First non-VA care denial letter received


Although there is no mention of the Veterans’ Choice program in my husband’s recent non-VA care denial letter, our “geographical hardship” plea fell on deaf ears at the White River Junction VHA.  They received a pulmonary consult and treatment request from his sharp PC doc at the Burlington Clinic. We were able to specify (using secure messaging) exactly which local pulmonary specialist we wanted to see at UVM; that request was forwarded to WRJ–but all for naught.

WRJ VA works with Dartmouth (NH) and has good doctors.  That is not the issue.  The issue is accessibility. Why should we drive 200 miles round-trip? We’re talking an all-day proposition.  Here’s the text since my scan isn’t too good:

“This letter is in regards to denial of the recently submitted consult for VA payment of non-VA medical care. VA Regulations require that VA facilities must be utilized whenever possible unless there is a valid medical reason why they cannot.” 

va denial

We are not going to appeal this decision but we will call and find out if this denial letter is a blanket Veterans’ Choice denial, as well as a non-VA care denial. It was a test case since we felt it more prudent to use Medicare given that the VA is ruining veterans’ credit scores by paying slow.

I suppose we should complain to our senators, Leahy and Sanders, and to our one lonely representative, Peter Welch, about this on-going barrier to local non-VA care. Add our voices to the choir.  They got rid of the “as the crow flies” rule but local specialized care is still a pipe dream. (In fact, some VT vets have to travel to the Boston VHA for care–a congested traffic ordeal.) And as for the appeal option–it takes years to figure out their crazy methodologies as we have learned here.

Then there is the matter of the travel allowance.  It has been reported to only cover one way versus round-trip mileage in VT.  If that is true, the trip is simply not affordable for some vets.  And if a veteran is working, he/she will miss a whole day of work, probably without pay. Another hardship.

To their great credit, VT DAV volunteers provide transportation to the WRJ VA and there is a DAV shuttle from the Burlington area.  A veteran can be picked up at his/her residence (LINK) and then must wait in the lobby for a return ride.  This could be stressful depending on a vet’s condition.  A vet with PTSD may have to skip riding with a well-meaning stranger for a host of reasons.  But without other healthcare options, the DAV transportation is a welcome practical service.

Need_A_Ride_image

Thank you DAV for your free transportation program. Click image for informtion

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5 Responses to First non-VA care denial letter received

  1. Sherry says:

    Update, finally gor approved for my hubby to see a local Urologist. I just happened to talk with a young man with VA Choice Program and he helped push it through as he stated “Your local VA Medical doctor is 39.4 miles from our home so I’ll go ahead and approve”. My husband had been seeing a Urologist at the MN Hospital for two years and nothing was done but medicine that did nothing. The private Urologist that VA approved for him to see did surgery right away and it has completely cured him for which he is so thankful for. If we had not stumbled across this young VA Rep that approved him to see a local doc he would still be on the meds that did nothing and having to self cath 5-6 times a day. Something so simple to fix according to this doc, but VA doc had said nothing more could be done.

    Now, the difficult time to save our credit. Because so many tests had to be done prior to surgery, many of the bills sent to VA have been rejected because they are coded wrong. It took me hours and hours to figure this all out. VA sends you a letter stating the reject and why but nothing regarding who billed it and what for, really half ass information considering if it’s not paid the medical facility will turn ME over to collections. It’s a non stop pass the buck information as no one seems to know anything. Now, after figuring out the problem regarding the wrong billing code used I called the X-Ray consultant back and told them VA said they used the wrong code as it all falls under Pre-op, they said they have no code that would cover the reading of the X-Ray and Pre-op, really? now I have to force them to invent one? My gosh this is complete horse sh…! I asked VA to speak to them and vise-versa but neither will call the other, they keep telling me to call the other. Again, complete horse sh..! My gosh this is like trying to work with spoiled rotten children!

    I am a stubborn person and that will help me stay strong, I hope any way. I cannot imagine a single Vet being ill could do this and it makes me ill to think how many give up because it all just makes your head spin. Thank you all for listening and letting me vent. I just keep repeating to myself “Stay strong and don’t let them cause you to throw your hands in the air and walk away” WOOHOO!

    Sherry

  2. Hinweis: Diese Webseite ist eine Sammlung von Informationen über früher und aktuell benutzte Hausmittel.

  3. Wie auch in amerikanischen Think-Tanks zu lesen: die USA haben eine große
    Angst vor einem wirtschaftlich-militärischen Zusammenschluss von Deutschland und Russland.

  4. Kiedove says:

    Thanks Sherry. We just have to keep on complaining.

  5. Sherry says:

    This “Choice Program” has some major flaws and none of it benefits the Vet at all. Just talking with a docs office that is listed as a non VA Choice Doctor you will hear them belly ache about really not wanting to help because it takes too long to get paid from VA. If your VA M.D. is within 40 miles of your home but all other specialty docs are not, you are screwed. So, seeing your specialty doc is 200+ miles away you will have to make those long trips. Who decided this? My gosh these people sure know how to come up with great programs for Vets but all their rules eliminate the help the program was designed do. We live in WI and have to go to MN, a completely different State for my husband Vet to see a specialist. I reached out to my Government officials and not one of them reached out to help. Stick head in sand and it’s really not a problem I guess.

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