{"aaData": [["SAMPLE SUSPENSION", "", "
\nWe recently processed your invoice(s) and for various reasons adjustments\nhad to be made to line items. The following is a list of those items\nthat were changed and the reasons why:\n
\n
\n", "
\nShould you have any questions regarding this letter, feel free to contact\nus at the VA Medical Center. Thank you for your cooperation.\n                            Medical Center Director\n                            James A Jones, MD\n
\n
\n"], ["UNAUTHORIZED DISPOSITION", "
UNAUTHORIZED CLAIM
\n", "
\nWe have carefully reviewed your claim for payment of unauthorized medical\nservices.  The following decision has been made:\n
\n
\n", "
\nIf you do not agree with the decision you have the right to appeal.  Your\nSincerely,\n  \n  \n  \n  \nChief, Medical Administration Service\nappeal rights should be attached for your review, if your claim was not \napproved.\n  \nIf you have any questions concerning this matter, please contact us at the\nabove address.  A copy of this letter is being furnished to the provider(s)\nof care, if applicable.\n   \n  \n
\n
\n"], ["UNAUTHORIZED REQUEST INFO", "
UNAUTHORIZED CLAIM
\n", "
\nWe have received your request for payment of medical services which were not authorized.  Before we are able to process your claim the following information is needed:\n
\n
\n", "
\nWe ask that you be prompt in supplying the requested information.  Failure to provide all the information within a year will result in an automatic disapproval.\nSincerely,\n  \n \n \n \nChief, Medical Administration Service\nLegislation requires that we notify you if your claim cannot be processed if entitlement to the services rendered has not been established.  Without the information requested above, we cannot consider your request\nfor payment as a proper invoice.\n  \nIf you wish us to process this claim, please resubmit the entire claim with the items listed to the above address.  We will notify you of our decision.\n  \nThe U.S. Department of Veterans Affairs assumes no financial responsibility for any costs incurred in obtaining the above information.\n  \n  \n
\n
\n"], ["1725 DISPOSITION", "
UNAUTHORIZED CLAIM
\n", "
\nConsideration of possible VA financial assistance has been given your\nclaim under the Veterans Millennium Health care and Benefits Act, H.R.\n2116.  The following decision has been made:\n
\n
\n", "
\nIf you have any questions or concerns, please contact us at the above\nChief, Medical Administration Service   \naddress.  A copy of this letter is being sent to the provider(s) of care,\nfor their information.\n \nSincerely,\n \n \n \n \n
\n
\n"], ["1725 REQUEST INFO", "
UNAUTHORIZED CLAIM
\n", "
\nConsideration of possible VA financial assistance is being given your\nclaim under the Veterans Millennium Health Care and Benefits Act, H.R.\n2116.  However, before your claim can be reviewed it will be necessary\nthat we receive the following information:\n
\n
\n", "
\nIf the formal claim(s) and/or additional evidence, statement(s), etc., as\nfor the costs incurred in obtaining the above information.\n \nSincerely,\n   \n  \n  \n  \nChief, Medical Administration Service\nrequested above, are not received within (30) days from the date of this\nletter, your claim will be deemed abandoned and payment/reimbursement will\nnot be considered on the basis of such abandoned claim, or any future\nclaim for the same expenses.  If an extension is required to submit the\nrequested documentation, it will be necessary that you contact the VA\nfacility designated as the clinic of jurisdiction for your area.\n \nThe Department of Veterans Affairs will assume no financial responsibility\n
\n
\n"]]}