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Service-Connected VET NEEDS HELP PLEASE!


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#1 StaysAhead

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Posted 31 May 2011 - 06:35 PM

Hello Guys, HAPPY MEMORIAL DAY!!!

I am a service-connected Veteran, and I trust the VA for these many years. I visit the VA for all my healthcare and medications. I also receive SSD, so I automatically qualified for Medicare part A (free for me because I get SSD).

On 2 different occasions, I was in critical condition DUE TO MY SERVICE-CONNECTION ILLNESS, so the ambulance rushed me to the nearest hospital, which is the same hospital TWICE. While in the hospital, I instructed them to BILL THE VA, but instead they billed Medicare! I was heavily medicated when some lady came in and spoke to me about the bill. Stupid me (I did mention that I have Medicare A, however I DID SPECIFY TO HER TO BILL THE VA. I ended up signing some sheet she gave me (being heavily medicated), and the next thing you know, I find out that the hospital ignored my request. Medicare paid the hospital 80% of the service that I received, and I'm stuck with the 20%, plus doctors bills, and ambulance bills, a little over $10000.00!

I know that the VA cannot pay for the same services that Medicare paid for as they are both government affliliated, and I also knew that if you are service-connected and you are seen at another medical facility besides the VA FOR THOSE SAME SERVICE CONNECTIONS, A VETERAN SHOULD NOT HAVE THEIR INSURANCE BILLED....BUT THAT THEY SHOULD HAVE THE VA BILLED FOR IT. THAT'S WHY I SPECIFICALLY TOLD THE HOSPITAL TO BILL THE VA BUT THEY DIDN'T.

SOMEONE PLEASE ADVISE ME ON WHAT STEPS TO TAKE.LIKE I MENTIONED, MEDICARE HAS ALREADY PAID 80%, I'M LEFT WITH THE 20%, PLUS AMBULANCE BILLS, DOCTORS BILLS.

SHOULD I CONTACT THE HIGHEST LEVEL OF AUTHORITY WITH THE HOSPITAL SO THIS SCREWED UP MATTER BE TAKEN CARE OF PROMPTLY??? PLEASE ADVISE ME. THANKS!

Tami

Edited by StaysAhead, 31 May 2011 - 06:39 PM.


#2 Guest_JUGGERNAUT_*

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Posted 31 May 2011 - 07:09 PM

Phone hospital; ask for the finance dept. Tell them can't pay the bill! Worked for me.

#3 AprilWhine

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Posted 31 May 2011 - 07:33 PM

To avoid this in the future, write the info on a card and keep it in your purse. Then, even if you are heavily medicated, you can hand over the card. :) Good luck with the present situation!

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#4 nana25k

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Posted 31 May 2011 - 07:39 PM

Actually call the hospital, speak only to the supervisor of the billing dept. Once you get that persons name send a certified, return reciept letter requesting that they rebill thru the VA and recind the bill to Medicare....that means they send the money back to Medicare. Also notify that since they made the error you expect not to be charged late fees and interest on the bill.Once you know they have the letter call that person back and proceed
again to get what you want.

The important part is to document the request in writing first, and document the phone calls with followup letters..sent of course via return reciept.

I know it is a lot of work but will enable you to follow up the chain of command at the hospital. Remember that everyone has a boss!!!

Just stand firm...and don't give in. I know they can do this because a hospital did the same thing to us some years ago...billing Tricare and not our regular hospilization....
If all else fials call you VA rep and ask them for help as well. Maybe do that first.

Good Luck!!

Edited by nana25k, 31 May 2011 - 07:46 PM.

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#5 acker1

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Posted 31 May 2011 - 07:52 PM

We had the same thing happen. Hosp redid the billing and sent it to medicare again! Finally told them to write us off as a hardship as we were not going to pay for THEIR clerical errors. And they did.
My wife was the one dealing with admittance and she wasn't under any medication. She specifically specified to send to the VA. First hosp did, ambulance did, last hosp didn't. They just plain screwed up.

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#6 crunchy

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Posted 01 June 2011 - 03:42 PM

I gotta go with Nana25K. Call the hospital, ask who runs the billing dept. Write to the hospital, certified, signature return receipt, then follow-up, and document EVERYTHING; phone calls, post cards, letters, smoke signals, personal visits, all of it with the who what were routine. Ensure that you make it clear in your letter to the hospital that you are trying to help correct their billing error, nothing more. Part of this problem is that most billing department employees can bill Medicare in their sleep, it takes action on their part to bill the VA. Contact the VA rep/finance rep, ask what they believe you should be doing, and while you're about it, ask if they can assist and how. You already have all the info from the billing hospital.

If all this fails, follow the next bit of advise from ACKER1 , contact the hospital, inform them that you cannot and will not be liable for the bill if they can't get their administrative staff to perform the correct billing to the proper agency, in this instance the VA. Might help to include a breif outline of what has been going on and what you've been doing to help them. If all else fails, and you cannot get it rectified, corrected or written off, you might also consider, if things continue to be so bleak, contacting the local paper, local state rep, or the state vets rep (every state has one). Might not work, but if you get to this point you are in FPF situation so you have nothing to lose. When everything else has failed, bite the bullet. Ask them for help on a payment plan based on SSD income since the VA income is "invisible", probably come out to about $20 a month. Funny how things get changed around when they know there is no way for you to pay and that they should have done it differently ( sometimes known as correctly ). We got a bill re-submitted/rescinded and the deductible written off from the hospital in this manner, took almost a year, albeit not in the same range of money. Now, when I have to use non-VA for emergency, Wife hands my VA card when the clerk asks for insurance.

I wish I had something more substantive for you. The preceding are ideas, thoughts, and my anecdotal findings of what has worked for me, might not work for you. I do wish you the best of luck in this, let us know what goes on.
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#7 StaysAhead

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Posted 01 June 2011 - 06:09 PM

WOW CRUNCHY YOU ARE ON THE MONEY!

I WAS ADVISED THIS SAME INFORMATION FROM THE VA FEE DEPARTMENT AND THE VA PATIENT REP WHO I SPOKE WITH.

I AM IN THE PROCESS OF WRITING A LETTER AND THEN SEND IT OUT TO THE HOSPITAL BILLING DEPARTMENT (SUPERVISOR), STARTING THERE.

THE GOOD NEWS IS THAT AFTER VISITING THE VA FEE BASIS DEPARTMENT ON SEVERAL OCCASIONS (THEY ARE THE ONES THAT THE HOSPITAL SHOULD OF BILLED!) ANY WAY, I WENT THROUGH 3 DIFFERENT EMPLOYEES THERE, PRACTICALLY BEGGING THEM TO CONSIDER PAYING FOR THE HOSPITAL BILL, AND I FINALLY GOT TO SPEAK TO THE SUPERVISOR IN THE DEPARTMENT, AND I AM NOT SURE IF THEY WERE TIRED OF SEEING MY FACE AROUND, LOL!! BUT HE TOLD ME THAT THE VA IS TAKING INTO CONSIDERATION OF PAYING FOR AMBULANCE BILLS, DOCTOR'S BILLS ETC. AND ON TOP OF THAT HE TOOK ME IN HIS OFFICE AND TOLD ME THAT HE IS GOING TO PUT IN A REQUEST TO EXPEDIATE THOSE BILLS TO BE PAID. THE SERVICES THAT I RECEIVED AT THE NON-VA WERE SERVICE CONNECTED RELATED TO MY ILLNESS, SO I'M CONFIDENT THOSE AMBULANCE BILLS AND DOCTOR'S BILL AND RADIOLOGY BILLS WILL BE PAID BY THE VA. AND THOSE SERVICES ADD UP TO A LITTLE OVER $10000.00!

SO THAT'S THE GOOD PART. THE HARD PART HE TOLD ME IS BASICALLY WHAT YOU WROTE IN THIS LETTER CRUNCHY, AND ALSO FROM ALL THE OTHER RESPONSES THAT I RECEIVED. HE TOLD ME THAT HE IS A VET. SO THAT MADE ME FEEL ASSURED WHEN I LEFT HIS OFFICE. HE TOLD ME THAT I MAY HAVE A HUGE BATTLE TO FIGHT, BUT NOT GIVE UP!! HE ALSO TOLD ME THAT THE REASON THE HOSPITAL BILLED MEDICARE EVEN THOUGH I TOLD THEM TO BILL THE VA, AND I EVEN HANDED THEM MY VA ID CARD, THEY WANTED TO GET THEIR MONEY FAST, AND HE TOLD ME THAT WHEN THE VA PAYS THE HOSPITAL, THE HOSPITAL GETS A SMALLER AMOUNT THAN WHAT MEDICARE PAYS FOR. SO IN OTHER WORDS, THE HOSPITAL SEEMS VERY GREEDY TO ME, AND THAT'S REALLY SAD, BECAUSE IT'S NOT LIKE THEY WILL BE LOSING MONEY IF THEY BILL THE VA. IT ACTUALLY HELPS THEM BECAUSE THEY WILL GET THEIR MONEY EITHER WAY! HE ALSO SAID SOMETHING THAT YOU MENTIONED CRUNCHY, ALL I HAD TO DO WAS TURN OVER MY VA ID CARD BECAUSE I HAD NEVER BEEN AT THAT HOSPITAL, AND NOW THAT I'M IN THEIR SYSTEM, I ALREADY KNOW WHO THEY WOULD BILL IF SOMETHING LIKE THIS HAPPENS AGAIN.........MEDICARE!!!

THANKS GUYS......PLEASE REPLY BACK TO THIS MESSAGE I SENT IF THERE IS SOMETHING THAT I AM OVERLOOKING OR MIS-STATED OR ANYTHING, BECAUSE I COULD BE WRONG IN SOMETHING IN THIS MESSAGE! THANKS!


I gotta go with Nana25K. Call the hospital, ask who runs the billing dept. Write to the hospital, certified, signature return receipt, then follow-up, and document EVERYTHING; phone calls, post cards, letters, smoke signals, personal visits, all of it with the who what were routine. Ensure that you make it clear in your letter to the hospital that you are trying to help correct their billing error, nothing more. Part of this problem is that most billing department employees can bill Medicare in their sleep, it takes action on their part to bill the VA. Contact the VA rep/finance rep, ask what they believe you should be doing, and while you're about it, ask if they can assist and how. You already have all the info from the billing hospital.

If all this fails, follow the next bit of advise from ACKER1 , contact the hospital, inform them that you cannot and will not be liable for the bill if they can't get their administrative staff to perform the correct billing to the proper agency, in this instance the VA. Might help to include a breif outline of what has been going on and what you've been doing to help them. If all else fails, and you cannot get it rectified, corrected or written off, you might also consider, if things continue to be so bleak, contacting the local paper, local state rep, or the state vets rep (every state has one). Might not work, but if you get to this point you are in FPF situation so you have nothing to lose. When everything else has failed, bite the bullet. Ask them for help on a payment plan based on SSD income since the VA income is "invisible", probably come out to about $20 a month. Funny how things get changed around when they know there is no way for you to pay and that they should have done it differently ( sometimes known as correctly ). We got a bill re-submitted/rescinded and the deductible written off from the hospital in this manner, took almost a year, albeit not in the same range of money. Now, when I have to use non-VA for emergency, Wife hands my VA card when the clerk asks for insurance.

I wish I had something more substantive for you. The preceding are ideas, thoughts, and my anecdotal findings of what has worked for me, might not work for you. I do wish you the best of luck in this, let us know what goes on.



#8 StaysAhead

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Posted 01 June 2011 - 06:15 PM

AGAIN, THANK YOU ALL FOR REPLYING TO MY POST. THIS INFORMATION IS VERY HELPFUL, AND I'M GETTING STARTED ON MY HOMEWORK IN THIS!!! THANKS AGAIN!



#9 nana25k

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Posted 01 June 2011 - 08:13 PM

Hope all turns out well....just take a deep breath, don't get upset and keep being nice to them. Kill them with kindess..and as always keep goingn up the line....don't be afraid to go to the Pres/CEO of the hospital if needed....The old Navy Family Ombudsmamn in me is telling you don't give up!!!
Ron & Linda

Class of 2007
2007 Dodge Quad cab Dually
2000 Holiday Rambler 32RKT

"Do what you can, with what you have, where you are" Theodore Roosevelt

"We can't control the wind, but we can adjust our sail"

"When man gave up his freedom to roam the earth, he gave up his soul for a conditioned ego that is bound by time and the fear of losing its attachments.
Ed Conley http://www.wyde-angle.com/?p=933 (A short editorial written about us by Ed when we hit the road.)

#10 StaysAhead

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Posted 01 June 2011 - 08:20 PM

THANK YOU OLD NAVY FAMILY OMBUDSMAN! I LOVE THE SERVICE THAT YALL DO!!! I AM TAKING DEEP BREATHS NOW! TODAY WAS A WORKOUT FOR ME ON THIS. STILL GOTTA GET MY LETTER PROOF READ (BY MY MOTHER) AND GET IT SENT OUT CERTIFIED/RETURN RECEIPT!

Hope all turns out well....just take a deep breath, don't get upset and keep being nice to them. Kill them with kindess..and as always keep goingn up the line....don't be afraid to go to the Pres/CEO of the hospital if needed....The old Navy Family Ombudsmamn in me is telling you don't give up!!!



#11 StaysAhead

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Posted 02 June 2011 - 11:17 AM

HEY GUYS! I GOT A SURPRISE CALL TODAY FROM THE SUPERVISOR AT THE NON-VA FACILITY WHERE I WAS SEEN, AND HE INFORMED ME THAT THEY ARE GOING TO SEND THE MONEY BACK TO MEDICARE AND BILL THE VA!!!! NOT SURE IF THEY WERE SICK AND TIRED OF ME CONSTANTLY CALLING THEM REQUESTING THAT THEY SEND THE BILL BACK, AND BILL THE VA....LOL!

AMEN!! THAT WAS EASY!

THANK YOU ALL FOR YOUR HELP IN THIS MATTER!

Edited by StaysAhead, 02 June 2011 - 11:18 AM.


#12 nana25k

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Posted 02 June 2011 - 06:27 PM

Well that is great news....The squeky wheel gets greased every time....
Ron & Linda

Class of 2007
2007 Dodge Quad cab Dually
2000 Holiday Rambler 32RKT

"Do what you can, with what you have, where you are" Theodore Roosevelt

"We can't control the wind, but we can adjust our sail"

"When man gave up his freedom to roam the earth, he gave up his soul for a conditioned ego that is bound by time and the fear of losing its attachments.
Ed Conley http://www.wyde-angle.com/?p=933 (A short editorial written about us by Ed when we hit the road.)

#13 RV

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Posted 02 June 2011 - 07:41 PM

Glad to hear you got a good resolution. And since these are your first posts here, welcome to the SKP forums!
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#14 crunchy

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Posted 03 June 2011 - 08:56 AM

glad things seem to be turning around. Hope it works out for you. BTW, welcome to the forums, and thank you for your service to our country
George & Sandee, Lil One & Squirt (Kommando Kitties)
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I predict future happiness for Americans if they can prevent the government from wasting the labors of the people under the pretense of taking care of them.

Thomas Jefferson