Medical Care for eligible VA Patients at Naval Hospital Bremerton explained

There are a few stipulations for some Veteran Affairs (VA) patients seeking treatment at Naval Hospital Bremerton’s (NHB) Urgent Care Clinic (UCC).

Unless a VA patient is currently enrolled in a TRICARE health care plan or is registered at the Bremerton Community Based Outpatient Clinic (CBOC), there might be an associated cost involved in receiving that care.

NHB and the Veterans Affairs Puget Sound Health Care System (VAPSHCS) formalized a Sharing Agreement in 2014 to link both organizations in providing specific types of medical care to current Veterans Affairs eligible beneficiaries.

As mission and operational tempo permits, NHB can provide urgent and inpatient medical services to the approximately 4,300 current VA eligible beneficiaries – out of an estimated 37,000 in the region eligible for care there – enrolled at the Bremerton CBOC.

According to Cmdr. Michael Mercado, NHB director for medical services, the agreement NHB has with the Bremerton CBOC does allow patients enrolled there to be seen at the UCC as a covered benefit.

“The bills being generated are for veterans presenting to the UCC who are assigned to a primary care manager who is not affiliated with the local CBOC,” said Mercado.

According to Ms. Elizabeth Y. Tellez, NHB Uniform Business Office and Third Party Collections, only VA patients enrolled at the Bremerton CBOC on one of the following teams – Eagle, Seahawk, Orca, Seal, Raven, or Salmon – are eligible to receive care in the NHB UCC.

“If a veteran who is not enrolled at the Bremerton CBOC seeks care at the NHB Urgent Care, that individual will receive a bill for their care. In some cases the VA has agreed to pay for the care after the fact, but until the VA makes that decision the patient remains responsible for the cost of the unauthorized care,” explained Tellez, adding that the timing of the billing is subject to data processing between the electronic medical record and the billing system.

Cmdr. Lisa Abels, NHB UCC department head attests that the UCC front desk staff ask all VA patients to read and sign the NHB VA agreement form. Along with asking VA patients to fill out an alternative insurance form, staff also inform VA patients that if they are not assigned to the Bremerton CBOC, they will likely receive a bill for treatment received.

Despite being informed during the check-in process, there are veterans who are surprised when they get a bill for the care they received at the UCC.

UCC staff theorize that many who don’t belong to the Bremerton CBOC seemingly assume that the care will be free since they are VA and NHB is a military treatment facility.

“They say they don’t mind paying a bill, but really don’t think they’ll get one,” said Abels.

“By law we are required to bill a patient who is not entitled to care at NHB for the cost of their care,” added Tellez. “Based on the services provided, standard costs are applied and billing information is submitted to the Treasury Department which bills the individual.”

NHB recommends that during normal working hours, VA patients should first seek care at the Bremerton CBOC.

NHB also stresses that the UCC is not an emergency department. It is imperative that anyone with a potential threat to loss of life, limb or eye-sight go immediately to the nearest emergency department – or call 911 – instead of traveling to NHB’s UCC.

If someone has any type of immediate life threatening problem, such as severe chest pain or severe abdominal pain – especially over age 50 – difficulty breathing, unresponsiveness, stroke-like symptoms with difficult speaking and walking, or severe bleeding and/or trauma, they need to be evaluated in an emergency department.

A visit in NHB’s UCC for authorized VA patients may also include diagnostic tests and professional services such as; endoscopy, gastroenterology, gynecology, neurology, ophthalmology, general surgery, orthopedics, and urology.

If a VA patient receives laboratory and/or radiology services directly related a UCC visit on the same day, those services will be covered.

Laboratory and pathology services will include anatomical pathology, chemistry, hematology and microbiology to support urgent/emergent and inpatient medical services.

Radiology services feature such services as Nuclear Medicine CT, ultra-sound, x-ray and angiography to support urgent and inpatient medical services.

Blood Product services for inpatients and outpatients will be calculated using direct materials, direct labor and direct production costs.

NHB will also provide inpatient pharmacy support, equal with the NHB standard of care to Department of Defense discharge patients. Upon discharge from NHB’s UCC, if the VA patient receives a prescription from a UCC provider related the visit, there is only one fill permitted that will be paid by the VA. If the patient requires refills, the patient must fill outside of NHB, and follow-up if needed with his/her Bremerton CBOC Primary Care Manager.

Additionally, veterans who are treated in the Urgent Care Center after hours or on the weekends may receive a written outpatient prescription but it will not be filled by NHB. Any outpatient prescription(s) services for VAPSHCS beneficiaries will be provided at the Bremerton CBOC or closest VA pharmacy to their home with his/her VA Primary Care Provider. If follow-on medical care is required after the UCC visit, the patient should contact the Bremerton CBOC or the VA for specific guidance.

Date Taken: 11.18.2019
Date Posted: 11.18.2019 13:29
Story ID: 352197
Location: BREMERTON, WA, US 

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DISCLAIMER: This article was originally published at the Defense Video Imagery Distribution System Hub ( The appearance of U.S. Department of Defense (DoD) visual information does not imply or constitute DoD endorsement.

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  1. I get that healthcare is complicated, I really do, but I think it’s especially frustrating when you make an honest effort to learn what the rules are, but then there is still all this built-in uncertainty in which insurance companies decide what they want to pay for after the fact.

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