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VA won't refer us to Mayo, even if we requested
I have been fighting for my husband, 100% disabled veteran, to be seen at Mayo for unknown GI issues. I've called Mayo and know they accept VA Community Care, but I keep getting told by the VA that Mayo doesn't take it. They currently have him being seen at Shands hospital, but I need a team to look at the whole parts instead of hyper focusing on one. Everybody seems to keep missing the issue and he has been dealing with this for almost 3 years. It doesn't make sense to us that his bloodwork shows he's fighting an infection, yet they can't figure out what. Also, bloodwork will show that liver and kidneys are going bad at times then other times they are fine. His Shands doctor told him that he doesn't have Pancreatitis, however we've had multiple GI doctors confirm that he does including a different Shands doctor (who performed his scopes). Gallbladder has been removed and that didn't fix anything. Now we are back to him barely eating. He can't eat red meat or anything red (strawberries, watermelon, tomatoes, Fruit Punch, etc). For about a year all he could stomach was soup. I just want answers. Our kids want their dad back. Anybody have any tips that I can try to get him into Mayo Florida?
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I'm in same position..I'm taking out t.v. ads to tell everyone how mayo Rochester wont join network. Mayo Rochester charges 150% more. Wont join network because v.a. doesn't pay those rates. V.a. refuses to even look at individual circumstances. I have cancer and havent even been seen anywhere to stage the cancer.
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2 ReactionsWelcome, @masterkunz. Mayo Clinic has long been committed to care for veterans, with various agreements in place for coverage. It sounds like you've run into a roadblock for being accepted as a patient at Mayo Clinic.
I recommend calling Patient Account Services, Mayo Clinic's customer contact center, to inquire about insurance types accepted and guidance on denied claims. Here's the contact information:
https://www.mayoclinic.org/patient-visitor-guide/billing-insurance/contact-us
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3 ReactionsHave you had your Dr's call the insurance company? I'm sure they placed a referral, but have then do it again. The insurance can do a video call with your team to verbally explain why you need it.
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2 ReactionsI am having the same run around with the VA. I have a very rare condition and Mayo has one of the very few doctors in the country that has any experience in dealing with it. VA absolutely refuses to refer me to Mayo claiming it is Mayo that will not accept VA and Mayo charges them triple if they were to refer. I can’t seem to get a straight answer from Mayo or the VA. So what is the issue? Is it the VA jerking my chain or is it Mayo that doesn’t want to work with the VA???
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1 ReactionWelcome, I'm sorry Mayo and VA don't come to an agreement that favors you. Two big bureaucratic organizations that are supposed to serve patients best interest ... It makes you want to write your Senators and Representatives.
Based on my experience with the Mayo this may be helpful. I have a Traditional Medicare Medigap policy, not the Medicare Advantage policy. Mayo accepts patients with Traditional Medicare coverage, not the Medicare Advantage. The Advantage reimbursement
rate is lower than that of Traditional Medicare. My guess is that the reimbursement rate from the VA is also too low for Mayo to stay in business, so they take a pass. IMHO, It is a brutal process. Could you consider calling Mayo directly to learn if you have any options? Self-pay would be one. I understand many of us do not have the financial resources for self-pay. But who knows, being a Vet (let them know that) might open a door for you. The best.....
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1 ReactionThank you for the advice. VA reimbursement is at the Medicare rate. So I would assume if Mayo accepts Medicare they would accept VA. The VA owns this issue as they caused it. A mis diagnosis and put on a medication I didn’t need. My guess is that the VA in the past had some issues paying their bills in a timely manner and this could be the reason Mayo doesn’t want to play. But I still really don’t know if it is Mayo or the VA that has the issue.
Re: your response to me. You could be Spot On; that is the reason I suggested you contact Mayo directly. It may provide insight and a possible option for you.
Thanks. Last time I contacted Mayo they told me that they did accept Va. Va tells me that no, Mayo doesn’t accept VA. Don’t know who to believe. Just keep kicking the can down the road. I looked on line and Mayo in 2020 was a partner in care in the community. Apparently that must have fell through very quickly. No new up dates from Mayo. Someone not wanting to accept responsibility? Don’t know. Can only speculate.
@nd120, Mayo Clinic has long been committed to care for veterans, with various agreements in place for coverage.
If you haven't already, I recommend calling Patient Account Services, Mayo Clinic's customer contact center, to inquire about insurance types accepted and guidance on denied claims. Here's the contact information: https://www.mayoclinic.org/patient-visitor-guide/billing-insurance/contact-us
Which Mayo Clinic location are you hoping to attend? Is it an issue with coverage or appointment availabiity?