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RI Veterans: Did you know? 5 August 21 – John A. Cianci

by John A Cianci, Department Veterans Service Officer,

                             Italian American War Veterans (ITAM)

Question

I sent an inquiry to a U.S Senator concerning the new policy of VISN1 to stop the use the kiosks for reimbursement for travel pay and was told the kiosks were no longer be used by Providence VA and New Bedford locations for reimbursement. Why are the kiosk still operational in VA locations in Connecticut of VA was discontinuing the use of the kiosk?

                          Linda P Town of Burrillville Veterans Service Officer

Answer

RINewsToday reached out to a spokesman from the VA and was told the VA Providence and VA New Bedford locations discontinued the use of kiosks because of FUNDING and LACK OF STAFF. Providence and New Bedford VA will process the backlog of claims for travel reimbursements.

In layman’s terms, those Veterans who don’t have a computer to apply online and don’t want to call and spend up to an hour for travel reimbursement on the phone to provide information for a VA representative to key on the information——–you will not get the required travel reimbursement for traveling to the VA for your service- connected disabilities.

Simply put, the VA seemingly doesn’t care about inconveniencing our Veterans in this case, that could have been resolved by funding overtime and or hire additional staffing on a program that was convenient for the Veterans to be reimbursed for travel. 

Veterans should attend and voice their displeasure on this policy change by showing up on August 11, 2021, at the VA Town Hall event, 5:00-7:30, at the New Bedford VA Community-Based Outpatient Clinic 175 Elm Street, New Bedford.

Moreover, urge the VA leadership team NOT to solve the backlog problem of processing travel claim on the backs of disabled veterans—-seek and demand more funding for overtime and or additional full-time staff to process travel reimbursements for disabled service-connected Veterans.

This Veteran reminds the VA leadership team of a quote from General George Washington to Governor Jonathan of Connecticut in June 1781:

“Permit me, Sir, to add that Policy alone in our Present Circumstances, seem to demand that every Satisfaction which can reasonably be requested, should be given to those Veteran Troops who, in the recent Conflict, have been so long and so faithfully serving the States”. 

In summary Linda, the decision to stop using the kiosk for processing travel reimbursements was a decision based on lack of funding and full-time staff to process the travel claims. Clearly, in this veteran’s opinion, without considering veterans who are disabled.

Know the VA Rules for The VA To Pay for Emergency Room Care

Did you know the VA must be notified of the treatment within 72 hours of your arrival at the emergency treatment facility? If the VA is not notified within that window, the Veteran could be responsible for thousands of dollars of hospital bills.

Home at last.

It’s been over a month since you were rushed to the nearest emergency department after suffering a heart attack while on vacation with your family thousands of miles from your home.

You are grateful to have survived the heart attack and half dozen other surgeries over the last two months as a result of complications from the heart attack.

After a week or so home, you receive a bill for over $500,000 for the emergency, hospitalization and rehabilitation you received after the heart attack. No worries on the amount of the bill, you know a Veteran enrolled and using VA healthcare; emergency medical care is covered. You simply ignore the bill and continue on with your daily life which included ongoing rehabilitation to recover from the heart attack.

Unknown to you, no one has notified the VA of the emergency care and additional medical care you have required over the last few months.

Based on the aforementioned information, do you know the VA by law is not required to cover the emergency and hospital costs because the Veteran or his or her representative failed to notify the VA within 72 hours?

And more than likely, if the Veteran does not immediately notify the VA after the initial notification of an outstanding bill, the VA will not pay the bill. The notification is a requirement of the veteran or his or her notification—————–not the provider of the emergency services.

The law and VA rules require prompt notification to the VA within 72 hours of presenting to the emergency room.

How should your representative, or you, notify the VA?

  1. Call the VA, Phone: 844-724-7842 (844-72HRVHA)  or
  • In-person: Appropriate VA official at the nearest VA medical facility

VETIP.  Document the notification to the VA. At a minimum, documentation should include (1) how the VA was notified, (2) date and time of notification (3) and other than online, who you spoke with at the VA. If doing online, I recommend you copy and print screen the notification for backup you notified the VA; I like to copy and paste the screen in an email I send to myself for future reference.

The information you should have when notifying the VA:

The person contacting the VA should be prepared to supply the information shown in the table below. If the caller is unable to supply all information, the VA will engage with the appropriate parties to attempt to collect the information.

Name

Gender

Social Security Number

Date of Birth

Veteran’s Address

Date presenting to facility

Date of discharge

Admitted? Yes / No

Chief Complaint – Admission Diagnosis and/or Discharge Diagnosis

Originating Location (where emergency event occurred)

Mode of Arrival

IMPORTANT: Failure to notify VA of care rendered through an in-network community facility in a timely manner prevents VA from authorizing the emergency care and prevents claims and payments from being made through one of VA’s third-party administrators.

According to the VA website retrieved information on August 2, 2021:

Veterans, their representatives, and in-network community providers should report instances of a Veteran presenting to a community emergency room to VA within 72 hours of the start of emergent care. Out-of-network providers are encouraged to notify VA as soon as possible.

  1. Notifying VA in a timely fashion is important because this:
  2. Allows VA to assist the Veteran in coordinating necessary care or transfer,
  3. Helps ensure that the administrative and clinical requirements for VA to pay for the care are met, and
  4. may impact a Veteran’s eligibility for VA to cover the cost of emergency treatment.

Case-specific details are necessary for care coordination and eligibility determinations. Providers, Veterans and representatives can utilize any one of the following options to report emergency services:

  1. Online: Emergency Care Reporting,

https://emergencycarereporting.communitycare.va.gov/#/request

  • Phone: 844-72HRVHA (844-724-7842)
  • In-person: Appropriate VA official at the nearest VA medical facility

The primary purpose of notifying VA of a Veteran in need of emergency treatment presenting to a community provider is to ensure proper care coordination. Notifying VA also allows covered Veterans to have their emergent treatment authorized by VA under Title 38 Code of Federal Regulation (CFR) §17.4020(c). The local VAMC will engage with community providers who report notification through the centralized notification process. However, if you have an urgent or emergent need to coordinate care and/or transfer a Veteran to a VAMC, please make immediate contact the nearest VAMC.

IMPORTANT: Failure to notify VA of care rendered through an in-network community facility in a timely manner prevents VA from authorizing the emergency care and prevents claims and payments from being made through one of VA’s third-party administrators.

In addition, the Veteran and or his representative must also understand VA rules after the initial emergency care treatment:

Generally, emergency treatment is only covered until such time as the Veteran can be safely transferred to a VA or other federal facility. If the Veteran refuses to be transferred to a VA or other federal facility after their emergency condition is stabilized, they may be liable for the cost of care beyond the point of stabilization. VA Form 10-8001, Refusal of Transfer to VA Health Care Facility, is used when a Veteran refuses to transfer to a VA Health Care Facility.

Refusal of Transfer to VA Health Care Facility, VA Form 10-8001

The single exception to this rule is if VA is contacted and unable to accept the transfer. If this happens, it is important that any attempt to transfer the Veteran be documented by the community emergency treatment facility.

Veteran Eligibility for Emergency Care:

VA has three legal authorities under which emergency treatment in a community facility may be paid for by VA:

  1. Authorized Emergency Treatment–Title 38 Code of Federal Regulations (CFR) §17.4020(c)
  2. Unauthorized Emergency Treatment (Service-connected)–Title 38 United States Code (U.S.C.) §1728
  3. Unauthorized Emergency Treatment (Nonservice-connected)–Title 38 U.S.C. §1725

Each authority requires the following General Eligibility requirements be met:

  • Veteran is enrolled or exempt from enrollment in the VA health care system.
  • A VA health care facility or other federal facility with the capability to provide the necessary emergency services must not have been feasibly available* to provide the emergent treatment and an attempt to use them beforehand would not be reasonable.
  • The medical situation is of such a nature that a prudent layperson would reasonably expect that a delay in seeking immediate medical attention would be hazardous to life or health.
  • Generally, emergency treatment is only covered until such time as the Veteran can be safely transferred to a VA or other federal facility. If the Veteran refuses to be transferred to a VA or other federal facility after their emergency condition is stabilized, they may be liable for the cost of care beyond the point of stabilization. VA Form 10-8001, Refusal of Transfer to VA Health Care Facility, is used when a Veteran refuses to transfer to a VA Health Care Facility.

Refusal of Transfer to VA Health Care Facility, VA Form 10-8001

The single exception to this rule is if VA is contacted and unable to accept the transfer. If this happens, it is important that any attempt to transfer the Veteran be documented by the community emergency treatment facility.

Additional Requirements for Authorized Emergency Treatment (Title 38 CFR §17.4020(c)):

In addition to the General Eligibility requirements, in order to be authorized for emergent care under Title 38 CFR §17.4020(c), all of the following criteria must also be met:

  • In-Network Status: The treatment was rendered at a community emergency facility that is in VA’s community care or PC3 network.
  • 72-Hour Notification to VA: VA must be notified of the treatment within 72 hours. If VA is not timely notified, the treatment cannot be authorized under this section.

Additional requirements for retroactive payment approval for unauthorized emergency treatment for service-connected Veterans (Title 38 U.S.C. §1728):

In addition to the General Eligibility requirements, for payment to be retroactively approved for emergent care under Title 38 U.S.C. §1728, one of the following criteria must also be met:

  1. Emergency treatment of a service-connected*, or adjunct condition* in a community emergency department; OR
  2. A Veteran who is permanently and totally disabled (P&T) as the result of a service-connected condition is eligible for emergency treatment of ANY condition, OR
  3. A Veteran who is participating in a VA Vocational Rehabilitation Program and requires emergency treatment to expedite their return to the program is eligible for emergency treatment for any condition.

NOTE: Legal authorities and payment methods for VA payment for emergency care of service-connected conditions are contained in Title 38 U.S.C. §1728Title 38 CFR §17.120 and Title 38 CFR §17.132.

Additional requirements for retroactive payment approval for unauthorized emergency treatment for nonservice-connected Veterans (Title 38 U.S.C. §1725):

In addition to the General Eligibility requirements, for payment to be retroactively approved for emergent care under Title 38 U.S.C. §1725, all of the following 5 criteria must also be met:

  1. Care was provided in a hospital emergency department (or similar public facility held to provide emergency treatment to the public); AND
  2. The Veteran has received care within a VA facility during the 24 months before the emergency care; AND
  3. The Veteran is financially liable to the emergency treatment provider; AND
  4. If the treatment was due to an injury or accident, the claimant has exhausted, without success, all liability claims and remedies reasonably available to the Veteran or provider against a third party for payment of such treatment, and the Veteran has no contractual or legal recourse for extinguishing, in whole, the Veteran’s liability to the provider; AND
  5. The Veteran is not eligible for reimbursement under Title 38 U.S.C. §1728 for the emergency treatment.

There are limitations on VA’s ability to provide coverage when a Veteran has other health insurance (OHI). If a Veteran has OHI but the OHI does not fully cover the costs of treatment, VA may pay certain costs for which the Veteran is personally liable, unless payment by the Veteran’s OHI was barred because the Veteran or provider failed to comply with the provisions of that health plan contract or third party payer; for example, failure to submit a bill or medical records within specified time limits, or failure to exhaust appeals of the denial of payment.

NOTE: Legal authorities and VA payment methods for emergency care of nonservice-connected conditions are contained in Title 38 U.S.C. §1725 and Title 38 CFR §17.1000.

If you made it this far, your head is spinning with all the aforementioned information. Here’s is my recommendation to mitigate any potential charges for unpaid emergency care treatment:

  1. Make up 2-3 index cards and label IVA REQUIREMENTS if EMERGENCY CARE TREATMENT IS REQUIRED:

Step 1 Ensure to tell the community emergency care provider you are enrolled and eligible for VA emergency treatment.

Step 2 Within 72 hours, the veteran or his or her representative:

  1. Call the VA 72 hour notification line: phone: 844-724-7842 (844-72HRVHA), ask for notification id number AFTER you provided the information.
  • In-person: Appropriate VA official at the nearest VA medical facility

Step 3 Place 1-2 card in an area in your home that is the hub for important information.

Step 4 Keep one in your wallet, and add the VA number to your phone, I suggest for name, VA 72 Hour Notice, number 844-724-7842.

VETTIP: Document. Document. Document all notifications to the VA. And keep your significant other informed of the 72-hour notification requirements.

Any questions or help needed, contact the Italian American War Veteran Service Officer, John A Cianci, [email protected].

Frequently Asked Questions

How do I file my claim?

File your claim by mail using an Application for Disability Compensation and Related Compensation Benefits (VA Form 21-526EZ).

Print the form, fill it out, and send it to this address:

Department of Veterans Affairs
Claims Intake Center
PO Box 4444
Janesville, WI 53547-4444

In person

Bring your application to a VA regional office near you:

VBA Providence, RI

380 Westminster St, Providence, RI 02903

With the help of a trained professional

You can work with a trained professional called an accredited representative to get help filing a claim for disability compensation.

REUNIONS

August 6, 2021, RING Summer Reunion, 11:00am Quonset Officer’s Club, 200 LT James Brown Rd. N, Kingston, RI. Cut-Off date is Aug 3, 2021. Early responses would be greatly appreciated. As always, spouses, friends, guest and significant others are always welcome. It’s an opportunity to reunite with friends whom we served with over the years.  A hot buffet will be included in $27.00 PP cost.  Make checks payable to mail to Bob Antonelli, 9 Hurlburt Ave, Johnston, RI 02919

August 7 Breakfast for Veterans and a friend or Family Member, 8:30-10:30am, Christ Church Parish Hall, 57 Main Street, Swansea MA. Gathering of veterans for comradery and a free breakfast.

This Saturday, August 7, is National Purple Heart Day — the day when we remember our service members who were wounded in combat or paid the ultimate price by giving their lives.

Today, an estimated 600,000 Purple Heart recipients are still with us. They’re living quietly with their memories — and their wounds. Beyond the loss of limbs, beyond the traumatic brain injuries, many have psychological wounds that can linger.

The Veterans motorcycle ride from East Greenwich to Westerly along Routes 4 and 1. Registration begins at 8:30. Kickstands up at 10. Meet at the parking lot of the Showcase Cinema, 1200 Quaker Lane, Warwick. Riders to follow the Purple Heart Trail to the Elks Club, 1 Dixon Street, Westerly.  Presentations at noon, followed by a BBQ and music.  Info: – Erikab673 @ gmail.com

The Veterans motorcycle ride from East Greenwich to Westerly along Routes 4 and 1. Registration begins at 8:30. Kickstands up at 10. Meet at the parking lot of the Showcase Cinema, 1200 Quaker Lane, Warwick. Riders to follow the Purple Heart Trail to the Elks Club, 1 Dixon Street, Westerly.  Presentations at noon, followed by a BBQ and music.  Info: Erikab673 @ gmail.com

August 11, Wednesday the Providence VA Medical Center (VAMC) and the Veterans Benefits Administration’s Providence Regional Office (VBA, RO) are hosting an in-person joint Veterans town hall meeting from 5:00 p.m. to 7:30 p.m. Wednesday August 11, 2021, at the New Bedford VA Community-Based Outpatient Clinic 175 Elm Street, New Bedford. Leadership from the VA Providence Medical System and the Veteran’s Benefits Regional Office will provide updates and respond to questions from the audience during the meeting.

“Veterans, patients, caregivers and community partners are all welcome to attend our town hall meeting, get an update on Veterans’ health care and benefits and ask questions,” said Larry Connell, Director of the Providence VA Medical Center.

September 15-20, 2021, USMC Tankers Association Facility: Crown Plaza Providence-Warwick, 801 Greenwich Ave., Warwick RI 02886. Point of Contact Name: John Wear. Point of Contact Telephone: 719-495-5998. Point of Contact Email: johnwear2 @ verizon.net.  Comments: The USMC Vietnam Tankers Association will be holding our 12th biennial reunion. Anyone who served with any of the Marine tank battalions or Ontos units in Vietnam . . . in any capacity is welcome!!!   

    


 [JAC1]

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