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Article by Harriet Nix

Change is Near — Credit goes to President Trump and Vice President Mike Pence!

Dear Mr. President:

The change I refer to is The VA Mission Act , recently signed into law by yourself. The VA Mission Act will replace the current Choice Program that ended May 29th. I have discussed the Act with some knowledgeable people, and some that are ill-informed.

It appears we can expect a learning curve on this legislation. Confusion on the issue abounds. That is to be expected ; like many of the positive changes made by your Administration, learning how the Act works is positive progress for the Veteran. Below is an example of what often happens when a Veteran is treated at a non-VA ER for emergency treatment.

All Veterans Please Be Advised:

From The Department of Veterans' Affairs:

"A Veteran who is Permanently and Totally disabled (P&T) as the result of a service-connected condition is eligible for emergency treatment of ANY condition"

Although this is a viable benefit. Not all providers and often the VA staff themselves do not understand the application process of said benefit. Its simple and precisely as stated: if a Veteran is 100% P&T they can be treated for ANY condition. Emergency treatment includes but is not limited to service-related conditions. Trying to help them comprehend this sometimes falls on deaf ears.

Veterans are asked not to try to act as the middle man. As for me: I received a "Secured Message" from my Primary Care Physician s office stating: "You cannot act as a co-administrator." For that reason I ceased trying to clear up the habitual mistakes and relied on the professionalism of the responsible parties to successfully communicate with each other. If the billing agency makes a mistake it is NOT the responsibility of the VA to correct the mistake. They often just deny the charges and it is the responsibility of the billing agent to investigate the reason for the denial of the claim. So the process typically goes like this:

1. A Veteran is admitted to non-VA ER for immediate treatment.

2. The Veteran presents his VA card for intended payment.

3. The Veteran requests that the billing agent knows it must contact the VA to verify approval.

4. Once the Veteran has been released the billing agencies for Drs. the hospital etc. send the invoices to the Non-VA Services Department.

5. If the statement is NOT correct the VA will send it back having been denied or not approved.

6. The billing agent only reads what the VA states on the denial which is often the most widely employed answer. The claim is denied for approval because the Veteran is not covered due to a mistake(s) made in the method it was presented for payment.

7. The billing office then sends a statement to the Veteran for payment.

8. The Veteran does not respond because he or she has been told in writing not to act administratively.

This is then where it falls apart:

1. The billing office notifies the Dr./ hospital that the costs were denied by the VA and they further attempted to contact the Veteran for payment. There was no response from the Veteran.

2. At some point the billing agency wants to clear the non-payments from their accounts.

3. They sell the debt to investors at a deep discount.

4. Sadly the provider the ER and hospital only get a portion of what they are justly owed.

From the Department of Veterans Affairs Office of Inspector General:

"The OIG conducted an accuracy review of claims for emergency medical care obtained outside VA and found that 31 % of denied or rejected non-VA emergency care claims-with an estimated contracted amount of $716 million-were inappropriately processed from April 1 through September 30 2017 creating the risk of undue financial burden to an estimated 60800 veterans."

Loss Investors love these type of deals. They buy a perfectly good debt that was denied by the VA for a host of reasons at a deep discount.

When the investor who often uses a collection agency circulates the debt back to the VA showing it is illegitimately charged the VA reopens the case and pays the investor the "full" amount.

Highly profitable to the Loss Investors! Yet often quite damaging to the credit score of the Veteran.

This is a "heads up" from a Veteran to other Veterans. Be sure and notify the VA you are being treated at a Non-VA ER. Do not rely on anyone but yourself regardless of admonition! Be your own advocate!

Semper Fi