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Grand Junction veteran faces continued difficulties with medical bill payments, faults VA contractor TriWest

Scott Lyons is asking, ‘Why are the issues with the VA and its contractor TriWest Healthcare Alliance continuing to persist?’
Published: Jan. 11, 2022 at 10:22 PM MST
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GRAND JUNCTION, Colo. (KKCO) - Grand Junction Veteran Scott Lyons is continuing to have trouble getting his medical bills covered, for care referred-to outside of the Veterans Affairs healthcare system, while others are getting their payments addressed.

Lyons is asking ‘Why are the issues with the VA and its contractor TriWest Healthcare Alliance continuing to persist?’ TriWest is a contractor that coordinates payments for healthcare outside of the VA system for veterans.

“All we really want is to get out medical stuff paid for,” explained Lyons.

He served in the 2nd Marine Aircraft Wing from 1977 to 1981. He was a helicopter crew chief and was based out of Jacksonville, North Carolina. The Colorado native has called Grand Junction home for the past ten years.

According to Lyons, “There’s been a fallout between the VA and TriWest as far as who’s responsible for this and how to go about getting this paid.”

In response to his difficulties, Lyons is asking, “Is there a way to get all the veterans together that are involved in this to get a class action lawsuit going against TriWest? They’re the ones who initiated the problem to begin with and now want to get into a contest, a verbiage contest with the VA. Meanwhile the doctors’ offices are not being paid.”

According to Colorado West Otolaryngologists, the provider Lyons went to over a year ago and still has an outstanding balance due for care received, that office has seen some movement with bills for more recent services.

As of October of 2021, there were about 400 outstanding bills for services done for veterans. That number has been cut in half since then. The office explained that older cases, like Lyons’, need special attention from TriWest to be addressed and cannot be handled through the computer systems that facilitate these payments. Getting the necessary people to actually address the issues is the challenge, according to Colo. West Otolaryngologists.

In response to inquiries into Lyons’ case, the VA Western Colo. Health Care System released a statement that reads, “An Equitable Relief Package was submitted to [the] Office of Community Care for consideration by the Secretary of the VA. The package was created and submitted to request approval to cover the costs associated with the Veteran’s unpaid claim under the Mission Act. The VA Western Colorado Health Care System is working with the provider to prevent action being taken during the review process. [The] VA Western Colorado Health Care System will keep the Veteran informed of the progress weekly (or at a set time increment) until final resolution is made which may include full payment of the claims.”

Lyons estimates that the scope of the issue reaches, “...thousands of veterans, there’s millions of dollars that are involved. The money’s there, it’s just not being distributed.”

The Grand Junction resident also worries that providers will start to turn away veterans because of these payment issues, and that they will have less choice when it comes to healthcare as a result.

TriWest did not respond to a request for comment on this matter.

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