Citation Nr: A21016579
Decision Date: 10/12/21	Archive Date: 10/12/21

DOCKET NO. 210108-179417
DATE: October 12, 2021

ORDER

The appeal concerning entitlement to payment for non-VA medical services provided to the Veteran on October 14, 2020 is dismissed.

FINDING OF FACT

Subsequent to the appeal of the denial of payment for non-VA medical services provided to the Veteran on October 14, 2020, the Agency of Original Jurisdiction (AOJ) administratively reversed the denial and approved the episode of care for payment.

CONCLUSION OF LAW

As the benefit sought on appeal has been granted and resolved by administrative action, there remains no allegation of error of fact or law concerning the issue on appeal; the appeal is therefore moot, and dismissal is appropriate.  38 U.S.C. § 7104; 38 C.F.R. § 20.104.

REASONS AND BASES FOR FINDING AND CONCLUSION

The Veteran served on active duty from February 1962 to November 1962.  The appellant in this matter is the vendor that provided the non-VA medical services to the Veteran on October 14, 2020.

The decision on appeal was issued in December 2020 by the Veterans Health Administration and constitutes an initial decision; therefore, the modernized review system, also known as the Appeals Modernization Act (AMA), applies.  

In the December 2020 decision on appeal, the AOJ denied payment of the charges billed by the appellant for medical services provided to the Veteran on October 14, 2020 under 38 U.S.C. § 1725 on the basis that the Veteran had not received VA treatment within the 24 month period prior to the emergency treatment.  

Prior to the Board issuing a decision on this appeal, a note was added to the claims file indicating that this claim was denied in error, and that there is a timely notification of the episode of care and the Veteran meets all criteria for the claim to have been processed under 38 U.S.C. § 1703.  A new transaction control number was assigned, and it was noted that it is set to be paid.  The claims file also contains a letter that was sent to the appellant notifying it that the "episode of care was approved in its entirety" and that it would receive an Explanation of Benefits (EOB) for each claim paid. 

In this case, the record indicates that the AOJ has reviewed and administratively approved payment for the non-VA medical services provided to the Veteran on October 14, 2020, representing a full grant of the benefits sought in this appeal.  As a result, there is no remaining allegation of error of fact or law for appellate consideration in the present appeal.  See 38 C.F.R. § 20.104.  Accordingly, the Board no longer has jurisdiction over the appeal, and it is therefore dismissed.  See 38 U.S.C. § 7104.  

If a later decision/EOB concerning this episode of care results in payment in an amount disagreeable to the appellant, the vendor may file a separate/additional appeal of that subsequent decision.     

 

 

MICHAEL MARTIN

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	A. Solomon, Counsel

The Board's decision in this case is binding only with respect to the instant matter decided. This decision is not precedential and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.