VA denied paying for my $28K gallbladder surgery?

[Carl the Engineer]

One part of your story is missing.  How long after the PA stated you needed surgery, and when you had the surgery?

You, as a Veteran, can go to the local ER, however, you, or someone else, is supposed to contact the VA with 24 hours or as soon as possible.  I would suggest the VA nurse line.

So, if the PA said you needed surgery and they immediately took you to the surgical floor and worked on you, then I think you have a case, even then, I feel you are obligated to call the VA nurse line and let them know what is going on.

But, if the PA said you needed surgery, say on Monday, and scheduled the surgery for Wednesday, then I think you are out of luck.

The VA is paying for your healthcare and can direct such.  You may not like how the VA performs surgeries or procedures, but when I had private insurance, I was forced to go to their providers, or pay some or all of the bills on my own.  The VA is no different.

The program(s) the VA uses for local care for it's Veterans is for the VA's benefit, i.e., staffing and mileage, etc..  As an example, I just had an eye exam at my local VA hospital 100 miles away, just like I did 4 years ago.  However, 2 years ago, they sent me to the local eye doc, 6 miles, because the VA hospital did not have a eye doc at that time.  

Just saying,

Hamslice

Now that I pondered a bit, if the hospital that worked on you where told in advance, like during admissions, that you only had VA insurance(?), and they excepted that, then you need to talk to the billing department at the hospital.  You would (should) have been told of your financial responsibilities for the procedure.  I take my wife to a clinic or a hospital 2-3 times a week for the last 3 years and always make sure the visit is covered, before I unload her out of the car...  

 

Edited January 3, 2021 by Hamslice
cause I can

[Buck52]

Jedmo1961 

Let us know how it goes

I wonder how the VA would react  to a Veteran that don't trust the VA for surgery?

I mean if they can't get  to him within a certain amount of time   there suppose to let the Veteran use the Mission Act that passed June 1 2019 for outside care...but what if the Veteran don't trust the VA Surgeons ? can he go have his surgery at a private Dr?  or Group of Dr's?