I had an extremely concerning experience with Advanced Urology in Marietta, Georgia, specifically related to how they handle VA Community Care patients and billing.
I was referred to this clinic through VA Community Care for a VA-authorized vasectomy. Shortly after being contacted to schedule, I was told I would need to pay a $250 booking fee out of pocket. As a veteran using authorized Community Care, this immediately raised concern. Only after I pushed back and involved VA Community Care did the clinic reverse that position and acknowledge that the booking fee should be billed to the VA, not the veteran.
After the appointment was scheduled, I then received messaging from the clinic stating that the procedure would cost $149 if a post-vasectomy semen analysis kit was included, and $0 if it was excluded. I was repeatedly told by the clinic that this analysis kit is a retail product and that, due to how they operate, the cost is routinely passed to veterans.
This directly conflicted with what VA Community Care confirmed in writing. VA Community Care explicitly stated that labs and pathology relevant to the referral are covered, including post-vasectomy semen analysis and post-vasectomy test kits, and instructed the clinic to bill Optum using CPT code 89321. VA also stated that if a veteran paid anything to the provider, those charges must be refunded. I have included screenshots documenting both the VA's written guidance and the clinic's messages quoting out-of-pocket costs.
I personally spoke with the director of the clinic's benefits department, who stated that CPT code 89321 does not cover the vasectomy or the analysis kit and that the clinic cannot use that code to bill the kit internally. Despite VA's written clarification, I was told that if I wanted the required post-vasectomy analysis completed, I would need to arrange follow-up separately through the VA.
After further confirmation with VA Community Care, I learned that the Atlanta VA does not even perform post-vasectomy semen analysis locally, meaning this proposed alternative was not viable and would have left me without proper follow-up or forced into paying out of pocket later.
Because the clinic could not or would not provide VA-authorized care from start to finish, and attempted to shift the burden of their internal billing limitations onto me as the patient, I cancelled my appointment.
Veterans should be aware that this clinic appears to accept VA Community Care referrals while disputing or declining covered components of care when they do not align with the clinic's internal billing model. I strongly recommend that any veteran considering this clinic obtain written confirmation in advance that all aspects of care, including required follow-up testing, will be completed and billed appropriately, with no out-of-pocket cost. read more