After performing a July cataract surgery on a veteran participating in the VA’s Veterans Choice program, Dr. Lawrence Goldberg of St. Petersburg is still waiting for the Department of Veterans Affairs to pay up.
“A couple of months would be fine, but this is getting kind of ridiculous,” Dr. Goldberg said.
Money isn’t the only problem. The Veterans Choice program was born to helps veterans get in to see private sector doctors and to reduce waiting times to schedule appointments. Heath Net, which runs the Veterans Choice program, requires voluminous documentation, Goldberg said.
“The documentation is way over and above. They want all the office notes, which if we had to do this with every patient, I really couldn’t practice and see very many patients in a day,” he said. For one patient, Goldberg’s office has spent multiple hours on the phone with Health Net.
“Each time you talk to them it takes about a half an hour to get in and talk to someone,” Goldberg added.
8 On Your Side found the problem with delayed payments isn’t confined to the Veterans Choice program. In October, the secretary of the VA received a letter from 12 Florida Congress members, informing him the VA was behind on its bills to Florida hospitals – about $134 dollars behind.
According to a survey taken by the Florida Hospital Association, the VA is looking at 29,760 unpaid claims in Florida. More than 10,000 of those are more than a year old. In fact, 5,812 unpaid claims are more than two years old. Congressman David Jolly (R) Fl., signed the letter demanding an explanation from V.A. secretary Robert McDonald.
U.S. Congressman David Jolly (R – Fla.) signed the letter demanding an explanation from VA secretary Robert McDonald. “The outside providers have to get paid for their work and what we’ve have learned is that the doctors on the outside are not getting paid by the VA, and that’s wrong because ultimately it reduces access to care for veterans,” Jolly said.
Health Net responded to a series of 8 On Your Side questions about delayed payments to doctors with a statement that in part says, “Waiting six months for a claim to be processed is not what Health Net wants for doctors and we apologize to any who may have experienced this kind of wait. In the recently released ‘Plan to Consolidate Programs of Department of Veterans Affairs to Improve Access to Care,’ V.A. calls for a simplified provider payment process. We agree with this recommendation, and we believe it could help reduce confusion and payment errors by standardizing reimbursement practices with the Medicare program, which is more widely accepted by physicians.”
Read Health Net’s entire statement here.
Health Net added that the Veterans Choice program is a year and a half old, meaning it’s still experiencing some growth pains. In 2015, the company says claims submitted to Health Net grew nearly 500 percent to an average of more than 100,000 monthly.
“It shouldn’t be this difficult,” Dr. Goldberg added. But it is, and if the difficulty continues, Goldberg doubts he will continue participating in the Veterans Choice program.
