Citation Nr: A25035595
Decision Date: 04/17/25	Archive Date: 04/17/25

DOCKET NO. 210402-186914
DATE: April 17, 2025

ORDER

The appeal for payment of the cost of non-VA emergency medical services provided from July 19, 2019 to July 21, 2019, claim number 302101100006615000, is dismissed.

?

FINDING OF FACT

Following the initial denial of original claim number 302101100006615000 based on untimeliness, the agency of original jurisdiction (AOJ) administratively reprocessed under new claim number 302124320063537000, and approved payment for emergency medical services provided by Blount Memorial Hospital to the Veteran from July 19, 2019 to July 21, 2019.

CONCLUSION OF LAW

The criteria for dismissal of the issue of entitlement to payment of the cost of non-VA emergency medical services provided from July 19, 2019 to July 21, 2019, have been met.  38 U.S.C. § 7105; 38 C.F.R. § 20.104.

REASONS AND BASES FOR FINDING AND CONCLUSION

The Veteran served on active duty from February 1977 to February 1980.

The appellant is a non-VA healthcare provider that furnished emergency medical services to the Veteran.??

In April 2021, VA received VA Form 10182 Notice of Disagreement from the appellant, requesting review of a January 2021 AOJ Explanation of Payment (EOP) that rejected a claim for the payment of the cost of non-VA emergency medical services.

However, the claim for payment was administratively approved while this appeal was pending.? In an August 2021 letter, the AOJ advised the provider that the appeal for payment of emergency medical services provided from July 19, 2019 to July 21, 2019, by Blount Memorial Hospital, was approved after secondary administrative review.  The letter explained that the claim related to this episode of care would be processed according to VA policy.  If the amount paid for the emergency medical services provided were disagreeable to the appellant, they were required to file a separate appeal of the latter decision pursuant to the relevant regulatory or contractual procedures, as applicable.

The administrative action approving entitlement to payment for the July 2019 episode of care constitutes a reversal of the January 2021 denial, and a full grant of the benefit sought in this appeal.  No determination remains with which the appellant disagrees and the appeal is therefore dismissed.  38 U.S.C. § 7105(d); 38 C.F.R. § 20.104.

 

 

RYAN T. KESSEL

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	S. Morford, 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.