(Message to the VA yesterday)
This has gone on entirely too long.
I was given the Optima line (phone number; that is the insurance that covers the community care service).
The VA Community Care Network (CCN) is VA’s direct link with community providers to ensure Veterans receive timely, high-quality care. CCN uses industry-standard approaches and guidelines to administer services, pay for services promptly, and manage the network to its full potential.
CCN is comprised of five regional networks covering all U.S. states and territories, and is being deployed in a phased approach. Once fully implemented, CCN will be the preferred national network VA uses to purchase care for Veterans in their community.
They said they didn't have the authorization, and gave me the VA cust svc phone number.
I called that (this made a total of 45 min on the phone)
The VA person said "I don't understand why Optima didn't get the auth number (VA0020532457), they should be handling this claim.
I gave the auth # to the receptionist the day of the appointment, because prior to that, she had no clue who I was or why I was there. Once I gave her the #, she said "Oh I see it now", and I went in to the appointment.
I now have a bill for this appointment, total was $705.00, adjusted to $211.50.
This bill came to me on Saturday, I have been obsessing over it all weekend.
I have now spent well over an hour on the phone trying to reach
So I finished up with the VA customer SVC, they got the piedmont billing people on the line, and with the three of us, I think that the bill will now be submitted to the proper entity.
I told the VA Customer SVC Lady that the DR ofc informed me via their secure message system, that the SLEEP STUDY (on Aug 3) will cost $6130 and is being billed to Medicare.
She said she didn't understand why Piedmont is billing medicare.
(Message this morning from the Community Care people at the Atlanta VA Hospital
Below shows what is authorized and #4 says that it includes overnight.
1. Initial outpatient evaluation and treatment for the referred condition on the consult order
2. Diagnostic studies relevant to the referred condition on the consult order
3. Labs and pathology relevant to the referred condition on the consult order
4. Sleep testing, in the home or clinic setting (including overnight), not limited to: Polysomnogram, CPAP/BiPAP testing with titration, Multiple Sleep Latency Test (MSLT)
5. Follow up visits for this episode of care related to referred condition on the consult order
I replied to him:
Thank you, but the point was that THEY (Piedmont) did not GET that information, until I spent nearly 2 hrs total on the phone yesterday
I should not have to spend MY time on the phone doing this stuff.
Granted, I think this time it isn't the VA fault, and I sent a message to the Piedmont clinic, they replied with the phone # to their billing.
That was one of the first things I tried yesterday, couldn't get through.
So I replied to them that it wasn't MY job to teach THEIR people how to do their jobs.
I must admit this has been a most unsatisfactory experience for me
!pinmapple 33.802061 lat -84.311769 long Atlanta VA system d3scr
Most egregious
by
Jerry E Smith
©7/19/2022
The photo was taken with my cellphone, but bill scanned and cleaned (hopefully) of my info
