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The Department of Veterans Affairs (VA) has announced that it will begin reimbursing non-VA hospitals for emergency care when it’s obvious that a delay in care would be hazardous to the veteran’s health and when no other VA or federal facility is available.
This is true for veterans who are:
— enrolled in VA health care;
— have been seen by a VA health care professional within 24 months;
— carry no other form of health insurance, including Medicare or Medicaid.
The VA pays 70% of the applicable Medicare rate, the veteran pays nothing, and VA payment is considered payment in full. The VA will pay for private-sector emergency care only until the veteran can be safely transported to a VA facility.
Under the new rules, civilian hospitals should report to the VA within 48 hours of treating a veteran who has no other means of payment. If any third party pays all or part of the bill, the VA will not provide reimbursement.
To obtain payment or reimbursement for emergency treatment, within 90 days of discharge, a claimant must submit to the VA medical facility of jurisdiction a completed standard billing form, such as a UB92 or a HCFA 1500. A signed, written statement certifying that the claim meets all the conditions for payment must accompany the completed form.
[Editor’s note: For more information about the emergency care benefits, go to www.va.gov/health/elig on the Internet, contact the nearest VA health care facility or call (877) 222-8387.]