Choice Program leaves veterans frustrated, clinics waiting for payment
Published 12:05 am Sunday, February 19, 2017
By Josh Bergeron
josh.bergeron@salisburypost.com
SALISBURY — From veterans to doctors, the VA’s Choice Program has left locals confused, frustrated and, in some cases, waiting for payment.
Created in 2014, the Choice Program was intended to help veterans avoid long wait times at hospitals run by the Department of Veterans Affairs. Now, veterans can use the Choice Program for a number of reasons, including: if he or she can’t be seen within 30 days, if a nearby VA facility can’t perform an operation and if a VA facility is more than 40 miles driving distance away. However, the program has brought frustration to veterans seeking care at non-VA facilities.
Following a story published in the Salisbury Post on Feb. 12 about Vietnam veteran Charles Greene’s problems with the Choice Program, a number of locals echoed his concerns in calls and emails. The story — “VA Choice Program: more problems than solutions for Kannapolis veteran” — detailed how Greene, who lives in Kannapolis with his wife Barbara, saw his vision deteriorate after receiving cataract surgery. When Charles and his wife Barbara turned to the Choice Program for answers, they found more problems than solutions.
For Ray Morris, who lives south of Faith, just getting into the Choice Program was difficult.
Morris said he was referred to the Choice Program after a doctor diagnosed him with cancer on the inside of his nose. In October, he was told he couldn’t be seen until January at the W.G. “Bill” Hefner VA Medical Center in Salisbury. As a result, he fit criteria for appointments that couldn’t be made within 30 days.
When he called to schedule an appointment, however, he was told he wasn’t even in the Choice Program’s system.
“I was given seven or eight extensions to call and nobody knew nothing about nothing,” Morris said.
Vietnam veteran Raymond Akres said he also had problems finalizing an appointment. Akres said he decided to try out the Choice Program so he could stay closer to home for care on his pacemaker and defibrillator.
When he called about an appointment, Akres said he was also told initially that he wasn’t in the Choice Program’s system.
Akres had a litany of other complaints about the Salisbury VA and the Choice Program. One such complaint included that veterans have to get every appointment OK’d through the VA before visiting a private doctor.
Rowan County’s representatives in Congress have pushed for veterans to see private doctors without preauthorization. Akres said removing pre-authorization would be a good idea. He also speculated about how Bill Hefner, the 8th District congressman from 1975 to 1999, might react to the current state of veterans health care.
“He’d be rolling over in his grave,” Akres said. “If Bill Hefner were alive today and I could talk to him, he’d have everything straightened out in 24 hours.”
Veterans aren’t the only ones who have experienced problems with the Choice Program. Health care providers say they’ve experienced problems with getting paid in a timely manner by Health Net — contracted to oversee the Choice Program. Novant Health Rowan Medical Center President Dari Caldwell said she’s met with Choice Program representatives to try and sort out payment problems.
Some clinics have dropped out of the Choice Program entirely because of payment problems, including Charlotte Eye, Ear, Nose and Throat Associates. The company, which has a facility in Salisbury, said it accepts regular VA insurance but won’t participate in the Choice Program.
“We do not accept VA Choice at CEENTA because of the administrative burden and the lack of timeliness associated with the VA Choice insurance program, which could distract us from our goal of providing premier care to our patients,” company spokesman Luke Foster said in an emailed statement.
Payment processing for the Choice Program isn’t handled at a local level. However, Salisbury VA Director Kaye Green says she’s aware that clinics have dropped out as a result of payment problems. She said it’s an issue she’s concerned about.
“It narrows the number of providers within the network and has the potential to negatively impact Veterans’ ability to use Choice as close to their home as they might prefer,” Green said in an emailed statement. “I personally have a conference call with Health Net every two weeks to raise issues like these.”
Green encouraged any facility who hasn’t received payment for services rendered to send her a letter with as much detail as possible. She pledged to use those letters to address concerns with Health Net and its payment center.
“We are committed to doing everything within our power locally to ensure veterans get the care they need and community providers get paid timely,” she said. “Unfortunately, the administrative authorization and claim filing burden has detracted many providers from signing up, or remaining in the Choice network.”
The Salisbury VA said Green could only speak about local issues. However, Green said the Choice Program isn’t easy to navigate for veterans.
“Our veterans have earned these benefits and we need to do everything we can to make it easy for them to get the care they need,” she said. “Right now, it is not easy – it’s not easy for our veterans, it’s not easy for providers who have signed up with Choice, and it’s not easy for the dedicated VA staff who only want to help veterans.”
Department of Veterans Affairs staff at the national level did not respond to multiple requests for comment about other Choice Program problems.
Contact reporter Josh Bergeron at 704-797-4246.