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VA won't refer us to Mayo, even if we requested

Posted by awworrell @awworrell, Aug 19, 2023

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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smitty38 | @smitty38 | Aug 20, 2023

It was my experience, in going to the Mayo, I contacted them. The Mayo secured my medical records, interviewed me for additional information and reviewed my medical insurance. The Mayo made the decision if they would accept me, not my current provider. In my case there was no referral. Hope this helps.

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1 reply
teacher502 | @teacher502 | Aug 20, 2023
In reply to @smitty38 "It was my experience, in going to the Mayo, I contacted them. The Mayo secured my..." + (show)
@smitty38

It was my experience, in going to the Mayo, I contacted them. The Mayo secured my medical records, interviewed me for additional information and reviewed my medical insurance. The Mayo made the decision if they would accept me, not my current provider. In my case there was no referral. Hope this helps.

Jump to this post

We simply made a phone call as well. No referral needed! We also brought records from other medical professionals to include reports of all testing, etc. Make the call - you will get the answers you need!

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nrocpop | @nrocpop | Aug 20, 2023

Yes, I agree with the people above. I think you should call them and tell them that he has a variety of problems and think what departments you would like him to be seen by. If it is several departments, they may set you up with an internal medicine doctor that looks at all the results from the other departments and tries to figure out what is going on. It sounds like he is a veteran and our veterans deserve the wonderful care Mayo Clinic can offer.

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1 reply
awworrell | @awworrell | Aug 20, 2023
In reply to @nrocpop "Yes, I agree with the people above. I think you should call them and tell them..." + (show)
@nrocpop

Yes, I agree with the people above. I think you should call them and tell them that he has a variety of problems and think what departments you would like him to be seen by. If it is several departments, they may set you up with an internal medicine doctor that looks at all the results from the other departments and tries to figure out what is going on. It sounds like he is a veteran and our veterans deserve the wonderful care Mayo Clinic can offer.

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The issue is that the VA is denying him being seen by Mayo. They keep telling us that Mayo isn't in network, which I know they are because I have personally called Mayo's billing dept to confirm. This is the only insurance he has and we can't afford to pay out of pocket.

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1 reply
awworrell | @awworrell | Aug 20, 2023
In reply to @teacher502 "We simply made a phone call as well. No referral needed! We also brought records from..." + (show)
@teacher502

We simply made a phone call as well. No referral needed! We also brought records from other medical professionals to include reports of all testing, etc. Make the call - you will get the answers you need!

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Unfortunately with the VA we do need a referral. It requires authorization, which VA keeps telling us Mayo is not in network. My husband only has VA, no other insurance.

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2 replies
teacher502 | @teacher502 | Aug 20, 2023

Wow....we have VA and tricare and now we have added medicare when we turned 65....the VA did agree that we should go there but we used the Tricare for insurance at that time. Hope you can make this happen because you really need some reliable answers. Is there a possibility of getting some extra insurance just for him - even if it is short term?

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Moderator
Colleen Young, Connect Director | @colleenyoung | Aug 20, 2023
In reply to @awworrell "Unfortunately with the VA we do need a referral. It requires authorization, which VA keeps telling..." + (show)
@awworrell

Unfortunately with the VA we do need a referral. It requires authorization, which VA keeps telling us Mayo is not in network. My husband only has VA, no other insurance.

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@awworrell, I might suggest that you contact Mayo Clinic to find out if they can help.
http://mayocl.in/1mtmR63

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awworrell | @awworrell | Aug 20, 2023
In reply to @teacher502 "Wow....we have VA and tricare and now we have added medicare when we turned 65....the VA..." + (show)
@teacher502

Wow....we have VA and tricare and now we have added medicare when we turned 65....the VA did agree that we should go there but we used the Tricare for insurance at that time. Hope you can make this happen because you really need some reliable answers. Is there a possibility of getting some extra insurance just for him - even if it is short term?

Jump to this post

I had to quit my job last year to take care of him. Doctor appointments, hospital visits, and making sure our 3 kids were watched for kind of took a toll, so I made the decision that my family was more important. So we lost the private insurance we had. Other insurance is outside of our budget.

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Mentor
Becky, Volunteer Mentor | @becsbuddy | Aug 20, 2023
In reply to @awworrell "Unfortunately with the VA we do need a referral. It requires authorization, which VA keeps telling..." + (show)
@awworrell

Unfortunately with the VA we do need a referral. It requires authorization, which VA keeps telling us Mayo is not in network. My husband only has VA, no other insurance.

Jump to this post

@awworrell I didn’t realize that the VA was so difficult. Have you looked into Medicaid? And @colleenyoung has suggested calling The Mayo Clinic yourself. I would second her suggestion. Maybe write out what you want to say and why you need help. T his will clarify everything for you and you wont forget important points.
Will you try this tomorrow and then let me know what you learn?

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katbear03 | @katbear03 | Oct 3, 2023
In reply to @awworrell "The issue is that the VA is denying him being seen by Mayo. They keep telling..." + (show)
@awworrell

The issue is that the VA is denying him being seen by Mayo. They keep telling us that Mayo isn't in network, which I know they are because I have personally called Mayo's billing dept to confirm. This is the only insurance he has and we can't afford to pay out of pocket.

Jump to this post

We’re you able to resolve this issue with the VA and get approval? We are in a very similar issue!!

I am so sorry you are going through this

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