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Q166:  I am a member of Veterans Choice. I recently went to my assigned doctor for a wrist problem. He told me to get an x-ray, so I went to the local civilian hospital and got an X-Ray. I've been tormented by the hospital administrators ever since.  They are demanding $400 from me. Nobody told me I would have to contact VA first before using a civilian hospital. What am I to do to keep this hospital off my back? 

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A1:  Do you have The Veterans Choice card? Did you ever obtain one? This is necessary to have. Did you discuss this with them 'prior' to your procedure? Contact The VA and obtain one, then submit the bill to them.  (CC)  10/25/18


A2:  Even though you signed up for the First Choice Program thru the V.A., there are certain procedures that you have to abide by. 1. Your Primary Care Provider has to notify by consult request to the First Choice Program that you are in need of another Doctor or Specialist to examine you. 2. Triwest will they administer the program here in Texas, it may be a different company where you are, will contact you by phone and mail that they have received the consult request. They will ask you if you have a Doctor selected, if not, they will find one for you. once they set up the appointment, you'll receive a letter with all the information. You have to have your Primary Care Provider send in a request about every 6 months. If you don't get a request you might have to pay the bill! I think it waste a lot of time and takes a lot of effort. I just use my medicare A & B and my supplemetal insurance when I want to see an outside medical specialist. Too much paper work and too much time wasted.  (RR)  10/25/18


A3:  You can not simply go to a doctor or have a procedure done without first getting authorization from the Choice program and having your VA doctor or facility also authorize you to do so.  (JD)  10/25/18














A4:  You have to get prior approval for them to pay for private care or either use your private insurance like Medicare or Tricare or any other private sector's hard due to time frame of medical care to get the VA to pay for civilian medical care whether you have choice care or not cause VA wants you to use their medical setvices... I don't agree with it but that's the NBC way the VA works.  (KS)  10/25/18


A5:  Contact your congress person and see if they can help.  (BW)  10/25/18


A6:  You should have read the letter that your Veterans Choice card came with. It explained all the rules. You are just screwed, tattooed and blued. Pay the hospital. Why didn't you get your exrays at the VAMC?  (TT)  10/25/18


A7:  Your primary care doctor must sign off. I had an MRI and was harrased for payment by the medical facility.   (MS)  10/25/18


A8:   Let me start by first saying that the whole Veterans's Choice Program was poorly developed, poorly managed, and we veterans were certainly uninformed as to how to properly access the program. The information has been out there for a while but really, many of us truly need a bit more information,  Anyhow, in order to use the VC program you must first have a referral from your primary care provider, which then goes through the approval process. FYI, this is a very simplefied example but actually, the whole process can take weeks if not months.  However, if your "assigned doctor" is at the VA, they should have directed you where to go for the x-ray in this case. Having VC doesn't mean we can go to a civilian provider unless so directed by the VA.  So, two points regarding the bill: 

1. Pay it yourself now or a collection agency will come after you; which will ruin your credit.
2. Find out who your head patient advocate is and get in to see that person A.S.A.P., plead your case and hopefully the your local VAMC will eventually get your money back.


If this doesn't work, contact your Senator and / or Representative for assistance.  (TB)  10/25/18














A9:  Unfortunately, since you did not follow pr and censures, you will have to pay this bill.  (AP)  10/25/18


A10:  Ask the Hospital Administrator if there is a Veterans Assistance Program available. Proceed to the local American Legion Office and ask for help. Do not stop asking for help. Your explanation is easy to understand- broadcast this as you ask for help and let the people know how bad the VA Choice really is. Its just another way of keeping us on the reservation and denying us the right to quality health care. We are less than dogs to the VBA and its DOD schizoid cousins.  (RB)  10/26/18