Billed by Urgent Care

You should not be billed for this urgent care visit if the facility was in VA’s contracted network and you are an eligible Veteran, as the VA is responsible for payment directly to the provider under the Mission Act (38 U.S.C. § 1703A). First, immediately call both the urgent care facility’s billing department and the VA Community Care helpline (877-881-7618) to report the erroneous bill, providing your VA file number and the visit details; instruct the provider that under VA regulations, they must submit the claim to VA’s Third Party Administrator (TPA), not to you. Under 38 CFR § 17.4600, eligible Veterans do not require prior authorization for in-network urgent care, but the provider must properly submit the claim. If the facility refuses to retract the bill, contact your local VA Patient Advocate and submit a written statement with all documentation (bill, proof of network status, and your communications) to VA’s Health Resource Center (HRC) to initiate a dispute. Do not pay the bill, as doing so may complicate VA’s obligation to reimburse. If the issue escalates, cite *Staab v. McDonald*, which reinforces VA’s duty to pay for authorized community care, and consider involving your Congressional representative. **This information is for educational purposes regarding VA benefits and procedures only and does not constitute legal or medical advice; for specific guidance on your claim, consult an accredited VA attorney or agent.**