From war to waiting: veterans see more problems getting care

VA hospital (FILE)_162120

DAYTON, Ohio (WDTN) – A 2 NEWS Investigation finds local veterans having trouble getting health care, again — while community doctors who see them are not getting paid.

After the world found out the VA was covering up long wait time for veterans to see doctors around the country, Congress took action and asked the VA to come up with a new way for Vets to get care faster. But that plan is leaving veterans without local access to the healthcare they need again.

“It’s just hell on earth”

Navy Veteran, Mario Mancini knew he needed to see a doctor for his PTSD. Since he used to work at the Dayton VA he wanted to see someone outside the system.

“It requires medication, it requires counseling,” said Mancini.

The VA told him they had a program in place to help with that called Veteran’s Choice. It allows vets to see a health care provider in their community instead of at the VA Medical Center. The goal is to get them faster care.

After months of trying to get an appointment he says he finally heard back. The doctor who can see him is in Columbus. More than an hour away.

“70 miles out of town to get treatment is appalling,” he said.

Mario wanted to know why he couldn’t just see one of the several qualified doctors in the Miami Valley.

“After talking with other veterans and such, I found the issue isn’t the resources being overwhelmed in Dayton, the VA is not paying these vendors.”

One of those local vendors is Dr. Kathy Platoni. A national expert in PTSD and veteran herself.

“I guess they thought this was going to stream line everything and make it easier for veterans to get treatment with non VA providers and the providers to get paid..and the system has failed miserably,” said Dr. Kathy Platoni.

Dr. Platoni says the VA used to pay the out-of-network doctors directly after seeing veterans. But now there’s a third party involved and for our area it’s called Health Net. Think of them as the insurance company. All claims go through and are paid by them. This is where Platoni says the mess started. She’s already owed more than $4,000 after she started seeing a patient in January.

“Providers are not being paid. Veterans are not being authorized for treatment,” said Dr. Platoni.

Platoni said doctors in the community don’t want to work with the VA and Health Net because their reputation is to not pay and that is leaving veterans without care in their community. It’s the exact opposite of what the program was intended to do in the first place.

“It makes me so angry that once again we have to pay in an emotional sense for a military service instead of being lauded, appreciated, rewarded and given the care that we were promised -we have to fight for it and still not get it,” said Dr. Platoni.

Platoni can’t get answers from Health Net or the VA so 2 NEWS Investigates started asking questions. The Dayton VA tells us Health Net is responsible for paying the claims, not the VA. Even so, a spokesperson did say they aware this has not been a smooth process.

He said they’re working with community doctors and Health Net on getting claims paid. In the meantime, he adds the Department of Veteran Affairs is also working on a long-term plan with Congress that includes improvements in healthcare and faster doctor reimbursements.

But these veterans say they are tired of excuses and plans. They say they want action that works and will work for years to come.

“It’s not about the money. It’s about another assault on the psyche for the people willing to die for their country,” said Dr. Platoni.

2 NEWS heard back from Health Net. They sent a short statement in response to my questions about lack of payment saying,

“We continue to work with the Department of Veterans Affairs to establish a health care cost reimbursement process that will better facilitate timely payments to providers who support veterans’ care needs within the community.”

I’ve sent a list of follow-up questions. I’ll let you know when we get a response.

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