spend on us.  

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