GRAND JUNCTION, Colo. (KKCO) – Grand Junction veteran Scott Lyons continues to struggle to get his medical bills paid for care referred to him outside of the Veterans Affairs health system, while others see their payments settled.
He asks why the problems with the VA and its entrepreneur TriWest Healthcare Alliance persist. TriWest is an entrepreneur who coordinates payments for health care outside the VA system for veterans.
“All we really want is to come out with paid medical stuff,” Lyons explained.
He served in the 2nd Marine Aircraft Wing from 1977 to 1981. He was a helicopter crew chief and was based in Jacksonville, North Carolina. The Colorado native has made Grand Junction his home for the past ten years.
According to him, “There have been disputes between the VA and TriWest over who is responsible for this and how to go about getting it paid.”
Responding to her difficulties, Lyons asks, “Is there a way to bring all of the veterans involved in this case together to get a class action lawsuit against TriWest?” They are the ones who initially initiated the problem and now want to get into a contest, a verbiage contest with the VA. During this time, doctors’ offices are not paid.
According to Colo. West Otolaryngologists, the Lyon provider went over a year ago and still has an unpaid balance for care received, this office has seen some movement with invoices for newer services.
As of October 2021, there were approximately 400 unpaid invoices for services rendered to veterans. That number has been halved since then. The office explained that older cases, like the one in Lyon, require special attention from TriWest to be processed and cannot be processed through the computer systems that facilitate these payments. Getting the people needed to actually solve the problems is the challenge, according to Colo. West Otolaryngologists.
In response to inquiries about the Lyon case, the VA Western Colo. Health Care System issued a statement which reads: “A fair relief program has been submitted to [the] Community Care Office for review by VA secretary. The kit was created and submitted to seek approval to cover the costs associated with the Veteran’s unpaid Mission Act claim. The VA Western Colorado Health Care System works with the provider to prevent action from being taken during the review process. [The] The VA Western Colorado healthcare system will keep the Veteran informed of progress on a weekly basis (or at a set time interval) until a final resolution is made, which may include full payment of claims.
Lyons estimates that the magnitude of the problem has reached, “thousands of veterans, millions of dollars are involved. The money is there, it just isn’t being distributed.
The Grand Junction resident is also concerned that providers are starting to turn away veterans because of these payment issues and therefore have fewer health care options.
TriWest did not respond to a request for comment on this matter.
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