Expectant Veteran gets help with community care billing issue

Emily, an expectant mother and Veteran, was anxious about her pregnancy. She had a good reason to be anxious: her first pregnancy had complications.

She was referred by VA to a local community provider in VA’s Community Care Network (CCN) because her VA medical center did not offer OBGYN care.

Unfortunately, there were some misunderstandings about payment procedures. Emily became frustrated when asked by the community provider to pay $500 even after explaining that VA had referred her and would be covering the cost.

Worried, she phoned the VA Connecticut Healthcare System’s Office of Community Care (OCC) to discuss her dilemma. Shortly after, Emily received a call from Amy Felt, a provider relations specialist for VA.

Community provider received necessary training

“I called the Veteran who was understandably upset,” said Felt. “I heard medical and money concerns and naturally felt her anxiety.” Felt told Emily she’d be fully reimbursed and offered to find her another doctor if it would make her more comfortable.

Veteran Experience Officer Janessa Smith then alerted the network’s Community Care Experience Team (CCET) to start the customer service process.

CCET works with providers in VA’s community care network and VA staff to address customer service issues and offer training and program information. The team makes sure both the Veteran and the provider are satisfied before closing the loop.

In this case, the solution was a win-win. The provider received the necessary training and Emily received the necessary health care. Emily later reached out to thank VA staff for caring and working closely with her.

“We get calls from Veterans on payments, scheduling or satisfaction,” said Smith. “The process is meant to be seamless between VA, community network providers and the Veteran. Sometimes, providers just need more training.”

Alfred Montoya, VA Connecticut Healthcare System Director, commented on the partnership. “The network’s Community Care Experience Team and VA work closely to deliver high-quality health care to Veterans when and where it’s needed.”

 Pallas Wahl is a public affairs officer for VA Boston Healthcare.