Bureaucratic and contractor delays in paying health care bills for non-VA care via the Choice Program has forced one veteran to pay out of pocket for his surgery due to Healthnet billing problems.
Vietnam veteran Bruce Berreth requires a knee replacement surgery that was outsourced through the Veterans Choice Program because Central Alabama Veterans Health Care System cannot perform the procedure within a reasonable amount of time.
In theory, Veterans Choice would pay the $12,000 tab for the procedure at Hughston Clinic. But that clinic is no longer taking VA referrals because Health Net Federal Service has failed to pay $1,500,000 in services to date.
As a result, Berreth must pay for the procedure out of pocket without the referral.
Both VA and Healthnet responded to queries about the payment issue. VA is apparently aware of the issue and is making arrangements with other area orthopedic providers who have not yet been burned by Healthnet’s tardy payment history.
Nationwide, many private health care providers refuse to accept Veterans Choice due to bureaucratic delays in payments making access to care impossible for many veterans who are only using Choice because their local VA is unable to provide the care needed.
As an example, one report shows Healthnet owes Florida hospitals $134 million in delinquent payments for veteran health care.
If you are like me, you are probably wondering, ‘How can this be legal?’
It is our honor and responsibility to serve the veteran community. We strive to provide excellent service to every veteran, every time. Health Net Federal Services has no higher priority than the fulfillment of our Veterans Choice program obligations in support of our continuing and long-term commitment to the veteran community.
Developing a complex and consistent new program like Veterans Choice is a team effort, and HNFS is working closely with Congress, the Department of Veterans Affairs, the Columbus VA Medical Clinic, and the 12,000 local health care providers like the Hughston Clinic to ensure the state’s 42,000 veterans have the appropriate, coordinated and convenient care they have earned for their service to our nation.
Health Net Federal Services
SECOND HEALTHNET STATEMENT:
Health Net Federal Services is working closely with the Hughston Clinic and the Columbia VA Medical Center to resolve any billing issues.
Health Net Federal Services
Central Alabama Veterans Health Care System takes the quality of the care it provides very seriously. When problems occur, they are quickly identified and addressed. CAVHCS is experiencing a lack of available orthopedic surgeons in the Columbus, GA area. Our largest Non-VA Care provider of this service is the Hughston Clinic. Due to issues with processing of health care claims by the Veterans Choice Contract Provider, Health Net Federal Service, the Hughston clinic is currently not accepting Veterans Choice program referrals. Health Net has assured CAVHCS leadership that they have been in constant communication with the Director of Reimbursement at Hughston Clinic in effort to work towards resolution regarding their claims. In the interim, CAVHCS continues to coordinate orthopedic care for Veterans in the Columbus, GA area by utilizing providers in LaGrange, GA, Opelika, AL. and with Martin Army Hospital at Ft. Benning, GA.
Central Alabama Veterans Health Care System