The following is very important information for people NOW living in or moving toThailand.
Subject: DIRECT BILLING TO THE FOREIGN MEDICAL PROGRAM [FMP] OF THE DVA
Date: Tue, 30 Jun 2009 12:56:01 -0400
THIS E-MAIL IS SPECIFICALLY DIRECTED TOWARD VETERANS IN THE
PACIFIC THEATRE WITH A SERVICE CONNECTED [SC] DISABILITY RATED BY THE DVA FROM 0% TO 100% AND RAO's/SERVICE OFFICERS
Dear Fellow SC Veterans,
In conjunction with my VFW Post Commander and fellow Service Officer, Comrade Mike Holmes and in behalf of our Post 12074 in the Rose of the North, Chiang Mai Thailand, we are most pleased to have worked out a program wherein SC Veterans can get medical care for their VA rated SC disabilities to include medications without paying up front for it.
We have coordinated directly with:
FMP of the Health Administration Center of the DVA in Denver
CHIANG MAI RAM HOSPITAL
SAMITIVEJ SRIRACHA HOSPTIAL * just north of Pattaya
Pronounced sa met e whey
MANIPHA CLINICS OF BANGKOK AND PATTAYA
We have run several test cases with each facility and all are happy with the results.
Let's face it, the days of Florence Nightingale are over and medical care is now big business.
Hospitals are in business to make money and can not be faulted for that. I have touched base with some of you in various countries and get pretty much the same results. A hospital in an emergency will do what it takes to stabilize you but after that if you don't have insurance or money up front'.. Your days might be numbered.
A couple of quick examples:
A couple years back, we had a WW II Veteran in Pattaya who was SC with CAD [coronary artery disease]. He was transported to a local major Intl' hospital who stabilized him but in the period of one day sucked up his emergency fund of about 85,000 THB [$2500] and
told him he needed immediate bypass surgery and needed to put up 1,000,000 THB for the surgery. Now this Veteran would have gotten 100% reimbursed by the FMP assuming he had the money up front to start with. HE DID NOT so the next day he was discharged & relocated to a Thai government hospital where he died in short
order. Not a nice picture.
Another senior vet needs dialysis on a very recurring basis and that falls under his SC disability. Originally, the vet was paying out of pocket, submitting his claim to FMP and hoping a refund would come in time for him to send the USD check to the States & withdraw money here in Thai Baht so he could pay for his upcoming treatments. This story has a different ending because now this vet
goes to one of the above participating hospitals and the hospital bills the FMP direct for his care. He no longer waits for reimbursement nor does he have to file a claim & worry about it not being correct. He goes in, gets his dialysis, passes his
regards to the hospital staff, winks at his 'special nurses' and
goes out to practice making babies... or whatever one does after
a dialysis treatment.
The FMP has told me that a conservative estimate is that 25% of
every claim submitted to them world wide is rejected. This does
not make for happy veterans and increases their workload
tremendously. Normally; rejections are for the lack of supporting documents or legibility. Hmmmm, been there, done that. I have learned. In the case of the dialysis patient above, the hospital learned real fast how to submit a proper claim. The claim is now the hospital's responsibility; not the Veteran's.
FMP eligibility is open to SC [VA RATED] veterans who travel or
reside outside the US except the Philippines. Guam and Saipan
which are considered US. If you come to Thailand from the States
or PI/Guam/Saipan to party or visit temples in Thailand and have a service connected disability problem, i.e. heart attack & are service connected for that, FMP will cover you. One thing that FMP does not pay for is MEDICAL TOURISM wherein you travel from one of the above areas specifically to circumvent the VA medical care provided there. A bonafide emergency is a whole different story and you will be covered by FMP if you have the money up front to pay the hospital to get you well.
If on the other hand you in fact live in Korea, Japan, Taiwan, Vietnam or any other country outside the in-house exposure of the VA, you may indeed come to Thailand & avail of FMP DIRECT BILLING.
Travel and lodging is out of your pocket.
In the brief I gave at the Department Convention on the 17th, I misstated the above benefit but FMP was kind enough to set me straight so we can present to you the best program legally possible. My apologies for mis-speaking.
Now we have a problem. If you had BLUE CROSS insurance, the hospital could call them up referencing your policy number and say, 'is he covered'. If on the other hand, you gave them your name and SSN, they could call up the FMP & ask, 'is he covered'; the answer would be something on the line of telling the hospital what they can go do themselves. The FMP falls under privacy and HIPPA laws and can not give out that information... and they
won't.. So how do the hospitals know what services they can provide and what will be covered? In our initial dealings with the hospitals and clinics, the deal was that Mike would prescreen folks for Chiang Mai Ram and I will do the same for Samitivej Sriracha and the clinics. None of the facilities will accept new
patients without prescreening & recommendation. The prescreening process can sometimes be done in an hour or two and other times, upwards of a month depending on obstacles incurred. Being prescreened for one facility will normally cover you for all as we
are endeavoring to be on the same sheet of music.
If being prescreened for this program interests you, please, and I
repeat PLEASE don't wait till the last minute. What will constitute an emergency to you might not do the same for me or Mike or we may be out of town or our counter parts in the
facilities might be out of town. Speaking of which, Mike will be out of the country from early July for a month with only limited access by e-mail and I will be out of the country for a period of
30-45 days with full e-mail access from mid August. A note here is warranted; even if you only visit Thailand once or twice a year; think of it as free insurance. If you have an urgent need now, please advise Mike or me upfront & we will do our best to expedite
getting you prescreened. There is no cost involved nor need to continue is you don't like the facility. FMP is still available to
you. You will get an EOB for every claim that the FMP pays on to be able to ensure correct billing for services provided.
Mike can be reached at
081-841-9342 domestic or 66 81-841-9342 Intl
I can be reached at
081-283-5075 domestic or 66 81-283-5075 Intl
Office hours 11-23:00 daily
PLEASE remember this: the FMP will ONLY pay for Service Connected
medical treatment and items that are caused by the disability or aggravate it. In some cases that will be a close call for the hospital to second guess the FMP and even though the FMP is quite liberal, the hospital might not want to gamble on the outcome. In some cases of these secondary items or even the first time you go to a facility, you might very well be asked to provide a guarantee [i.e credit card or the like.] You will be personally responsible
for things the FMP will not cover. Please also realize that the hospital or clinic has the final say as to whether they will
accept you as a FMP patient. Once you are screened and ready to go to the facility the first time [or before], we will provide you a direct English speaking POC and help the skids on the first go-round.
I would expect this program to grow as right now, these two Hospitals and clinics are the only ones in the world doing FMP direct and have a monopolistic head start. For those Service Officers upcountry or Japan, Korea, Okinawa or Taiwan; you might want to think about why you don?t have such a program. I know that
many of you have MTF's but not all SC Veterans are retirees. Like I previously mentioned, hospitals are in the business to make money. Tease those hospitals with that thought. Your in country
disabled Veteran?s are certainly worthy of your efforts and no
doubt will appreciate it to no end. If you want to know who will
do that for you; look into your nearest mirror. I?ll be at the
other end of your keyboard if you need assistance.
For those of you who might still be doing your own claims to FMP,
you no doubt have been confused by the FMP?s cover letter or the requirements for a successful claim. I have talked to the FMP
about revisions and unfortunately we are back to the bureaucracy
of changing a government form. I'm told, 3 years. To work round that and with a little guidance from the FMP, I developed the
attached FMP cover letter for your personal claims which if you take a serious look at it, will help you develop a good claim.
They will accept this form and it is up to you if you want to use it or not.
If you know any vets in Korea or Japan or Okinawa or Taiwan,
kindly forward this to them as not a single post or district has bothered to respond to my requests for who their service officers
were and their e-mail address with the exception of Post 1054 in Japan.
For those of you who would even think it; neither Mike nor I nor
the VFW nor VA endorses these facilities. We likewise receive no
type of remuneration for our services. We pass this info to you as
dedicated Service Officers in the hope it will make your life better and longer.
WIDEST DISSEMINATION REQUESTED
Please feel free to contact Mike or me with questions on the program or to get prescreened to avoid delays in time of need.
Yours in Comradeship,
Asst Department Service Officer
Department of the Pacific Areas, VFW
Warden, US Embassy, Bangkok