The client and the provider should have a clear understanding of exactly what services have been authorized and the dollar amount of the fee for each particular service. Both the client and the provider should be made aware that it is necessary to obtain pre-authorization for any additional service or else BVS will not pay for it. However, the regulations should be flexible enough to make allowances when a physician determines that more tests are needed to make an accurate diagnosis, and that having the client make a return trip of many miles would be impractical and inconvenient for both the doctor and the client. The client should not be penalized and forced to pay additional charges for these services if the provider does not call for pre-authorization and the client had no idea that it would have been necessary to do so. Since authorizations could be needed at any time, a staff person who has the authority to make quick decisions should be available at all times in each BVS District Office.
Physicians consider the client ultimately responsible for the bill.
To avoid a bad credit record, the client has no choice but to pay promptly. Most VR clients are already in financial straits or they probably would not be in the program. Authorizations should be processed and paid for in a timely manner. Matters like this should be taken care of within the system so there is no need for clients to have to contact the Client Assistance Program or take further action. Several other consumers have called me having had similar situations.