Citation Nr: A21019372 Decision Date: 12/06/21 Archive Date: 12/06/21 DOCKET NO. 210303-166002 DATE: December 6, 2021 ORDER The appeal concerning entitlement to payment for non-VA medical services provided to the Veteran on October 9, 2020 is dismissed. The appeal concerning entitlement to payment for non-VA medical services provided to the Veteran on December 10, 2020 is dismissed. FINDINGS OF FACT 1. The claim of entitlement to payment for non-VA medical services provided to the Veteran on October 9, 2020 was rejected on the basis that the wrong member ID/Social Security number was submitted; there is no initial decision for appeal. 2. The claim of entitlement to payment for non-VA medical services provided to the Veteran on December 10, 2020 was rejected on the basis that the wrong member ID/Social Security number was submitted; there is no initial decision for appeal. CONCLUSIONS OF LAW 1. There being no decision for appeal at this time, the appeal concerning entitlement to payment for non-VA medical services provided to the Veteran on October 9, 2020 is dismissed. 38 U.S.C. §§ 5104, 7105; 38 C.F.R. § 20.200, 20.201, 20.202. 2. There being no decision for appeal at this time, the appeal concerning entitlement to payment for non-VA medical services provided to the Veteran on December 10, 2020 is dismissed. 38 U.S.C. §§ 5104, 7105; 38 C.F.R. § 20.200, 20.201, 20.202. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The notices on appeal were issued in February 2021 by offices of the Department of Veterans Affairs (VA) Veterans Health Administration (VHA); therefore, the modernized review system, also known as the Appeals Modernization Act (AMA), applies. In the March 2021 VA Form 10182s, Decision Review Request: Board Appeal, the appellant elected the Direct Review docket. The appellant in this matter is the vendor who provided the medical services to the Veteran on October 9, 2020 and December 10, 2020. In February 2021, the VHA Office of Community Care sent the appellant a notification letter that it had received claims pertaining to the Veteran for the dates of service in question, but that the submissions could not be processed due to invalid or missing information; specifically, that the subscriber name and ID were not found. The notice letter contains no decision as to the merits of the claim under the relevant law. A May 2021 Report of Contact indicates that the wrong Social Security number was used, that this was subsequently explained to the appellant, and that the appellant indicated that they would make the corrections and resubmit the claims for processing. While the Board acknowledges receipt of a VA Form 10182, it finds that there is presently no decision for appeal. Decisions and notices of decisions are described under 38 U.S.C. § 5104. Specifically, a decision "shall include an explanation of the procedure for obtaining review of the decision," and requires that a decision include the following: identification of the issues adjudicated, a summary of the evidence considered by the Secretary; a summary of the applicable laws and regulations; identification of findings favorable to the claimant; in the case of a denial, identification of elements not satisfied leading to the denial; and an explanation of how to obtain or access evidence used in making the decision. 38 U.S.C. § 5104. Here, there has not been a determination which meets the legal criteria for an appealable decision. Entitlement to payment for non-VA medical services provided to the Veteran was not denied by VA in February 2021; rather, the VA Office of Community Care identified a procedural defect in how the claim was filed, and further identified the information needed and the steps that could be taken in order for the claims to be considered. Thus, there being no decision for appeal, there can be no appeal to the Board. See 38 U.S.C. §§ 5104, 7105; 38 C.F.R. §§ 20.200, 20.201, 20.202. The appeals concerning entitlement to payment for non-VA medical services provided to the Veteran on October 9, 2020 and December 10, 2020 are therefore dismissed. 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.