Veterans Cautioned To Get Authorization For Veterans Choice

May 4, 2016

Credit en.wikipedia.org

Ministry Health Care, part of the nationwide Ascension health provider network, announced last month that it is now part of the Veterans’ Choice Program where eligible veterans can obtain care from providers that are not part of the Department of Veterans Affairs health care system.

“As part of the largest nonprofit health system in the country, we saw an opportunity to help America’s veterans gain better access to health care,” Dr. Shishir Sheth, regional vice president of Ministry Medical Group said in a March news release. “Our mission calls on us to deliver high-quality, compassionate, personalized care to all, with special attention to persons in poverty and those most vulnerable. Our country’s veterans deserve that compassion, and we are eager to serve them as they have sacrificed and served us so well.”

Area Ministry hospitals participating in the program are: Ministry Saint Mary’s Hospital, Rhinelander; Ministry Sacred Heart Hospital, Tomahawk; Ministry Eagle River Memorial Hospital, Eagle River and Howard Young Medical Center, Woodruff. Ministry Medical Group clinics include: Crandon, Eagle River, Laona, Rhinelander and Tomahawk.

While the addition of the 27-hospital Ministry/ Ascension statewide health care system presents increased health care opportunities, area veteran service officers and VA officials are reminding veterans that there are several steps that need to be completed before signing into a non-VA facility. “I’m happy to hear Ministry is now an approved facility for the Choice Program but some of the veterans I serve are confused,” said Jason Dailey, Oneida County Assistant Veteran Service Officer. Veterans see the commercials and newspaper advertisements and assume that they can make their own appointments, receive treatment and Veterans Affairs pays the bills, he explained. “While nothing being advertised is incorrect,” Dailey said. “Our office has been receiving a large number of calls about the advertisements.”

Dailey said the requirements and process for the Veterans’ Choice program or other non-VA health care providers have been established for several years. “Nothing has changed,” Dailey said. “If you don’t go through the proper channels you will end up with the bill, and you will be responsible for it.” “The VA does count the Rhinelander Community-based Outpatient Clinic (CBOC) as a medical location,” said Forest County Veteran Service Officer Robb Koplien. “They (veterans) still need to go through the proper channels to get outside care.”

Veterans should work with their VA primary care provider first, he recommended. If necessary care cannot be provided locally or if there is more than a 30-day waiting period, the choice program may be an option. “It’s up to the VA,” Koplien said. “The veteran will get stuck with the bill if he or she goes to a non-VA facility without approval.” If the veteran’s local VA provider cannot provide the care, VA will send an authorization to HealthNet, a nationwide managed care organization that administers health benefits for veterans and other recipients of government-based health care programs, who will then contact the Veteran to set up an appointment. “We recommend that veterans talk to their VA primary care provider before anyone else because this is going to be the first step in getting setup to use the Choice Program,” Koplien said. Even with the addition of the Ministry health care system into the Choice Program, veterans must still meet eligibility requirements, explained Brad Nelson, Oscar G. Johnson Medical Center public affairs officer.

There have been no changes to policies set by the Veterans Access, Choice and Accountability Act of 2014. “Ministry Health has signed up its providers to be a choice provider, which is good. We’re in a rural area with few providers,” he said. “It means there are now more local choice providers that veterans, who meet the criteria, can choose from.” Veterans must be enrolled in the VA health care system. Participating in the program does not affect the veteran’s VA health care or other VA benefits, he said.

To be eligible for the Veterans Choice program, veterans must: • Live more than 40 miles driving distance from the nearest VA health care facility, including the Rhinelander clinic; • The appointment is more than 30 days from the VA provider or the patient’s desired date; • The local clinic or medical center is unable to provide specialized services such as cardiology. Some of these stipulations can be waived on an individual basis if roads are inaccessible, hazardous weather conditions or the veteran’s medical condition limits his or her ability to travel. “We will help the veteran obtain non-VA care if we can’t provide it,” Nelson said. “We will coordinate with the Choice Program.”

Veterans and their families can learn more about the Veterans Choice program by talking with their VA health care provider, calling the program at 866-606-8198, visiting the website, www.va.gov/opa/choiceact/ . Veterans can also contact the Ascension National Veterans Call Center at 844.623.3003 or by visiting the organization’s website: http://ascension.org/veterans. ###

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