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Grand Junction veteran faces difficulty with getting bill for referred care paid

Marine veteran Scott Lyons says the issue has persisted for over a year
Published: Oct. 18, 2021 at 10:16 PM MDT
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GRAND JUNCTION, Colo. (KKCO) - Grand Valley veterans rely on the Veterans Affairs Western Colorado Health Care System. Grand Junction veteran Scott Lyons is saying his bill for care referred outside of the VA system is where there is an issue.

According to Lyons, “Back in September of 2020 I had to go see an ENT, and I went in, I had the authorization, and, because it’s a multi-step process, they had no problem, went into the appointment. I received a notice probably 30 days later that they hadn’t received payment.” Over a year later, the bill from Colorado West Otolaryngologists has not been paid.

He is worried about the bill going to collection, and what impact that may have on his credit score.

Lyons has been a Grand Valley resident for ten years. He served the country in the Marine Corps, and relies upon veterans’ benefits for his healthcare.

Colorado West Otolaryngologists Practice Administrator Ken Schreiner explained that Lyons’ issue with the VA-TriWest Healthcare Alliance billing system for referred care is far from isolated.

Schreiner detailed how, “Right now...we’ve got well over 400 claims that we’ve submitted for services that go back as far as more than a year ago, and that we’ve not gotten any payment on. And it represents probably, at least 200 individual patients.” The bills from these outstanding payments totals over $200,000 according to Schreiner.

The VA Western Colorado Health Care System released a statement regarding this situation that reads, “We recognize this situation is a problem and we are working closely with TriWest to serve our Veterans’ health care needs. This case was caught between two different contracts with deadlines and fell between the cracks. We are in the process for a waiver for the invoice to be paid. We take our Veteran’s bills very seriously; our mission is to care for those that have served this country.”

Lysons shared his concerns that these difficulties may plague other veterans who go outside of the VA Healthcare System for referred care. “It, as far as the scope of this [TriWest], being a national company, I’d like to know, ‘Where are we nationally?’ I’d like to know, are the veterans important enough to Lauren [Boebert, R-Colo.] to do something about it, to take some kind of action, cause there are people who are being hurt from this.”

TriWest says they are working towards a resolution with the VA and will be in touch when those details are figured out.

Lyons further explained his worries that health care providers may start turning away veterans who go through the VA for referrals because of the delays with bill payments, limiting veterans’ choice and access to care.

According to Schreiner, veterans who are having issues like this should stay in touch with their doctor’s office about the problem to help avoid bills going to collection.

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