VA Revokes TriWest Veterans Choice Duties

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TriWest

TriWest will no longer schedule veterans for non-VA care as part of the government contractor’s duties in the Veterans Choice Program. The move will result in VA employees again making appointments for Alaska veterans for non-VA appointments.

Veterans nationwide have complained about problems making appointments through TriWest. Alaska veterans will now be able to enjoy interfacing with VA employees again due to persistent failures that have led to numerous medical specialists outside VA refusing to care for veterans.

PROMISE TO VETERANS

On its website, TriWest says it is “taking care of our nation’s heroes” and apparently getting paid well to do it:

“TriWest Healthcare Alliance has the privilege of serving our nation’s heroes as the partner of the Department of Veterans Affairs (VA) in administering the Patient-Centered Community Care (PC3) and Veterans Choice Program (VCP).”

Does it sound like TriWest is actually taking care of heroes?

OLD TRIWEST PROBLEMS

In 2011, TriWest reportedly paid $10 million in a settlement where a whistelblower alleged the company “systematically defrauded” the Tricare program by billing higher rates.

According to Wikipedia on the subject, the company also deceptively circumvented accepted checks and balances created to prevent fraudulent billing:

“The lawsuit also said TriWest sent 3,000 claims through one location a day to intentionally bypass checks to avoid late-payment fees, and that it paid claims for ineligible beneficiaries.”

While ending TriWest’s involvement in scheduling may benefit veterans somewhat, the government contractor will continue to be responsible for billing and connecting with medical professionals. These are also two areas where the company is reportedly failing.

Isn’t it interesting that these same companies linked to deceptive billing and basically fraud are the same companies our nation rely on to help veterans get timely care?

RELATED: Choice Contractor Health Net Has Sanctions History

And after the contracts are signed, those same companies fail to provide needed services they were hired to provide.

Source: http://www.alaskapublic.org/va-relieves-contractor-of-role-in-appointments/

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Seymore Klearly
Seymore Klearly

Given the now nearly two year history of the choice program I would like to remind everyone that the end of the program is within site and it is still not functioning.

According to the Federal Register:

“The Program is funded with $10 billion in appropriated resources in the Veterans Choice Fund through section 802 of the Act. The Program is authorized to continue until the date the Veterans Choice Fund is exhausted or August 7, 2017, whichever occurs first. Sec. 101(p), Public Law 113-146, 128 Stat. 1754.”

“Expanded Access to Non-VA Care Through the Veterans Choice Program”
“A Rule by the Veterans Affairs Department on 10/29/2015 ”

“https://www.federalregister.gov/articles/2015/10/29/2015-27481/expanded-access-to-non-va-care-through-the-veterans-choice-program#h-8”

Need to remember that the program was funded for three years of expected operation with an expected cost of $10 Billion. From the $10 Billion of funding Congress provided for the program. There was $3 Billion of the funding diverted to provide access for Veterans to the new Hep-C Medication.

The same Hep-C Medication that was developed by a VA researcher and tested the medication using Veterans. The researcher then sold the patent rights to Big Pharma for a big payday.

So with the nearly 1 year worth of funding diverted from the program the funding for the program should be exhausted sometime within the next three months. Since the Program is authorized to continue until the date the Veterans Choice Fund is exhausted or August 7, 2017, whichever occurs first.

Great time for Politicians to jump on the band wagon to fix the broken Veterans Choice Program to llok good for the voters.

namnibor
namnibor

Do not forget about the $$$$$$$$$$$$$$$$ diverted from “Choice Act Funds” for “Resettlement Of Refugees”. I forget the exact $$$ amount but it takes another huge bite out of the Choice Cookie Jar…and that is what Choice Act has been for the VA, a huge free-for-all Cookie Jar….Veterans? What Veterans?!

Seymore Klearly
Seymore Klearly

Namnibor,

I didn’t know about that action I am trying to find more info on it any sujestions on where to look. Thank You.

Also Something I found while trying to find info on the Resettlement of Refugees using Veterans choice act bucks.

“Veterans Affairs Last year, NGA worked with the Department of Veterans Affairs (VA) to facilitate state compliance with Section 702 of the Veterans Choice, Accountability and transparency Act (Choice Act), which requires public post – secondary educational institutions to provide in – state tuition rates for out – of – state veterans and their dependents. As a result, all states and territories were in compliance with the law as of December 31. Last fall, the NGA Center for Best Practices completed a two – year demonstration project for the Department of Labor to explore best practices for state licensing and credentialing of Military service members and veterans. The accompanying report and cost analysis was published in October.”

National Governors Association
NGA Federal Relations Update Homeland Security and Public Safety Committee Winter 2016

“http://meetings.nga.org/files/live/sites/meetings/files/resources/CoG/WM16HSPSLUpdate.pdf”

Even the National Governors Association is a piece of the Pie.

David
David

I cannot say Veterans Choice is perfect. However, they have done a very good job scheduling my surgery. All my flights and appointments have been made with just a few minor mistakes. Alway check back to make sure everything is going as planned. Thank you for taking care of veterans through VA Choice (TRUMP).

Seymore Klearly
Seymore Klearly

Forgot to add — with the 6 month to a year lag time Veterans Choice providers have to wait for payment it will be some time after the election that we will hear how the program ran out of money.

So I guess it is time for Veterans to re-assume the position drop your drawers, bend over and crack a smile. It is the politicians turn since the AFGE, VA, TRiWest and Health Net have already had there turn.

crazy elf
crazy elf

@Seymore Klearly

Check out some of Ben’s Blogs from around July and August last year.
Ben wrote about how McDonald or Gibson said they were going to shut down the VAMC’s nationwide IF they didn’t receive more money. I believe this is when the Choice Program was gutted!

Seymore Klearly
Seymore Klearly

Elf,

I do remember that episode of “The VA Comett for More Cash”. At that time I remember Jeff Miller and all of his bogus speeches about we will give them more money this time but next time we will need accountability.

So Congress gave McDonald more money than he asked for but didn’t let him play pocket pool with the choice Bucks. Remember McDonald going we have the money but it is like it is in the wrong pocket. That why this and next years appropriations are no longer mandated to programs within the VA so McDonald can Play Pocket pool.

crazy elf
crazy elf

Here’s a question.

I’ve noticed, and heard, many VA employees talking about using Choice!
I’ve personally overheard employees bragging about how they get to use Choice.

Now, that being said.
How many VA employees are allowed to use “Choice”? When the majority of us ‘regular vets’ are denied?
I will bet VA employees are granted Choice, where we ‘regular vets’ are turned down for it on a myriad of EXCUSES!

Think about it. Where’s all the monies going IF veterans are being denied the use of Choice?
As namnibor said, some of the monies were diverted in the middle of 2015! To “What”? Where did it go?
What are our lawmakers doing, except grandstanding or doing photo-ops to be re-elected!
I look at it this way, everyone who is in office right now, (except for a very few), need to be kicked out of office next election cycle! Put in “unknowns”! It couldn’t hurt. Look what we have now!
Do we want to continue down this road again?

crazy elf
crazy elf

When I typed this I should have said;
“VA employees who ARE veterans” using Choice!

Seymore Klearly
Seymore Klearly

Elf,

What really sucks is that those Veterans who are employees are covered under the Federal Insurance Health Plan so they do not need to use Veterans Choice.

Seymore Klearly
Seymore Klearly

But I guess that is what being a good AFGE member does to some people. Help to burn up the Veterans Choice bucks so Veterans the program was sold as being for don’t get to use them to receive health Care.

crazy elf
crazy elf

The reason I brought up this question is simple. There are VA employees who are veterans at the new Lake Nona, Florida VAMC who have “bragged” about their being able to use Choice. Yet, they also were caught asking questions amongst themselves over WHY (regular) veterans were being denied access!
I have the name of the “travel accountant” who was surprised on why regular veterans are being denied!
It seems, at least to me, regular veterans are being taken advantage of in more ways than we know!

@Seymore Klearly
IF VA employees, who are veterans, are union members, and decide to opt out of using that insurance healthcare, they are indeed helping blow through the Choice Program monies. It also puts more money in their pockets!

91Veteran
91Veteran

I would like to know how VA employees who are veterans can use Choice of they have other insurance. I have a letter from a Healthnet flunky stating clearly that HealthNet is considered a Secondary payer for any Choice appointments, which means a VA employees insurance would have to pay first, then Healthnet.

If Healthnet is paying first for a VA employee, then they are REALLY ripping off the program.

namnibor
namnibor

Did Bobby McDonald or Sloan Gibson ever *find* that magically *missing* $3 BILLION from Choice Act Funds from last year when they held Veteran Healthcare Hostage?

I am thinking the VA will be all out of Choice $$$ by THIS Summer, not 2017. I am still looking for that proposal and diversion of some Choice Act $$$ for Syrian Refugees, but I am not mad as a hatter, I succinctly remember that and it may have been effectively whitewashed by now. A lot of hands in the Choice Cookie Jar at the VA but sadly, not Veterans even getting the fallen crumbs from Choice Cookie Jar.

Now the VA ‘revokes’ TriWest’ yet continues to use abysmally terrible HealthNet??? Makes no sense. This is more than likely the VA’s way of making the waters really murky with Choice Act $$$ allocations and contracts so accountability could never ever happen…the VA Kryptonite, Accountability.

crazy elf
crazy elf

@namnibor
Which one, HealthNet or TriWest, was the entity used by Obamacare that failed miserably?
Seems I remember something about Michelle Obama being involved in this!? Could be wrong!

My minds not operating at full capacity this a.m.! Still have max stress factor today!

____________________________

I received an email from “military.com” this morning. Where VA is sending “mental health professionals to Orlando” to help with what happened yesterday at the “Pulse” Nightclub!
On the “700 Club”, “Democrats are calling for more gun control!”
Mr. Trump is “…calling for stricter immigration laws!”
“Congress, (Liberal Democrats), are calling for stricter gun control!”
There’s more to this story coming out! The MSM is getting caught NOT reporting the truth about that “Muslim Extremist” who murdered those at that nightclub! But FOX and other entities are getting the truth out!

Y’all might want to Google “military.com” to see other articles pertinent to what’s going on in today’s world!

namnibor
namnibor

Really high anxiety day for me. My bank account was hacked early this A.M. and through -7- different purchases to some skateboard attire place in Australia to the tune of a couple thousand $$’s. Made police report, fraud investigation ongoing and I more than likely will get all that back as the banks just write that off, canceled card and new one coming in 4 days.

I am very, very careful and have no idea how this happened but the police told me these new ‘chip cards’ are NOT as secure as the ones used in Europe because…the Big Banks did not want to *inconvenience* people shopping by requiring them to use a PIN when making online purchases as they indeed do in Europe, and was CHEAPER for the Banks, but end result is, there were other people in my small village in line behind me having similar, but different circumstances with $$$ electronically stolen, so am sharing what I am going through as a reminder to be extra vigilant. I even have an RFID protection wallet, that’s how careful I always am, so it can happen to anyone. I was able to report it before every $ was drained, but am thinking of going back to paying cash for as much as possible rather than using the Debit Card with Chip…it obviously does not matter these days and so sad ALL the Banks/Credit Unions have the same attitude…it’s just a write-off, screw the customer….just like the VA does with Vets.

I am now going to fog my apartment with Xanax RX. 🙂

crazy elf
crazy elf

@namnibor
I stopped using my cards over a year ago out in town. The only time I use the card is when I go to the bank to get cash.
I’ve paid cash for everything since. The wife carries a few hundred as I do! No more b/s!

Seymore Klearly
Seymore Klearly

Hey Namnibor,

Really sorry to hear about your account being hacked. It happened to me not to long ago.

I do buy a lot of stuff off the internet like car parts on ebay or from companies that maintain websites. What I do now is use a prepaid debit card from Walmart for purchases on the web and cash instead of my debit card for everything else. Also I only use one ATM to make all of my withdraws off my regular debit card.

By using the prepaid card from Walmart I can just go to Wally World once a month an put the amount on it that I expect to spend for the month and not have to worry that I might lose everything in my regular bank account. That way I can still run a subscription to Netflix’s and make purchase over the web without having to worry about anyone getting my information from hacking my home system or a website to get my bank info.

Best of luck

Seymore Klearly
Seymore Klearly

Hey Namnibor

Regarding the hep c and Veterans choice dollars.

“$2.75B in Unexpected Healthcare Spending Impacts VA Budget”
By Jacqueline Belliveau on June 08, 2016

“http://revcycleintelligence.com/news/2.75b-in-unexpected-healthcare-spending-impacts-va-budget”


The programs needed $2.34 billion to maintain an increase in participation. This accounted for 85 percent of the total funding gap in 2015.

To resolve funding gaps in the healthcare budget, Congress allowed the VA to use $3.3 billion from the Veteran’s Choice Program, an initiative that allows veterans to receive care from different providers when their local VA medical centers cannot provide close or timely care.

Despite an increase in veteran care access through these programs, the reallocation of funds indicated that the Veterans Choice Program experienced significantly lower utilization rates that anticipated.

Out of the $3.2 billion program budget, the Veterans Choice Program only used $413 million. The report explained that the initiative suffered from administrative weaknesses, such as incomplete provider networks and uninformed VA medical center staff who recommended veterans to other community care programs despite a separate budget for the Veterans Choice Program.

The VA’s take on the extra $3.3 Billion Congress released to the VA for treatment of Hep C. Don’t use the money to treat Veterans. Instead use the money to do some more research using veterans.

VA websites

“http://www.hepatitis.va.gov/provider/hcv/choice/”

and

“http://www.research.va.gov/topics/hep-c.cfm”


About the Program

The Veterans Choice Program allows eligible Veterans to receive care from non-VA facilities and community providers, including treatment for hepatitis C. Learn more about the Veterans Choice Program on the VA’s Office of Public Affairs web site.

Are you a VA staff member? Access VA documents regarding the Choice Program and Hepatitis C on the National Viral Hepatitis Program intranet. Requires log-in.


VA research on
Hepatitis C

Hepatitis C, caused by the hepatitis C virus (HCV), is a condition marked by inflammation of the liver. Inflammation is swelling that occurs when tissues of the body become injured and infected. It can cause organs to not work properly.

HCV is spread through contact with infected blood or contaminated IV needles, razors, tattoo tools, or other items.

Most people with hepatitis C do not have any signs or symptoms of the disease for decades. By the time the disease is diagnosed, there can be significant damage to the liver, leading to complications such as cirrhosis (scarring of the liver) and liver cancer, and sometimes resulting in death.

VA research on hepatitis C includes clinical trials of treatments, epidemiologic studies, investigations of the biological mechanisms of infection, and studies on identifying and removing barriers to treatment.

Given the budget for Veterans choice was for 3 years and was funded by $10 Billion. The $10 Billion minus the re-aporated $3.3 Billion now being used by the VA to further study Hep C. Left enough in the budget to fund two years. Which should mean the program runs out of money in August.

But given the information that the AFGE and VA employees have been able to sandbag the programs to prevent it’s utilization. They have proven to be really effective in prevent Veterans from receiving proper medical care.

For example from the first article I listed above showing the amounts used during the first year.

“Out of the $3.2 billion program budget, the Veterans Choice Program only used $413 million. The report explained that the initiative suffered from administrative weaknesses, such as incomplete provider networks and uninformed VA medical center staff who recommended veterans to other community care programs despite a separate budget for the Veterans Choice Program.”

So the true amount of money remaining it the cookie jar is an unknown.

If the VA continues to be this effective in preventing Veterans from receiving proper Health care from the Choice Program as demonstrated by only allowing $413 million to be spent on Veterans of the $3.3 billion budgeted for the first year. That is only allowing 12.5% of the budgeted money to be spent on Veterans in the first year.

By the 17th of August 2017 they will have only spent $1,239 billion on veterans receiving care through the program. Since the program was funded with $10 Billion after taking out the $3.3 billion for hep c research and the $1,239 billion used to provide care for Veterans the VA will get a big payday of the remaining $5,461 billion to do with as they want.

crazy elf
crazy elf

@Seymore Klearly
Very informative.
I still wonder what the percentage ratio is on VA (who are veterans) employees are vs. (regular) veterans being allowed to use Choice?
I will guarantee the majority who use Choice are vets who are VA employees!

James
James

Bow so veterans male appointments for outside care.

Choise had still not contacted me

MIFNP
MIFNP

Hi James,
I am not sure where you receive VA care, but I know I had to contact my local Veterans Choice Rep so that they could upload the consult in the system. The process is the following: 1. Your provider submits a consult for Non-Va care, either fee-based services or Veterans Choice 2. It goes through Fee-Basis and the Department Head of that service. 3. Once the consult is uploaded and approved, the Veterans Choice Rep (usually a RN with utilization review experience) will upload the consult and the eligibility form together to then be picked up by the VCP. 4 The VCP can only call you if they have received these two forms. They cannot access the VA’s system without it, and they are restricted in their access of medical records not pertaining to your consult. In other words, get on VCP Rep at your local VA!! I just had to go through this ordeal at the Detroit VA three weeks ago. I hope that helps a little bit.
Thank you for serving our Country.
Kind regards,
MIFNP

James
James

I never applied for Choise through anyone ? One day I received a letter from Choise.

The letter had a card ? So I called the number and they made me an appointment with a M.D. and it was his last day.

Was told from know on you will be seen by a nurse ! No way

I called Choise and told them this story And they said ok. We will make an appointment with another doctor.

Nope They made an appointment with the same nurse. Called them back. Were will male you and appointment with a M.D. !

Have not heard back from them.

So it seems someone else set me up with Choise.?

Someone not me.

Tks

MIFNP
MIFNP

Hey James, I just want to let you know that the “nurse” they wanted to set you up with is a Nurse Practitioner. I am a nurse practitioner and we are not inferior providers. Please be mindful of the comments you post implying health providers that are physicians are not as adept. NPs have usually been registered nurses for many years before being accepted into a nurse practitioner program. All NPs have at least a master’s degree and many have doctorates (like myself), which means my education and training is equal to that of an MD. The focus for NPs is diagnosing and treating, but also includes a good portion of prevention management and therapies, which doctors do not do. MDs do not like to be reminded that NPs have better patient outcomes. We are well-versed in complex patient disease states and are able to manage difficult patient processes. However, research has found patients under the care of a NP to have better health outcomes and greater satisfaction.

Hey, it may be worth the try. If you don’t like the NP, you can always be seen by another MD.

Have a great day!

James
James

I have nothing against nurse’s. But my preference with my conditions to me require more experience.

My sister us s nurse. But I would not let her treat me. Choise !

And I do thank you for the information about Choise. I did as you recomended and the rep. Made a 3 way call and they said I will be seen by an M.D..

Since you are a nurse. Would you let another nurse be your perment provider and would you follow all their orders.

When would you see a medical doctor or do you just see nurse’s.

Nurse’s. Are very important to health care. But many people would rather see a medical doctor !
But anyway your advise helped me with making an appointment and you got me to the right person.

So thanks !

MIFNP
MIFNP

James,
Yes, I would gladly be treated by a NP. My primary care provider is a NP and she’s outstanding. I fired 4 MDs before her because of inappropriate (and dangerous) treatment plans. Do you think NPs working as providers in primary care only have a four-year degree? NPs are advanced level providers. Many have doctorate degrees. In my clinical experience, I worked with medical residents and medical students and DOs. Our attending prefers our Plan of Care to that of the other providers.

You sister might be a nurse, but I doubt she is a nurse practitioner, so legally she couldn’t “treat” you. I tried explaining this to you in a previous post. NPs ARE the provider, so yes, I would have no problem adhering to their treatment plan. If you knew how much education and training went into becoming a nurse practitioner you wouldn’t be so dismissive. My doctorate program was extremely difficult. Just because someone is a nurse doesn’t make them a nurse practitioner.

Never mind, it doesn’t matter. I am glad you were able to get connected to the right people who could get you an appt.

Best.

James
James

If I offend you.I apologize ! I’m man enough to apologize. Some people would never do that !

I know VA employees who would rather spread s lie about another person and those people who listened to their lies !

Believed those lies and punishes veterans using the lie as truth or fact and those people not forcing those employees to provide proof of any wrongdoings on the veterans part !

Some veterans would have settled for an apologize !

I’m not picking on you. Because I know how it feels to be labeled. It’s not s good feeling.

IF only management at the VA. Would stop the God syndrome and some times just admit they messed up and tell the veterans !

Yea. We made an error in your case. Make an apologize to the veterans and take action to repair the damage the lie has created !

That would include a letter admitting the mistake and file that letter and correct the medical records to show anyone looking at the veterans chart. That an mistake occured and has been corrected.

I. We wish you only the best and hope that you continue to ❤ for your patient’s. As we know you can !

Veterans need good everything. Nurse’s doctors. Psychiatry and psychology. Neurologist act !

Please have a good evening !

Thanks again

MIFNP
MIFNP

Hello James,
No, you didn’t offend me at all. You made a statement about nurse practitioners and I saw that as an opportunity to open a dialogue and share with you why NPs are safe and quality providers. I am NOT a VA employee. I am not a spy, a troll, and I do not stink of “urine.” The way I have been attacked by a vicious veteran on this blog is completely inappropriate and unacceptable. I have no ties to the VA, so I cannot speak to their processes of reconciling mistakes. What I can say, and perhaps Ben can provide further guidance and advice, is that each state has what they call so-called “apology” laws. I read your previous post to another veteran and gleaned that your VA is in Colorado. Colorado HAS an apology law. That means if a patient has been harmed in some way by the health organization, the provider can offer condolences, empathy, say he/she is ‘sorry’ to you or a family member, and that information NOT BE used as evidence of liability. I know from my own debacles with the VA that all I wanted was the provider to own up to his/her mistakes (BTW, these were MDs screwing up, not nurse practitioners!!), and yet they were too arrogant to do so. In NP school, they stress the importance of the patient-provider relationship, so ensuring the patient is completely satisfied with his.her care is No #1. VA physicians just do not understand that. In my opinion it is cultural. And the culture in the VA is about as toxic as it gets.

Nevertheless, I agree that one a mistake has been discovered, the VAMC should contact the veteran and damage repaired. Because your medical record is a legal document, YOU have to initiate changes to correct inaccuracies. Ben can further elaborate on that, too.

I have gone through 5 primary care providers: 4 MDs and now I have a NP. I fired all 4 docs because, as foreign physicians, they knew NOTHING about my military service and what makes me “tick” as a veteran. I would love to open up that can of worms here, but I would be hogging the whole blog and I don;t want to do that. Suffice as to say, international providers are at a disadvantage working in the VA because there is no formal orientation/training on Veteran Identity. If these providers actually knew what was important to vets, they could incorporate that into their clinical practice. Since I am devising this training right now with my research partner, I cannot go into further detail, other than to say I really hope my program hits a nerve with the provider-veteran relationship. We are developing a teaching on military core values and giving VA providers “templates” for reference so they understand that Veterans are a unique and distinct demographic. Pray for me. This program is for all of us vets, so I am invested in its success.

I am with you: Stop the “God Complex!”

You needn’t apologize to me for anything. You did not call me names or insult my character. When veterans act out of control angry like Seymore, we all get lumped into the same batch of uninformed, uncontrollable veterans. Nobody wants to hear those kind of hateful rants. It makes one look stupid.

Thank you for reaching out. Have a great night!
Kind regards,

James
James

Should read how do veterans make an appointment here has it changed for Choise?

MIFNP
MIFNP

I don’t understand your question. Are you asking if there has been a change in the way veterans make appointments using the Veterans Choice Program (VCP)? The answer to that question is above. You contact your local VA VCP Rep. Call the operator at your VA and ask who the Veterans Choice Rep is and they will connect you.

I understand if you are frustrated. Me, too! After my consult was written, nobody told me anything. I had no idea what to do! After months of “waiting for someone to get their act together,” I started calling around and found out each VA has a VCP Rep. That is your point of contact. Get in good with that person, trust me. They can advocate on your behalf if there are goof-ups. The Patient Advocate MUST respond to inquiries around VCP and wait times, so create a paper trail by secure messaging the Patient Advocate and enlisting their help with securing a timely appointment.

This is the route I took and it worked.
Take care!

James
James

Will do that right now tks

91Veteran
91Veteran

In my opinion there is no difference in the way TriWest or HealthNet conduct business. Both are corrupt and in it to enrich politically connected cronies.
Read HealthNets financial filings. Their sole concern is how some scandal or privacy breach might affect their bottom line. There is no regard for whether they are delivering what they are contracted for, which doesn’t matter because the VA does not oversee the contract effectively, and extends it regardless of whether veterans are getting care.
I mentioned this in another comment, but it amazes me that HealthNet is considered a Secondary payer, and that they have an entire patient grievance section. I suspect they also have a provider grievance section, both of which ignore grievances brought by veterans and unpaid providers alike.

yesIcomplainloudly
yesIcomplainloudly

I have used Choice Program for a surgery months ago and now are getting EOBs (explanation of benefits) from my medicare plan telling me what they have paid my providers. I called up my “choice champion” person at my local VA hospital and asked him why medicare was billed at all – that I was told by the VA and the doctors there that Choice would pay the entire bill (as if you were getting it done at a VA Hospital). He tells me my medicare plan has to be the primary payer and then Choice acts as a secondary payer. I think this incorrect. I also fell I had to wait for months to get approval and authorization for requests for additional services I had to get before the surgery on my artery and could have easily died from a stroke since my neck artery was blocked 90%. Medicare approves it in one minute. So I had to wait for approval for this secondary insurance, Choice. Meantime my medicare had to deny payment for some test procedures because it wasn’t pre-approved. The providers didn’t think Medicare had to be contacted to pre-approve, because Choice was supposed to pay for everything. So I am in a large battle with everyone – Choice/Healthnet, choice champions, my outside providers. These days I ask to speak with the CEO of Healthnet when ever I call and they put me on with a supervisor. I ask to speak with the New CEO of my provider Hospital system and they put me on with a VP. I want to speak to the CEO, dam it.

91Veteran
91Veteran

I fear I am going to be in the same boat. VA didn’t have a neurosurgeon on staff and would not refer me to another VA (I asked), so they approved a Choice appointment.
I expect to be stuck with the bill, regardless of whether it was service connected or VA inability to provide the care or a referral.

If this truly is the case and written as such by Congress, veterans then certainly have been fed a load of BS.

James
James

Call the Denver vamc and ask for Autumn. She the person that helps with problems veteran’s are having with Choise.

She should be able to help you. After all employees are their to help.

I called her today and she got Choise on the line three way conversation. She accomplished in 15 minutes. What I had been trying for month’s by contacting choice directly.

Another veteran or nurse advised me to call and it worked. So give it a try 1 888 336 8262

Good luck. If she helps let us know !

Seymore Klearly
Seymore Klearly

Ooo that smell. Can’t you smell that smell. Ooo that smell.

MIFNP take your VA AFGE sales pitch down the road.

We are disabled Veterans here that are sick of the system you are promoting.

Your Trolling here only makes it profoundly clear how unethical you people have become.

MIFNP
MIFNP

Hello Seymore. I am a 100% T& P disabled vet. I do not work at the VA, thus I am not “pitching” anything or anyone, and am extremely offended my your remarks. Are you implying I “smell like a rat”? You need to elicit information before you make inflammatory accusations that are patently false.

I was trying to help James get connected to the right person for his Choice care, when he made a comment about nurse practitioners. I am a nurse practitioner so this is a topic I know a lot about. Instead of flying off the handle and accusing him of disrespecting my profession, I chose to educate him, and anyone else, about APRNs. I also received Vocational Rehab for my education. I love to be well-informed on issues that directly affect me as a totally disabled vet; I suppose that is why I am “trolling” this site. I am a fierce veteran’s advocate because of the travesties that happened to me while in a VA hospital. I have no problem giving you my real name and personal email, but will not tolerate being bullied and called names as part of a veterans’ group I am clearly a member of.

Was it really necessary to attack me like that?

Warm regards,

Seymore Klearly
Seymore Klearly

MIFNP

I am telling you that you smell of rancid Urine. You are nothing but a Troll that believes you can spread your VA AFGE bullshit to veterans by trolling these pages.

Your claim of being a Nurse Practitioner with a doctorate degree relying on the choice program for medical care show you are totally full of bullshit.

As far as your stating I need to ask you to tell me more lies. I don’t need to I already know the Troll stench of rancid Urine when I smell it. Consider yourself hosed and move on.

Of course since you are a clearly morally and ethically challenged person we know that isn’t going to happen.

For a quick recap you claim to be a Nurse Practitioner with a Doctorates degree collecting 100% disability from the VA and working somewhere other than the VA. For some unknown reason the other place you are working at as a nurse practitioner with a doctorates degree and collecting 100% disability doesn’t provide you with Health Insurance. So you are forced to use the Veterans Choice Program for Medical Care.

Ooo that smell, Can’t you smell that smell. Ooo that smell. The smell that’s around you.

MIFNP you are a total Fricken Troll.

MIFNP
MIFNP

I receive care at my VAMC because I earned it. There are many veterans who wish to receive care at their VA for many different reasons. My goodness, why are you so nasty? I can see that you are very angry, but I will not accept that it has anything to do with me. You know nothing about me, so stop attacking me. Your bullying behaviors do not intimidate me. Be well.

Seymore Klearly
Seymore Klearly

Oh almost forgot.

Piss Warm Regards to you too!

James
James

Seymore. Did the same thing to me. Trying to push my buttons. Claims she/he is a street veteran !

Whatever that means !

I am a former VA employee and a 100 percent disabled veteran. Who has had a VA employee falsely accuse me of disruptive behavior !

Seymore. Tried belittling my concerns that I have with trying to fight back and tried to make it sound like. I was just a winer !

That to me sounds just what a VA employee would do !

Were here for each other. No matter who thinks it should be one way !

Some people are not happy unless someone else is unhappy !

Oh well. Life go on

Seymore Klearly
Seymore Klearly

Oh James don’t be so modest. You worked for a VA health care facility for 22.5 years now retired with the federal retirement package that includes Social Security and are also eligible for the Federal Health insurance package which also includes Medicare, which you claim you do not receive, also you are collecting a 100% disability from the Veterans administration. Also a loyal dues paying member of the AFGE for 22.5 years.

Your big claim about the VA is that because of the disruptive committee your life has been totally destroyed because you cannot get treatment at a VAMC. You poor poor person James keep up the good fight to force the VA to provide you care in the Deadliest medical system in America and don’t forget how the union you helped support for 22.5 years is number one in corruption.

James aren’t you also a Member of the American Legion and the DAV?

“AFGE Leads All American Unions in Criminal Misconduct by its Officials”
“http://nlpc.org/stories/2016/05/04/new-york-afge-president-pleads-guilty-wire-fraud”

So James while you are rolling around in the troll excrement your friend is leaving on this page feeding it lines to help it promote the VA’s attempt to change the Federal Regulations to allow Nurses to perform the work of doctors know that the same smell is getting all over you.

As for me I am a regular disabled Veteran who has not worked for the VA. Although I did learn my lesson about trusting VA Health care after being crippled by a surgery done by a researcher at the VA. Those magically disappearing records and the stacked against a real Veteran claim system.

But you and the Disruptive committee how dare they treat you like some Veteran off the Streets. You get um James.

So James go roll around in some more troll excrement you do seem to attract a good number of them and you always seem so apt at feeding them lines to promote what ever the current VA propaganda is.

James
James

Your comments are unneeded. You act like you know more than the person themselves !

You do not know what you talking about ? You know nothing about anyone. YOU try and put your own words into people’s posts.

What makes you quailifed to make statements about what another veteran is or has done in their lives.

You make it sound like you know everything about a veterans life. Now much they make the what insurance They have ect !

When you post that veteran’s have this or that and your wrong !

You think your smart. But you comments suggest other wise. !

What you doing is the very same thing employees are doing to veterans. Making false allegations !

Your truth is not the truth. !
Your crystal ball. Must have a crack in it. Giving you the wrong reading.

If all you like to do is play the role of a current employee. Get the facts and stop spreading untruths. !

Seymore Klearly
Seymore Klearly

“AFGE Leads All American Unions in Criminal Misconduct by its Officials Since”

See more at: “http://www.fedsmith.com/2015/06/04/afge-leads-all-american-unions-in-criminal-misconduct-by-its-officials-since-2014/”

Seymore Klearly
Seymore Klearly

James I know that what I am writing about is true. You remember you told me all of this. Just because you don’t want to hear what you told me repeated doesn’t make my statements untrue.

Certainly if you lied to me when you said everything then it would be untrue, but I am only repeating what you personally have told me in other post.

Now go back to rolling around in troll excrement you certainly seem to love doing that. You really are smelling pretty rancid in your writing. So go on back to your troll friend and feed the troll some more lines so it can troll this site further with the latest VA Propaganda. What is it this time nurses instead of doctors wasn’t it.

Personally I really do care to waste any more time on you.

James
James

If You check your posts Tks it shows where you put that I was getting such and such and I told you that was wrong!

And your replies were smart Alix. If someone says something. Keep you thoughts to your self. !

In other words don’t put words into something that you think you know.

VA employees are good at trying to twist the real truth. I may have been shot in the head. That does not male us easy target’s. !

I still know when someone is belittling me !

Who’s YOU next triumph !

Seymore Klearly
Seymore Klearly

Sorry James you are not making any sense. If I remember right you live in Colorado I don’t know you but your writing seems to reflect you have been maybe smoking a bit of the Green stuff. Your ability to put meaningful sentence together and your spelling seem to continue to go down hill as well.

Remember James you started attacking me first with insulting posts both further down in the comment section and up above. All I have been doing is being honest about you.

Oh and James trying to play the TBI card for your current behavior doesn’t cut it since you did work 22.5 years at a VA Health Care Facility. Your inability to act responsibly and coherent would have been notice long ago and you would not have been employed for the 22.5 years. Especially at a health care facility.

I am done with you James so you can go over an lay down by your dish. I really don’t care to hear from you again you really are a total waste of time.

James
James

TBI card. Took me forty year’s to find out I had a TBI and only after the VA let me be seen as an employee. And I was able to express myself about me being shot in the head while in the military.

As they refused me treatment for forty year’s. So I lived all those year’s with the TBI.

You have no clue. What challenges I had to over come in those forty year’s.

So play your stupid card. !

I’m lucky to be alive.

I did work all my life as a VA employee and I made sure if I seen any veteran being disrespected that employee would be imediently reported and that employee was counciled. !

I’m not ashamed of working to feed my family. I wrote down everything I needed to know in a Manuel for future reference !

Suffer from severe migraines and memory loss.

What have you accomplished. Beside belittling people. !

As for smoking the green stuff. You should try it. It may enlighten your senses. You Know its not against the law?

I would rather be with people that smoke the green stuff. Than be around people who drink. !

Their more mellow and don’t want to fight everyone. !

Last post to you. !

Be happy don’t worry. !

namnibor
namnibor

“…Ring the bells that still can ring / Forget your perfect offering / There is a crack in everything / That’s how the light gets in…”- Leonard Cohen

Corruption cannot survive Accountability, and we Veterans are that light. Peace.

Reuben Castro Acosta
Reuben Castro Acosta

VA DEATHCARE ONE BIG BIG FEDERAL RICO CRIME RACKET VETS YO ARE SOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOO SCREWED !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

James
James

Can’t wait until something happens and you can say ! Told you so !

And I’m praying it sooner than later !

NiteWish
NiteWish

I shared some of my story in the article “pbs-story-shows-longer-va-wait-times-after-2-years”. Here is some update. My appt to go to the VA’s pain clinic was cxl by VA due to the long wait time of 4mos to be seen. I spoke with a gal from Choice & the appt will be in my home town, there are providers available. I then received a letter from the Choice/TriWest with an appt to see an Anesthesiology provider 44.6 miles away from my home, which I had to cxl due to the distance & needing to go to 4 visits. So if I understand this right I’m being sent out of the VA to get pain medication from another provider because I refused to take a drug called Gabapentin which was offered by my PC. My PC also wants MRI on my shoulders. Choice has made that MRI appt for the end of this month but not with the provider of my choice but that appt is in town. Now that I know I’m dealing with TriWest aka Choice, I’m getting a CT scan for my TMJ through the DDS referral because I know I’ll be sent out for substandard imaging & what an aggravating hassle it is to deal with this.

Seymore Klearly
Seymore Klearly

Good call on refusing the Gabapentin. Bad call on the CT scan. you should read up on ct scans. Especially around your head and throat.

Sandy Hale, Disabled Combat Veteran, Retired Nurse
Sandy Hale, Disabled Combat Veteran, Retired Nurse

I think these Trolls are getting aggressive in their strategy and trying to pose as veterans with FAKE SOB STORIES and FAKE CREDENTIALS that we have no way of confirming and mix in among us to argue for the VA system to DIVIDE AND CONQUER. It’s not working. because Nobody and I mean nobody that has actually had to use the VA system to do ANYTHING more than once can promote it. There is no such thing as more than one or two pleasant experiences with the VA and the rare and I mean very rare exceptions are individual employees that do not represent the entire VA system. God bless the very very very very few VA employees that are actually trying to make a difference, but they are so outnumbered that they are almost non-existent. I still have all my senses and my brain still functions so I’m not impressed with all these FAKES and their opinions don’t matter. I think we should just IGNORE them and go on with the real facts and maybe they’ll just get tired of being ignored and troll somewhere else. Calling attention to them is necessary, but trying to reason with them is impossible. They are on a mission and they will not alter their thinking so trying to convince them is fruitless. They already know they’re WRONG. they don’t care, its just a paycheck and a job like garbage collecting. The job stinks.

James
James

I don’t know about other x employees ! I was denied treatment for forty year’s And the VA regional office lied about my records being destroyed in the saint Louis ?.

I decided back in 1973 to work for the VA in fort Lyon co. The VA told me the only position I qualified for was a janitor. I did this for about 3 month’s and quit.

The VA called me and told me the IRS. Had a training slot in the file room as a GS1. I took the opportunity and got my training !

I quit and moved to Phoenix. Their I was hired as a GS 2 file clerk. No contact with veterans.

I did not want to stay as a file clerk. I felt I could be more help working for and with the veterans.

I seen that employees would call in sick and they had no one to cover that position. I advised management that they needed to start a new position called rover. !

No one signed up to train in all administrative positions to cover when needed.

I did and I was trained in ever position and that put me a position to help my fellow veterans.

I would pass on to them everything I knew to male sure they were treated with respect and if I seen anything or anyone mistreating them. That employee was reported.

I have helped many veterans By giving them needed information.

I was not liked by some employees due to me turning them in.

Management kept charging and I had to file against them for passing me over and over for certain positions.

I was a loner and took care of my family and did not mingle with other employees. Besides work !

I knew that I could not be the only veteran that the VA had lied too !

As you can see by my posts that I was shot in the head and denied treatment.

As you can see a VA employee falsely accused me of disruptive behavior and only as a retaliation for me speaking about her under performance of s committee.

I know other veterans that worked for the VA and the employees that never served did their best to give us a hard time.

These veterans did their jobs hand did not take any carp from anyone.

So I had the pleasure of helping my fellow veterans in an a sometimes hostile involvement.

The VA accused me. They were the judge. Jury.Prosecutor and punisher!

Think they would do that to an employee that was a pain in their side. Because I would not let them bully me !

So if anyone thinks I’m Be them.that’s their problem. !

I’m still fighting the VA and will until they kill me or I die of old age !

Unless someone has evidence other wise. I hope they.you don’t label me. Until you meet me. !

The VA should be shut down hand many employees deserve to be in jail. !

Have a good day. !

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