VA Prosthodontist

[McRay]

I'm service connected for dental care. Recently I have a problem with a bridge loosening up and it's complicated by bone loss and a span of 7 teeth. I saw my VA dentist yesterday and the Tucson dental clinic doesn't have a prosthodontist currently. One guy retiring, another being hired and going through the process. There are 5 prosthodontists in the community, but it seems the dental clinic has changed their provider contract to Tri-West? and they won't pay the going rates the community  docs are charging. Apparently the new community care guidelines don't apply to dentistry? Any of you guys had problems like this or any recommendations?

[McRay]

On a side note, I dropped off the form for travel pay and the lady told me they had moved to a new system and were working on travel pay forms from the 1st of July. Wonder if this is indicative of cost cutting measures?

[broncovet]

Two parts:

1.  Contact one or more of the prosthodontist and explain.  Be sure and tell him "the benefit to him" for accepting VA's pay level:  He will likely get referrals from other Vets, that is, more money.  Explain to him if he is willing to accept VA's rates, then there will be likely many Vets who would go to his office.  

2.  I always do my travel pay "at the kiosk" at the VAMC, and that seems to better and faster than a paper form.  If this is available, by all means apply for your travel pay via the kiosk.  As far as "dropping" or lowering the travel pay benefit, VA has already kind of done that.  They now pay mileage in the shortest route possible.  I never drive that way, its 20 traffic lights and I go to the hiway which cuts out about 18 of those traffic lights.  

    For 2020, I noticed IRS mileage is   57.5cents per mile, while 2019 was 58 cents.  Fuel cost(s) probably went down that year.  They sure are not down now, however.  Gasoline is up about $1.00 a gallon from a year ago.  And climbing.  

    It appears VA mileage rate is 41.5 cents a mile.  More VA math.  

[McRay]

Thanks @broncovet good advice.

I guess another part of my question centers around 'Choice Care'. I thought vets were allowed to go into the community for care if they were over a certain distance from the VA med facility or if there was a scheduling problem where the Vet would have to wait to long for the appointment. Maybe this doesn't apply to Dental patients? I would think my situation would certainly apply for community care -- I'm more than 50 miles away from the treatment facility and they don't have a prosthodontist on staff at the current time.

I sent the information via Secure Message to the dental clinic this morning and by noon, the dentist had called me back to tell me how she had gone to her boss and he had informed her the VA had no 'contract' with any outside prothodontists. I asked her "so this is basically a money/fee problem" and she said yes.

I'm considering contacting the patient advocate, but I've got a feeling this is one of those 'dead end' paths. The dental clinic has decided my only treatment option is a denture and they are going to do whatever necessary to prove themselves right.

Why is it that VA Math always favors the VA?

[broncovet]

You could consider contacting either the Patient advocate, or, in my VAMC you can easily speak to the hospital administrator (head honcho of hospital) and tell him or her your problem.  My head honcho's office is pretty good at solving problems like this.  

If you are good at math, you can look at the disability compensation rate tables and notice a "huge problem".  HUGE.  One that is unfair to Veterans.  Example:

The 100 percent rate is 3161.42 (no dependents). So, 10 percent of that should be 316.14, right?  Nope.  

the 10 percent rate is 144.14   What happened?  

"Rounding" over the years.  Disabliity compensation rates were "rounded down to the nearest dollar".  So, you lost a dollar.  No biggie.  Next year, not only did you lose the original dollar, but you lost the cola from that you did not get.  It made for this unfairness over time.  

Each of the disability compensation rates has this unfairness built in.  

A 90% Vet "should" get 90% of 3161.42 or $2845.27.  NOPE he is shorted almost $1000 every month at 1887.18.  Congress wont fix it because it would cost billions.  However, now rates are no longer "rounded down", you get paid to the penny.  

Social security still "rounds down" to the nearest dollar.  Its not as noticable because there is no "10 percent social security".  

Inflation reminds me of the proverbial Frog in a cold pot of water on the stove.  Since the heat comes over the frog slowly, he boils to death.  However, if the frog were placed in boiling water, he would rapidly jump out, but when the temp rises slowly, he does not notice the slow temp change and eventually boils to death.  

We lose purchasing power each month with inflation, and its always more than our cola.  (Our government has used some fancy math figuring out cola, which understates inflation by a rather significant amount over time.  

This is why you see poor people on social security.  It seems like enough, but then, inflation eats it away over time.  If you retired in 1972, the social security minimum was 170 per month.  Now its 886.  This is why you sometimes see people earning only 400 a month or so on social security.  They retired long ago, and inflation ate up their social security.  

[McRay]

I sent a secure message to the patient advocate this morning. Here's the response:

Quote

Although the Choice Act is no longer in effect, under the provisions of the MISSION Act of 2018 the VA is able to refer patients needing authorized services to community care providers who choose to contract with the federal government. While the SAVAHCS does often refer patients to community care providers, regrettably, if a provider does not wish to contract with VA, SAVAHCS is unable to refer patients to that provider.
 

It appears the VA is cost cutting. Not one of 5 prosthodontists in the Tucson community is accepting Tri West. Seems odd.. Guess the next step is my congressman..

[broncovet]

Or, you may get a prosthodontist outside of your city.