Hello from San Diego

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keepcoming

Moderator - Living & General Stuff
May 25, 2011
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Hi I`m a software provider and one of my main products is a EHR for veterans clinics. There are 2 in Santiago, 2 in Pto Plata and 3 in Santo Domingo, All of them support FMP and TRICARE. Just in case this information works for you.
Curious, are you affiliated with the VA EHRM Integration Office, as this is who is deploying the new EHR product? I know this process was previously delayed.
 
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chico bill

Dogs Better than People
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Even if they provided full VA care it would be useless.
They only thing VA doctors learn is more pills, more pills
 

JD Jones

Moderator:North Coast,Santo Domingo,SW Coast,Covid
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Even if they provided full VA care it would be useless.
They only thing VA doctors learn is more pills, more pills
The Miami VA hospital does whatever is necessary for patients to feel no pain, for sure.

But I have been hospitalized there over a dozen times and was never prescribed more pills than necessary to recuperate from surgeries, and I can count on one hand how many times they gave me opioids on an outpatient basis.
I did see a lot of guys complaining about the doctors being "uncaring" because they wouldn't give them any more pills.
 

isaaky

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Aug 26, 2023
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Just to clarify:

Those clinics are NOT affilliated to VA neither my EHR system. Those clinics operates under local regulation. They usually use USA EHR system. My EHR is just designed for being more compact and more specific needs for them, for example matching names for medications in spanish and available in local market.

What they do is create the best environment to veterans providing the services and resources more convenient to them in a local scope. They are founded by veterans who know the process.

As an example imagine the common scenario without the clinic:
- You visit a local clinic/hospital and get attended for a therapist for a service connected diagnostic and be attended in spanish.
- You pay for the services
- You then fill out a claim form, with the service you got
- You send this claim to FMP.
- You receive a check and EOB of the payment. Possible wrong if you dont use the right medical terms

With these special clinic you:
- Get attended by a therapist that know english.
- You dont pay for the services.
- The clinic fill out the forms for you with right terms and codes (CPT and ICD) you signed.
- The clinic send the claim to FMP.
- Clinic receive the payment and EOB, if they got it wrong they assume.

This is just a simple example of service, they also help you with the prescribed medication etc.

As you can see no do required to be affiliated , because VA affiliation just exists in USA , Canada. This kind of services started in Panama like Hospital Brisas there, that also is NOT affiliated with VA.
 

JD Jones

Moderator:North Coast,Santo Domingo,SW Coast,Covid
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Because clinic is the party that send the claim and receive the payment via registered company in USA instead of the patient itself. They pay 3 months after is the only drawback.
I'll ask again, How does the clinic make money?
 

isaaky

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Aug 26, 2023
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I'll ask again, How does the clinic make money?
The same as any clinic. A clinic make money because of insurance payments and sometimes, they charge co-pays. As I mentioned, they keep they money paid by FMP. Maybe it was confusing when I said "veterans dont pay".
 

JD Jones

Moderator:North Coast,Santo Domingo,SW Coast,Covid
Jan 7, 2016
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The same as any clinic. A clinic make money because of insurance payments and sometimes, they charge co-pays. As I mentioned, they keep they money paid by FMP. Maybe it was confusing when I said "veterans dont pay".
Exactly. And that's the difference between the VA and private clinics.

Veterans never pay in a VA clinic.
 
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keepcoming

Moderator - Living & General Stuff
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As someone who has done government medical billing for years, the VA will NOT pay any bill (outside clinic, not VA affiliated) unless it is pre-approved by the VA. I would be very leery of going to a clinic and sending the bill to the VA thinking that the VA will pay. I would be surprised that a clinic in DR would bill the VA without having some type of payment upfront. And it is very incorrect to say if the billing clinic "gets it wrong they assume". If the VA comes back and says the services are not covered then it is the clinics right to charge the patient. Wrong information can cause some serious issues (financial, etc..) for those who may want to try this in the DR.
 
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isaaky

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As someone who has done government medical billing for years, the VA will NOT pay any bill (outside clinic, not VA affiliated) unless it is pre-approved by the VA. I would be very leery of going to a clinic and sending the bill to the VA thinking that the VA will pay. I would be surprised that a clinic in DR would bill the VA without having some type of payment upfront. And it is very incorrect to say if the billing clinic "gets it wrong they assume". If the VA comes back and says the services are not covered then it is the clinics right to charge the patient. Wrong information can cause some serious issues (financial, etc..) for those who may want to try this in the DR.
They have been operating for years and getting paid by the FMP without any impersonation, the documentation contains the location and that the service was done in DR. I think you are mixing VA Clinic with FMP. FMP pays to any foreign services if signed by the patient. You dont need a VA clinic for using FMP. Any hospital/clinic can attend you and you send your claims to FMP to refund what you paid in advance. In contrast, FMP pay overseas no domestic (USA). We are talking here about receiving medical outpatient service ina foreign country. "VA Clinics" only exist in USA and territories like PR.

This is what they FMP website( https://www.va.gov/COMMUNITYCARE/programs/veterans/fmp/index.asp) says:
Does FMP authorization cover required health care services while the Veteran is visiting in the United States?
No. FMP authorizations are limited to health care services obtained in foreign countries only. Should services be required while in the United States, the Veteran should contact the nearest VA health care facility. Visit the VA Facility Locator page to find your local VA health care facility.
 

keepcoming

Moderator - Living & General Stuff
May 25, 2011
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Again, I would caution against using this service/method. You can go to any clinic in the DR regardless of whatever insurance you have (referring to insurance outside the DR) and after the fact submit claim forms requesting to be reimbursed. If you would like to start another thread with solid information about which clinics in the DR have successfully done this process with the VA/FMP that would be great. However, this really is all off topic.
 
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keepcoming

Moderator - Living & General Stuff
May 25, 2011
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If you would like to start another thread with solid information about which clinics in the DR have successfully done this process with the VA/FMP that would be great.
 
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lasalsa

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Hi I`m a software provider and one of my main products is a EHR for veterans clinics. There are 2 in Santiago, 2 in Pto Plata and 3 in Santo Domingo, All of them support FMP and TRICARE. Just in case this information works for you.
Amazing! I was wondering about that. I retired from the Air Force in 2013. Looking to live for 6 months out of the year in the North Mountains. I also work in the Healthcare Software (VHA) space. Let's connect.. PM..
 

Radical

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Jan 5, 2021
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As someone who has done government medical billing for years, the VA will NOT pay any bill (outside clinic, not VA affiliated) unless it is pre-approved by the VA. I would be very leery of going to a clinic and sending the bill to the VA thinking that the VA will pay. I would be surprised that a clinic in DR would bill the VA without having some type of payment upfront. And it is very incorrect to say if the billing clinic "gets it wrong they assume". If the VA comes back and says the services are not covered then it is the clinics right to charge the patient. Wrong information can cause some serious issues (financial, etc..) for those who may want to try this in the DR.

Stop embarrassing yourself - the poster isaaky is dead on in everything he/she has posted and 100% correct.
 

Radical

Well-known member
Jan 5, 2021
497
327
63
SOMEWHERE
They have been operating for years and getting paid by the FMP without any impersonation, the documentation contains the location and that the service was done in DR. I think you are mixing VA Clinic with FMP. FMP pays to any foreign services if signed by the patient. You dont need a VA clinic for using FMP. Any hospital/clinic can attend you and you send your claims to FMP to refund what you paid in advance. In contrast, FMP pay overseas no domestic (USA). We are talking here about receiving medical outpatient service ina foreign country. "VA Clinics" only exist in USA and territories like PR.

This is what they FMP website( https://www.va.gov/COMMUNITYCARE/programs/veterans/fmp/index.asp) says:

isaaky,

You are 100% correct in everything you've posted - please stop wasting your time with folks that have no idea how these local non VA affiliated clinics work directly with the FMP VA program to provide services in the DR for all service connected disabilities for any US Veteran
 
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