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012. Are There Restrictions On Getting Care In Private Facilities At Va Expense?


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#1 Tbird

 
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Posted 23 November 2005 - 04:24 PM

12. Are there restrictions on getting care in private facilities at VA expense?

Yes. Care in private facilities at VA expense is provided only under certain circumstances, namely, when VA has a contract agreement for certain services or when a service disabled veterans lives too far from a VA facility to receive care

#2 Chuck75

 
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Posted 25 January 2007 - 11:54 PM

12. Are there restrictions on getting care in private facilities at VA expense?

Yes. Care in private facilities at VA expense is provided only under certain circumstances, namely, when VA has a contract agreement for certain services or when a service disabled veterans lives too far from a VA facility to receive care



In addition, the VA must be notified within a fairly short timeframe. I.E. Emergency care was needed on an immediate basis, and the VA must be notified within (I believe) 72 hours at the longest. Who gets notified at the VA? and what phone number? I have no idea. I have seen forms for this sort of thing, but have no idea where to get them.

#3 Guest_rickb54_*GuestMember

 
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Posted 26 January 2007 - 12:09 AM

Another way would be under the fee basis program. A veteran can request a fee basis card for a specific medical problem when the VA medical center cannot treat the veteran due to lack of physicans, or if the veteran might have to wait a long time for treatment. Fee basis is not always approved. In my case it was offered to me once years ago.

#4 hayley3

 
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Posted 16 May 2007 - 08:05 PM

How far away do you have to be to qualify?


Another way would be under the fee basis program. A veteran can request a fee basis card for a specific medical problem when the VA medical center cannot treat the veteran due to lack of physicans, or if the veteran might have to wait a long time for treatment. Fee basis is not always approved. In my case it was offered to me once years ago.



#5 jbasser

 
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Posted 19 May 2007 - 10:50 AM

For emergancy care it needs to be the closest hospital. They may stabalize you and transfer you to a VA hospital. Also Several VA's are associated with University Hospitals where procedures the VA cannot perform are usually performed there. If you are 50 percent higher and you do not have private health insurance it should pay for all conditions. If you are treated for a SC disability they should pay. If you have private insurance, then they usually dont pay.

It wouold be best to call your nearest VA and speak to the Fee Basis people to inquire about the distance and health care. They may refer you to a Va CLINIC. ( a Clinic set up in a remote town for Veterans care and also they have a home based care where the doctor comes to you)


J

#6 cuchi

 
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Posted 07 January 2008 - 10:36 AM

Hello ,
I am 100% for advanced prostate cancer my private doctor just gave me added prescriptions for my hormone treatment, avodart, casodex, ursodiol, fosamax plus a script for a QCT scan to rule out Osteoporosis. Can I get these filled by a VA clinic or hospital we have a clinic but the hospital is 120 miles away.
Thanks,
Cuchi

#7 steve&pat

 
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Posted 07 January 2008 - 10:26 PM

[ Cuchi
[/quote]


HI- with outside prescriptions-I usually get 10 day prescriptions from my outside doctors and then turn in copys of my reciepts to FEE BASIS TO GET REFUNDED---Then inform my VA doctor of the new MEDS... (you may also be able to collect "TRAVEL PAY also"}
My last bill of of around $25,000 dollars ,I spent in the hospital across town from my VA HOSPITAL for HEART PROBLEMS++++ The only problem was getting the answer machine --instead of a PERSON THEY WERE INFORMED ) alls well -.
BUT MY CARD SAYS ___ NO LIMITATIONS----
--- Steve---

#8 Danalinds

 
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Posted 06 December 2010 - 10:29 PM

I have a question but I can't post a new topic (?) so I'm asking here and hoping it helps the original poster as well...

My husband was severely burned. He was taken by ambulance (they debated airlifting) to the nearest burn center and the EMTs called the VA to see if they were able to treat a severe burn. He ended up in a private hospital because the VA had no burn center.

My husband was then my fiance. He was in the burn unit for 10 days and home care for the rest of a year. On the 3rd day or so, I met with the social worker. I specifically told her he was a disabled vet. She said to go to the county to see if they would assist , that the hospital couldn't help us, and said nothing to me about the Millennium act. I was completely ignorant to any of these things... I was just panicked and trying to be a nurse and figure out all of this billing stuff and help as best I could but I was really admittedly unprepared. Anyway, I went to the county and met with a representative there... they were also told my husband was a disabled vet, and they made no mention to me of the millenium act and also rejected us as far as assistance goes.

At this point I suppose I should have been in contact with the VA, but again I was very new to this entire thing, had no knowledge of any laws paying for private care, and my husband was pretty out of it for months after the injury.

Now we're more than a year out and dealing with a hefty bill, as you can imagine. While researching payment plans, we tripped upon the millennium act. My husband calls the VA, and is told that there is nothing he can do, that the hospital was supposed to contact them within 90 days and didn't, and that the hospital can now file an appeal. Now the hospital is *supposedly* filing an appeal to the VA and we are in a holding pattern.


Okay so my questions:
1) When you're first in a private hospital, is it the vet's responsibility or the hospitals, to contact the VA?
2) Was the person he spoke to at the VA correct that it's something between the hospital and the VA and that the veteran has no contact with the VA regarding the bill?
3) If it's correct that the hospital neglected to bill the VA, do we have recourse when (as I assume they will more than a year out) the VA denies payment to the hospital?

Thanks everyone for your help, ANY information on any of this would help.

I saw mention of 5 things you have to meet in order to receive payment to a private hospital, does anyone know those 5 things?

Thanks!
D

#9 Philip Rogers

 
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Posted 07 December 2010 - 05:19 AM

All hospitals are supposed to ask if the patient is a veteran before the patient is seen but it is his responsibility also.

pr

#10 Vync

 
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Posted 07 December 2010 - 06:22 AM

All hospitals are supposed to ask if the patient is a veteran before the patient is seen but it is his responsibility also.

pr


Never had that happen

#11 john999

 
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Posted 07 December 2010 - 09:40 AM

Dana

I think you should try and appeal this decision by the VA. If you can show that you tried to have your husband admitted to a VA hospital but were diverted due to lack of services I would argue that the VA was notified of the care your husband was getting at a private hospital. There was no way you were able to get care at the VA. Do you have documents to prove you advised the hospitals and social workers your husband was a vet? You know any decision the VA makes about care can be appealed. This is a nasty little game the VA plays with vets to try and avoid paying for expensive treatments. Put your request that the VA pay this bill in writing and when they refuse appeal the denial.

#12 akon

 
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Posted 16 December 2011 - 07:28 AM

Never had that happen

so good post by you i want to say what has happen to this cartoon why it is making hard straggle.....