Spoke with a VA patient advisor this week regarding my denial of payment at a hospital ER due to having Medicare.
She said that VA will only pay for hospital charges if you are referred by a clinic doctor when Medicare is also in play. If it is a service connected issue they will however pay. There are also other rules in play. If you are out of state you have to get VA clinic or MC of the particular state you are in to put you in their system as they are the once that will get billed. If you are not in the system no payment will result.
She agreed with me that those of us having Medicare coverage are being punished for being well insured.
If Telecare tells you to go to the nearest hospital it it not considered a proper referral (as was my case). The referral for the hospital has to be done by a doctor.
So I will not be using Telecare anymore but just walk into a clinic next time I have a problem. My primary care nurse had asked me to use Telecare instead of walking in without any appointment if I had problems and then Telecare would check with my primary as to what time they could see me.
It seems to me that nothing but barriers are being put up to make emergency care difficult.
I am 90% connected as stated in my previous post.
One more thing, if you pay the bill or part of the bill they will not reimburse you even if the hospitalization was justified.
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