VA IG Press release on non VA health care claims

[Berta]

 

 Just yesterday I was able to tie in with the NSC Community Care Program, for my neighbor.

It seems any balance of his hospitalization ,not covered by Medicare A & B could be paid by the VA.

This concerns me:

"The OIG found 13 percent of the contractor’s claims decisions did not align with OCC guidance, increasing the risk of inaccurately decided claims that could shift the financial burden to veterans. VA agreed that oversight of the contractor’s performance was not robust and stated that it has strengthened its processes."

https://www.va.gov/oig/pubs/VAOIG-19-06902-23.pdf

My neighbor had a regular VA appointment about 2 weeks ago and was rushed to a non VA Hospital early Sunday AM ,with a heart attack and they put in a stent.

Something seems odd about that. 

I wonder if the 13% vets above got stuck with bills, that VA should have paid but didnt. I hoe they appealed any payment denials.