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Question #47 I was
just wondering. I have a 70% Disability for PTSD for years and I have been going to the Doctors there for years, and I just
received my Medicare Statement where my Doctor with the VA charged my Medicare and my Supplement Policy for my Visit. Can
they do that? I have been with the VA for years and this is the first time they ever charged my insurance
for anything and I have been at 70% for years. Just a little confused about this, can you give me an answer on what to do?
A1: By law, the VA is required to recoup treatment costs from anyone that
has secondary insurance. That is why they always ask if you have another form of insurance. (AP) 4/25/2016A2: Every once in a while the VA will ask you to update your insurance. I'm 100% P
and T with SMC-S and I get billed for services by the VA. What happens is the desk clerk does look to see what you are service
connected for and sends your insurance to one of the 7 CPAC units in the country. CPAC is the Consolidated Patient Accounting
Center. My spouse is an auditor for a CPAC. What you need to do is call the CPAC responsible for your regional area and ask
a support person in Billing to review the claim. If you are service connected for what was treated, the CPAC will tell the
insurance carrier to delete the claim. Now Medicare will not pay the government because it would be paying itself. What they
are doing is filing your Medicare to get at your supplement. I've attached a link to all CPAC units. The name of the city
is listed in each area. Where you live look for the city designated on the map. I live in NC and the CPAC is located in Asheville.
http://www.va.gov/CBO/cbo/cpac/docs/fs_veterans_01.pdf (CP) 4/25/2016 A3:
I have never heard of that. It has never happened to me. Contact the Patient Advacate. And if they say they
can do it ask them to show you the VA document that says so. Please post back here as to your results. (LT)
4/25/2016 A4:
It is my understanding, the VA always bills your insurance company regardless of your percentage of disability. (RJ)
4/26/2016 |
If you can help please respond to this question.
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Question #48 I
am rated 100% and I have had prostate cancer. They did a radical surgery and removed my prostate. I may be too old to start
a new family but, I am not too old for sex. Because of the cancer I am unable to have sex. Do I qualify for this $20,000 that
they are talking about?
A1:
The only thing I can recommend to you is for you to apply for service connection for loss of creative organ secondary to prostate
cancer and Diabetes Mellitus, Type II. You probably will be service connected at a 0% rating with a Special Monthly
Compensation K Award of $103.23 per month for loss of creative organ. This is the third time I have heard the $20,000
amount mentioned. That amount is not authorized by law or by regulation. The only think I can thing of is that
someone may have filed for service connection for something along with the loss of creative organ and received a payment for
past due benefits that was around $20,000.00 so it became an urban legend that you would get $20,000.00 for a male's loss
of creative organ. This is a legend like all of those people who tell you that they got their 100% rating in 90 days
after appealing a VA rating denying disability compensation. It could happen, but I have had few people who have gotten
SC that quickly on an appeal. (AP) 4/25/2016A2: The $20,000
is currently in a bill in Congress. Rep Miller is the sponsor. According to the brief of the bill you must have lost the use
of reproductive organs as a result of combat. It pays 2 installments of $10,000. If you served in Vietnam Prostae Canccer
is an Agent Orange presumptive condition.
http://www.militarytimes.com/story/military/2016/04/12/bill-would-compensate-veterans-devastating-groin-injuries/32580679/ (CP) 4/25/2016 A3: I spoke with our local VA hospital administrator and she said they would NOT pay
for claims as you described. However, you can file for a special monthly compensation for lose of use of your creative organ.
See your local Veteran Service Officer for help. (RJ) 4/26/2016
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