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2015-12-17

Non-VA emergency medical care for veterans

By Dennis Birchall Veterans Service Officer

I recently met with Calvin Plummer and Robin Hamill of the Bandera County Emergency Medical Services (BCEMS) to discuss ambulance service billing for veterans. After discovering that not all veterans are treated the same for non-VA emergency care, I'm sharing what I found out with my fellow veterans.
Bandera EMS will only transport a patient to the closest appropriate hospital based on the patient's current condition. The exception comes when the closest hospital does not have the capabilities the patient requires. Combative psychiatric patients will be transported to a facility with appropriate security and resource personnel, such as University and Methodist Specialty and Transplant. It will do no good to argue with the EMS technicians, as they do not have authority to change the rules. This is a liability issue for BCEMS.
Veterans with VA healthcare should only call an ambulance in an emergency. VA defines an emergency as a situation where you believe your life or health is in danger. You do not have to call VA before calling an ambulance or going to the emergency room, just dial 9-1-1 or go to the emergency room right away.
If a physician at a non-VA facility wants to admit a veteran for an emergency, the veteran does not have to notify VA prior to being admitted. However, if it is not an emergency, then the veteran must notify the nearest VA medical facility prior to admission. A veteran, family, friends or the hospital must notify the nearest VA hospital within 72 hours.
The VA will then let you know what charges the VA will cover - and not. If a VA bed is available, and the veteran can be safely transferred, the veteran must transfer to the VA facility when directed, or the VA will not pay for any further care.
If a veteran's emergency is for service-connected conditions, the following criteria must be met for VA to pay for care or services:
• Care or services were provided in a medical emergency
• VA and another federal facility were not feasibly available
• VA was notified within 72 hours of the admission
If a veteran's emergency is for non-service connected conditions, the following criteria must be met:
• Veteran is enrolled in the VA He4alth Care System
• Veteran has receive health care services from VA within the previous 24 months
• Veteran has no other health insurance coverage.
Further eligibility guidance is available from the Audie Murphy Non-VA (Fee) Care Office at 210-617-5300, EXT 13850.
Veterans must file a reimbursement claim for emergency medical care with the billing office of the nearest VA medical facility within 90 days. The Kerrville VA Medical Facility Billing Office phone number is 830-792-2435.
Outside the United States, the VA will only pay for emergency care for service-connected conditions. Contact the Foreign Medical Program (FMP) at 877-345-8179 or go to the FMP website at http://www.va.gov/hac/forbeneficiaries/fmp
For additional information, contact Dennis Birchall at the Bandera County Veterans Service Office at 830-460-1643 or at dbirchall@banderacounty.org.