Your Opinion: Veteran struggles with billing issue

A true story... My name is George David Ellis Sr., a Vietnam veteran with a Purple Heart, living in Douglas. (My hometown is Willacoochee.) My dad died in Vietnam, and his name is now on the Vietnam Wall. I was 17 years old when I learned that my dad died there. I knew then I had to go. I was and always have been proud to be a Marine and to serve my country. After placing myself in harm’s way time and time again, God’s grace saw me home to live my life here.

Several years ago, I started utilizing the VA hospital for my health care needs. I don’t have other insurance and never needed any before now. The VA has taken care of my needs 100 percent of the time; they’ve been awesome. I primarily use the Lake City, Fla., and Gainesville, Fla., VA hospitals with my primary doctor being in Valdosta at the VA clinic there, unless I have an emergency.

On July 23, 2008, I was taken by ambulance from my workplace to Coffee Regional Medical Center here in Douglas (which was the nearest ER) with severe chest pains. I was diagnosed with a very large pulmonary embolus (blood clot) in my right lung just outside my heart and subsequently developed pneumonia.

My family notified them I was a VA patient. I was admitted to the ICU in CRMC due to my unstable condition for five days, when the doctor told my wife of his concern that my condition was worsening rather than improving. He felt it was necessary to transfer me to another facility at this time due to my condition and the fact that I was in need of a pulmonologist, which CRMC didn’t have on call during that particular weekend.

Knowing I was “VA,” he attempted to transfer me to Lake City VA, Gainesville VA and Dublin VA to no avail. No one would accept me because of my condition! So he started calling civilian hospitals; no one wanted to accept me there either because “he’s VA!”

Finally, a caring doctor at South Georgia Medical Center (in Valdosta) agreed to accept me when no one else would. I was transferred there on July 28, 2008 for further treatment. I was in the ICU in South Georgia Medical Center for four more days under the care of specialists like a pulmonologist and cardiologist. After two days of treatment at SGMC, the doctors made the decision to “hold all meds” and took a “wait and see” approach. To the doctors’ surprise, God stepped in, I pulled through and started making improvement.

The VA paid all the balance at CRMC (Douglas hospital) immediately, but the bills from SGMC (Valdosta hospital) are still outstanding. The VA has denied payment, stating “a VA facility was available,” even though as I stated earlier no one would accept me. The cardiologist in Douglas has even mailed a letter stating all the contacts that he attempted to get me transferred to a VA facility.

I have been trying, ever since getting back on my feet, to get this bill paid. I have cooperated with all their requests, sending them all the required documentation. I received a letter from them stating they would “send the case to Washington, D.C.” after receiving five letters of denial.

Most recently, I received a “statement of case” letter stating that the transfer was “unauthorized and unnecessary,” never mentioning the “VA facility availability” issue mentioned earlier. Any other excuses not to pay? These doctors provided the best care possible to me regardless of my insurance status at the time. I think they need to pay them for their services.

I wonder if any of these people making decisions have ever had a seriously ill family member that needed transfer to another facility for further treatment of a life-threatening condition. What if they couldn’t or wouldn’t?

As I understand at this time, it may be another year before I even know if they are going to pay. The hospital billing department won’t wait. What’s a veteran to do?



Sincerely,



George D. Ellis Sr.

Douglas

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