ChampVA Pays $16 of $15,000 Hospital Visit Then Sent To Collections

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ChampVA Collections

ChampVA, the insurance for dependents of qualified veterans, paid a whopping $16 toward a $15,000 bill before it was sent to collections.

My wife and I were contacted by an area collection agency for $2,000 in unpaid hospital charges related to the early birth of our son last year. The problem with this scenario is my wife has a primary insurer through her employer, and ChampVA is secondary. That means we should normally receive no bill from any health care provider.

I called collections to find out what happened.

The company granted us a grace period to resolving the issue citing previous knowledge that VA might not be processing claims properly. I faxed a notice to the collection agency contesting any liability.

Again, we have two forms of insurance, and VA is required to cover any remaining liability for any normal medical bills.

One VA clerk from ChampVA confirmed a VA adjudicator screwed up processing the insurance claim, but the amount of the scope of the mistake was illuminating.

Apparently, the previous adjudicator failed to review the billing statements and only paid the amount listed on the bottom of each document without considering the other amounts on the itemized bill, like he was supposed to.

As a result of the mistake, for a $15,000 bill, VA only paid $16.

While we still do not know the full amount of the mistake when deducted against the primary insurance company, the amount missed by the adjudicator is obviously a lot given the $2,000 bill we received from the collection agency.

VA generally pays Medicare rates, which is substantially lower than the normal amount a hospital bills insurance, so if the $15,000, who really knows that the final tally comes to. Either way, we should not have been billed anything, much less have had any collection agency call us demanding $2,000.

If this were isolated, that would be one thing.

This is the second time in less than a year that VA has made a substantial mistake when processing coverage of our health care fees. Given the nature of what I do, expose VA scandals, fraud, waste, and abuse, I am not surprised by this growing pattern.

Seem like a coincidence or does VA like staying in the headlines?

In June, KARE 11 News covered VA’s denial of my emergency room bill under the prudent layperson framework. Basically, VA claimed other veterans would not seek emergency room care if they experienced my symptoms. Those symptoms I experienced that night were those of a heart attack.

RELATED: Is VA Engaged In Bad Faith Insurance Adjudication?

Exposure of that scandal resulted in Rep. Tim Walz calling for a federal investigation into VA’s non-VA emergency care program.

And, if VA would screw up my claim costing me thousands, I can only imagine how many other veterans are affected.

As for my case, VA is now supposedly investigating the ChampVA issue. While the agency is presently stating it committed an error, one never knows precisely how VA will resolve the matter.

RELATED: ChampVA Frequently Asked Questions

ChampVA is short for Civilian Health and Medical Program of the Department of Veterans Affairs. It provides insurance coverage for the spouse and dependents of certain qualifying families of veterans with 100% Permanent & Total disability ratings.

RELATED: ChampVA Will Cover ADL Claims For Spina Bifida Kids

Anyway, my friends over at KARE 11 are interested in learning more about ChampVA. If you have a story of VA failing to cover health care bills, definitely provide your comments below.

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namnibor
namnibor

Benjamin- Good job! You foiled some pack of VA rats getting brand new bonus ratty hats this year in behalf of your using outside medical care and the passive-aggressive VA trying to screw you for that $$$. Systemic problem, not isolated.

namnibor
namnibor

By the way, McCain and Graham have been screwing with ChampVA and McCain is personally responsible for copays and all fees for ChampVA going up substantially and McCain wanted even MORE increases. I bet he might have a different attitude if his wifey-poo was not a mega-millionaire beer mogul…perspective is everything.

Lem
Lem

My bills weren’t as bad. Choice didn’t pay a $150.00 lab bill because the Banner Health Lab wasn’t part of the Approved Banner Health Clinic and was a separate entity at the Banner Health ER/Hospital in the same compound.

The VA didn’t pay a Clinic visit before I was approved for Choice because I chose to take an “urgent” care problem to the Clinic instead of the ER after calling the VA and explaining that I had an infection that needed urgent care and the roads were bad, the nearly 200 mile trip to my “assigned VA” hopsital couldn’t be made because I didn’t have a driver and because of my TBI couldn’t drive on the iffy road conditions. $75.00 plus $25.00 for the Rx.

Yes, the VA has been making a habit of putting costs off on us and our families for a very long time. When I was in Douglas with a 120 mile trip to Cheyenne the VAMC refused to pay my travel pay though I was being seen for a service connected condition rated at 30% because”Reagan had signed a denial for travel pay to veteran’s who didn’t have the qualifing 30% and weren’t being seen for a service connected condition but were poor. So my family (brother and AM Legion Volunteer) had to provide my travel to Cheyenne without reimbursement hoping we would complaint so the Director’s friends could get their travel pay as they had been in the previous years.

And so the wheel keeps turning as it has since the banks picked up the revolutionary war warrants for pennies on the dollar by lobbying for delay in payment. And the lobbyists keep working to make sure the taxpayer dollars are spend on war hardware not those flesh and blood costs.

Oldmarine
Oldmarine

I know one thing that is a fact if you owe them 20.00 past 3 months due they will take it out of your SS disability check with a extra 20 fee if If you have a 0% rating, Happened to my brother.
They don’t pay their bills but they will make damn sure you pay yours .

Crazy elf
Crazy elf

I agree Ben, your a “target” by VA. Because you bring out the truth behind the MASSIVE corruption, waste, fraud and abuse in VA!
For example. I made a valid HIPPA complaint through my Congressman’s office and was, within a few weeks after, informed they “MIGHT lower my compensation!”
One phone call from my (POA) representatives settled that discrepancy quickly.
You see, the VA owes me quite a chunk of change. Due to them stating I never served in the Army. And because they “claimed” I never served in the Army, I could have never served in Vietnam! Therefore, how could I have been injured in Vietnam!
(Note: the VA had been in possession of my Army Medical File since the early 1970’s! Which clearly shows a “combat injury”, while stationed in Vietnam!)
There’s more to this, yet I believe y’all get the point!

Crazy elf
Crazy elf

Y’all need to google the following website and read what’s going on.
“Military.com”
Is full of articles today which may interest you!
VA says “bad discharged veterans won’t be given new ID Cards!”
McCain’s opening his mouth against President Trump again!
Bergdahl says the enemy is more truthful than the Army!

There’s more on it today!

Dennis
Dennis

Ben,
Let’s be honest here, ok? You are responsible at the very least for intervening personally and directly and adversely impacting VA across the board all the way to the very top. All the way from 25,000 wrongfully processed TBI claims vets to a litany of revelations about this most corrupt agency in American history you personally have been identified by name and recognized at a national level by federal authorities…

My friend you should be THANKFUL for two things;
1) That VA paid even $16 for you personally, AND
2) That Hillary did not get elected – because if she had taken power the next thing you personally would know is that the IRS decided to audit your last 15 yearly tax returns….as a starting point….

Personally if I were you I would take the $16 and run! In Oregon that will get you about half a gram of great hash! Semper Fi

Crazy elf
Crazy elf

Dennis,
You forgot about, IF Hillary had been elected, Ben’s body might be found with two bullets to the back of his head. Where the autopsy report would declare it a suicide! You know, how so many others have been deemed to be suicide!
Just thinking out loud here!

namnibor
namnibor

Don’t rule-out the VA’s Disruptive Behavior Committee going entirely rogue, regardless of whom is POTUS. I cannot believe the butthurt snowflakes still pretty much have sand in their vaginas and anterior orifices…yeah, I’m in a mood. How about a Bergdahl Blanket Party? (BBP)

windguy
windguy

Go figure elf – since Trump was elected I’ve been considering at least one bullet in the front of my own head – two if I can figure out a bump-grip…

Seymore Klearly
Seymore Klearly

It use to be called Arkancide.

Devil Dog
Devil Dog

I am Lean Mean Machine Marine always be a Marine I am Listening.

Seymore Klearly
Seymore Klearly

You are nothing but a paid troll that is harassing Disabled Veterans.

BLAKE LEITCH
BLAKE LEITCH

As a Veteran Service Officer I have asked over and over again for some sort of training for CHAMPVA and low and behold they don’t provide for any kind of training whatsoever. This benefit is one that is hard to explain to veterans because it is hard for even me as a seasoned VSO to understand it. Can you provide any insight to this?

Don Karg
Don Karg

10/23/2017

Dear Benjamin Krause

This was no accident or an “honest Mistake” [Torrance, CA] this was wanton.

Sincerely,

Don Karg

namnibor
namnibor

Some overcooking cabbage?

namnibor
namnibor

Holly spellcheck….**Someone overcooking cabbage?**

Crazy elf
Crazy elf

Is your neuropathy acting up again namnibor?
Mines been outta wack for a few days now!

namnibor
namnibor

YES! I was *just* cursing my own difficulties in attempting to hold-onto anything small or large today in my hands. Good to know it’s not my first thought that a VA Hack Witch Dr. made a voodoo doll of me…but still not ruling that out. I can barely type now…eek! Where’s my cat with the vaporizer? My turn already, Bogart Kitty!

ANutterVet
ANutterVet

Our cure; cannabis. The VA’s cruelty and poisoning; Gabapentin. Turd hanging ass wiping Rat Basturds (the VA). That’s a damn fuzzy bergdahl for ya my friend. Grab that cat by the tail, and charge that vaporizer. – – – Nutter.

Chuck Vroman
Chuck Vroman

Ben, the VA denied two previous non-VA emergency room bills of mine when I lived in the Fredericksburg, Virginia area. The closest VA emergency department is at the Hunter Holmes McGuire VA Hospital in Richmond, which was, at the time, 1 hour and 20 minutes (or 69.2 miles) away from where I was living. I was in the early stages of anaphylaxis and the VA hadn’t sent my Epi-Pens to me at that point. I was taken to the emergency department at the Mary Washington Hospital in Fredericksburg. The second was for the same thing and the same ER, the difference was I had one expired Epi-Pen which was almost completely in effective. I did not find out about these debts until earlier this year when I was trying to apply for a VA Loan to buy a house. Then I was told by VA that they would not pay the bill because 1: it was not a “life threatening situation which required emergency care” and 2: it was not filed correctly by the hospital within the allotted amount of time (which they refused to elaborate further on and hung up on directly thereafter). Now I’m on the hook for almost $10,000 in medical judgements because VA did not do their job. How do I get this cleared up so that I can buy a home for my children and I instead of renting the rest of my life?

91Veteran
91Veteran

Chuck, about the only suggestion I can make without more detail is to contact the Facility Revenue Manager at the VA that should have paid the bill. You should also find out who the Privacy Officer is at the same VA, and submit a FOIA request for any documentation regarding either of those bills.

Mari
Mari

Many years ago, I was content with CHAMPVA and they seemed to be efficient, then some changes told me things were changing cause somebody always has to change something that was working, at least for some things. First, I noticed there was not online access to check claims or prescriptions requested through meds by mail anymore. So, one has to haphazard a guess if the claim or the prescription was done correctly.

Sure, one can call in to inquire and “if” can get an efficient and helpful person, one is doing good. Today I had to call to inquire about a soon needed prescription (was it even received?) since I have no other way to track, except to know the provider sent it in through electronic system. Today, it didn’t work out so well for me to believe they are efficient. How dare I call with a question?

Hope your issue will be fixed expeditiously.

ANutterVet
ANutterVet

Off Topic Repeater (no trolling) – – – Anyone being prescribed Soma (Carisoprodol) by a VA Medical Provider? Please list VA facility, treatment for what symptom(s) [muscle spasms, pain, anxiety, etc.], how long been prescribed for ito treat symptom(s), strength; 250 or 350mg, and how many per day. No names. Your input can possibly help me in having the VA to reinstate Soma back onto my personal VA formulary. – – – Nutter.

Ralph M. Maddox-aka Old Hippy
Ralph M. Maddox-aka Old Hippy

@ANutterVet, Told you once, I think. might not. I have been getting it since 2003 from Carl Vinson VAMC, Dublin,Ga. 350 mg. 2 pills twice daily for muscle spasm, pain and Migraine Headache. Hope it helps ya man.

Nic Mach HM (FMF)
Nic Mach HM (FMF)

Dear Ben,

Good job. You scammed the government in getting both active military retirement benefits (CHAMPVA = Tricare), without a proper retirement and you got a VA rating of a brain injury, without having a real brain injury (that is a term of art I guess, or unless going through law school damages one’s brains?). YOU ARE MY HERO! How do I get what you have…I wan’t to be you.

Seymore Klearly
Seymore Klearly

Nic Mach a.k.a. (Concerned Veteran, Devil Dog, …)

Total Troll

namnibor
namnibor

~~Gurgle~~ Again, that is the sound of Satan’s asshole calling for his dingleberries and hemorrhoids to come back home! ~~Gurgle~~ (fuck-off)

91Veteran
91Veteran

Have you received the documents Ben in which they are claiming they only paid $16 because he only looked at the figure at the bottom of the page?

If so, using their emergency room visit logic, would a reasonable person make the same mistake? Or only an idiot?

How many other documents are reviewed by any kind of adjudicator who only looks at the bottom of the page?

As I have said before, using the Law of Averages, one would think the VA would make a mistake that does not favor the VA once in awhile. Why is it every single time they screw up, it just happens to favor the VA?

Note to anyone submitting bills to the VA: Write the amount the VA must pay at the bottom in large block figures, underline it, then highlight it using a green neon highlighter marker.

Does the VA pay their contractors the same way?

Seymore Klearly
Seymore Klearly

Sad but True!

Navy veteran Dan Parks, who served our country during the late 1960s and early 1970s. Was discharged from service due to Radiation Exposure. It is even stamped on his discharge DD 214. Today he suffers with throat cancer and has been treated by VA Doctors. Multiple doctors with the US Department of Veterans Affairs have written letters saying there is a better than ever chance that the cancer was caused by Parks’ radiation exposure during his time in the Navy.

Of course, all claims with the VA have been denied. They say there’s no proof he was exposed to radiation in the Navy.

“VA denies veteran disability benefits despite evidence of radiation exposure”
Nick Ochsner, WBTV, 10/23/2017
“http://www.wbtv.com/story/36660004/va-denies-veteran-disability-benefits-despite-evidence-of-radiation-exposure”

Seymore Klearly
Seymore Klearly

“Practices at Billings VA Dental Clinic Led to Delayed Care”

“Veterans who were denied outside consultations were forced to drive hundreds of miles to the nearest VA clinics”
By Associated Press / Oct 23, 2017

“BILLINGS — Practices at the Billings Veterans Affairs dental clinic led to delays in care and in some cases risked patients’ health, according to a federal investigation.

Billings dentist Kelly Hale complained in 2016 that former chief of dental services Robert Bourne didn’t allow staff dentists in Billings to access a computerized system to log requests for consultation and treatment for veterans outside the VA system, The Billings Gazette reported.”

Seymore Klearly
Seymore Klearly

“House Oversight Committee may subpoena agencies not providing info on private email use”
By Eric White, FEDERAL NEWS CAST, October 23, 2017

“The Government Accountability Office said VA lacks a way to count how many contract physicians and medical residents it has on board at any given time. The department also has problems with the methods it uses to measure doctors’ workloads, and VA can’t track how productive its medical centers are. Inaccurate metrics mean VA can’t evaluate which recruitment and retention strategies are working best. VA said recently it has more than 35,000 full time equivalent vacancies.” At: “http://www.gao.gov/assets/690/687852.pdf?utm_medium=email&utm_source=govdelivery”

Seymore Klearly
Seymore Klearly

So, with those 35,000-full-time equivalent vacancies now filled by contract physicians and medical residents. Why is the VA paying employees’ salaries to protest under the AFGE with the bogus number of 43,000 vacancies if 35,000 of them are already filled by contract physicians and medical residents?

ANutterVet
ANutterVet

Additional monies are padding the linings of some VA Leadership’s pockets or purse. Where there is NO ACCOUNTABILITY, there’ll be CORRUPTION. Don’t believe me? You read it almost every day right here on Ben’s blog.

I’m going to roll a fat old-time single camel back doobie (using wheat paper), and then visualize being outside training my K9 PTSD Service Dog. Fuck off trolls, and fuck you VA-AFGE. Deeply seated in a stubborn mood, and I’m not moving. Really. – – – Nutter.

Ralph M. Maddoxaka Old Hippy
Ralph M. Maddoxaka Old Hippy

OK. Aug. 2016 Dublin, Ga. VAMC sent me to Augusta University Health to have cervical spine completely fused to a titanium plate. They sent me there through the CHOICE/PC3. On Sept.12,2016 I went in having the surgery. Had 2 post op visits with the Neurosurgeon. Well, The bill for over $104,000 has not been paid. Last week I get my Medicare notice that the NON VA Provider charged my Medicare Account and I now have a CoPay of approx. $800.00 that they are sueing me for. When calling Mediare all I get are Spanish accents that don’t understand my problem. Surprise, Surprise. HealthNet Fed. Services, the PAYOR for VA, tells me that I was using the PC-3. OK. Well, The hospital is not in that program. They are in The CHOICE Program. The Surgeon is in the PC-3 Program NOT the CHOICE Program. One would think, since it took over 2 years to get the surgery arranged, the VA would have had all that squared away. NOT!! And HOW did the NON VA provider even get my Medicare account number??? I would like to know. Well HealthNet tells me that they must get my VA Providers to SPLIT BILL so they can pay the NON VA Providers. If it doesn’t get “Split Billed” what then ??? He tells me that the records show a statement was processes for $104,000.40. The bill was approved with a payment of $0 paid. due to the CHOICEvsPC3 issue. All the parties involved, you know the ones that say “Thank You For Your Service”, know the problem, yet I am still going to bee sued for $800.00. Well Ben, you asked for others stories about VA not paying. Here is mine. What do you think??

Seymore Klearly
Seymore Klearly

“Army widow battles Department of Veterans Affairs over pair of costly mistakes”
By KRISTIN DAVIS THE FREE LANCE–STAR, Oct 21, 2017

Image the feeling of a loved one, set to receive survivors benefits and the VA somehow keeps sending lump sum payments to someone else’s bank account.

The nightmare the wife and their newborn had to go through having to fight the never ending bullshit at the VA to try and get it straitened out. All because she made the mistake of trusting someone at the VA.

“http://www.fredericksburg.com/news/local/army-widow-battles-department-of-veterans-affairs-over-pair-of/article_967a970e-2418-5269-b535-68ffe2845e75.html”

Seymore Klearly
Seymore Klearly

“Illinois AG: Veterans defrauded in VA pension scam”
By Robert Channick, Chicago Tribune 10/23/2017

“The seminars took place at assisted living facilities and other venues across Illinois and were presented as community outreach to help veterans and their families navigate certain pension benefits available from the Department of Veterans Affairs. Applicants were then steered into purchasing unnecessary annuities to qualify for the benefits, the lawsuit alleges.”

“Hosted by the American Association for Wartime Veterans, the seminars were actually a platform for insurance pitches by Atlantis Marketing Solutions”

Seymore Klearly
Seymore Klearly

One of the hundreds of thousands used in Chemical weapons experiments has now won his claim against the VA. He is in a nursing home in Macon, Mo., and his family planned to inform him of the decision either Monday night or Tuesday.

“Missouri World War II veteran wins appeal proving health problems from mustard-gas exposure”
By Chuck Raasch St. Louis Post-Dispatch, 6 hrs ago

“http://www.stltoday.com/news/local/govt-and-politics/missouri-world-war-ii-veteran-wins-appeal-proving-health-problems/article_a8ccf33f-9b29-558c-843f-0e15fb34d38e.html”

“In a “findings of fact” document, the VA concluded that “the veteran was subjected to full-body exposure to mustard gas while he was stationed at Camp Crowder, Missouri, during World War II.””

Copy of the decision at: “https://urldefense.proofpoint.com/v2/url?u=https-3A__www.mccaskill.senate.gov_imo_media_doc_2017-2D10-2D06-2520Arla-2520Harrell-2520Appeals-2520Decision-2520redacted1.pdf&d=DwIFAg&c=UCja3IwhyjPGYeHcG7oIbg&r=FP7rII86D_LVEDyLLtp8Hn0Y-aXg9_RIDjbGZCcGQak&m=gwBwjZlNGMB8S3DKAynsB5E2b4cUe_dUrheftuHZgnQ&s=o3I578Fw93hVxq6Bxxyj_URa7Vh_H0_Rolkg1bPntYA&e=”

Jim Nose
Jim Nose

I have Medicare and Aetna which is Medicare advantage. I am 60%
va diaabeled connected. USAF nam. I only go to va for meds and
a second opinion. Any major or minor procedures I have performed
at my civilian hospital. Eg. Emergency heart attack. One stent
bill for the month over $400,000. My portion $1,000. How can you
beat that?

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