Apria Healthcare

We have reviewed the patient’s account and confirmed they received CPAP supplies for date of service October 16, 2015. The claim was submitted to Anthem for payment and was denied as maximum benefit reached; therefore, account was changed to bill to patient under self-pay. The patient can reach out...

to the insurance for additional questions in regards to the claims not being covered, and if there is anything we need to do to correct the claim we will assist with that. The account reflects an open balance of $306.69 for date of service October 16, 2015. We do apologize for the miscommunication as our goal is to ensure customer satisfaction as well as accurate billing.   Sincerely,Apria Healthcare, LLC.

We would like to apologize for the level of customer service you have experienced. During a review of the your records, we confirmed that due to a  break in service with Apria which was greater than 60 days, we are required to obtain a new prescription from your servicing physician for your...

respiratory needs. Once this information is received, your request will be processed.
We greatly appreciate you for taking the time to bring your concerns to our attention. We welcome all patient feedback as this provides us with a valuable insight into our services from the patient’s perspective which allows us to make service improvements, as it has done in this case.

We have reviewed patient account with assistance from Customer Service and confirmed that the entire order for date of service September 30, 2015 will be adjusted off and is no longer patient responsibility as patient was not advised she would be responsible for any out of pocket or deductible...

expenses. We do apologize for the miscommunication as our goal is to ensure customer satisfaction as well as accurate billing.
 
Sincerely,
 
Apria Healthcare LLC

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and have determined that this proposed action would not resolve my complaint.  For your reference, details of the offer I reviewed appear below.
Yes Apria did tell me that I would be responsible for any deductible and out of pocket expenses, it was at that point I told them I would not be placing the order if the supplies were not covered 100%. As a customer who stated that the order would and should not be placed unless it was covered at 100%, it does seem that a mistake was made here however, it is not on my part. This would not be allowed to happen in any other industry, I was told once price and am being charged another.  Is there a record of how many instances this same "miscommunication" has occurred with other customers? This is not acceptable. Regards,
[redacted]

Item # 1:  Ms. [redacted] stated she would like the charge to patient for $186.78 to be written off because she provided Apria Healthcare with her insurance [redacted] in a timely manner.   RESPONSE: We have reviewed Ms. [redacted] daughter account and confirmed that on April 17, 2013 we...

submitted claims to [redacted] for the monthly rental of her oxygen 02 concentrator. Ms. [redacted] insurance termed on January 1st, 2013 and was billed in error for that date of service because we did not receive the updated insurance information from Ms. [redacted] until September 16th, 2013. We were unable to bill her new primary insurance [redacted] for date of service April 17, 2013 because it was past CCX 45 day timely filing limit which is why the balance of $186.78 is now patient responsibility. The balance automatically rolled over to collections on January 18, 2014 after being outstanding for over six months. We do apologize for the miscommunication as our goal is to ensure customer satisfaction as well as accurate billing.     Sincerely,   [redacted]
 
[redacted] Billing Center Quality Specialist

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and have determined that this proposed action would not resolve my complaint.  For your reference, details of the offer I reviewed appear below.
Not only did I contact the business after they repeatedly told me I had to rent the machine, but even had medical approval from [redacted] that I was to have the machine under my medical insurance coverage. After repeated harassing calls, I gave in (due to the fact that having the machine was the only way to breastfeed my daughter) and told them I would rent said breast pump machine. I finally said I would rent the machine that I had medical coverage for - this should be against the law. It certainly is the direct opposite of Obamacare and legislation. They then asked for my billing information to charge my account and I gave them my information - under the pretense that I would be charged a little over $40 a month to RENT THE MACHINE. One month later I was charged over $588 as purchase of the machine. I called over and over and no one would give me a straight answer except to say I owned the machine then put me on hold. I begged and told them I could not afford that amount and would be put on hold for over 25-35 minutes at a time. I called their offices demanding a supervisor and every time I was being "transferred" to a supervisor, I would just be put on hold for no less than 30 minutes, until I would hang up. I have a full-time job and family so I cannot be on hold like that. I would, however, call back the next day and the same thing would happen. I NEVER GAVE THEM THE AUTHORITY TO WITHDRAW THAT AMOUNT. I ONLY gave them the credit card information to RENT the machine. I even had my own bank try and dispute the charges. The terribly sad part is, I was on phone calls with people for all these, so I have nothing in writing myself. Just my word and my husband's word (since he was with me most of the time) against theirs. I have read reviews of this place and they are known for this. It is a terrible company. They continually harassed a person with MEDICAL INSURANCE COVERAGE for a machine for rental information until I gave in. I thought I was giving them money to rent the machine. They lied to me. And after charging me the $588+ dollars, would never work something out with me or even speak to me, for that matter. 
Regards,
[redacted]
Please find attached the approval from the Pediatrician to have the pump covered through my [redacted] Health Insurance up to and including DECEMBER 2015.

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and have determined that this proposed action would not resolve my complaint.  For your reference, details of the offer I reviewed appear below.
[redacted]
Regards,
[redacted]
Why did they not send me a bill then or charge my credit card that is on file. Why 18 months later. We could have settled the account then. I never received any statement from Apria. My point is, Apria was negligent as they did not notify me in 2015 that insurance did not pay and I did not get any statement then. I feel that I should not be penalized for their billing negligence. This is not a good practice. If they billed me then either by sending me a bill or charge my credit card, I would not be paying this amount because I would have pursued it then. My insurance will not pay now - 18 months later. No wonder Apria has such negative comments on line with their billing. Probably the OIG should look into this negligent practice.

We would like to apologize for the level of customer service you recently experienced regarding the delivery of your respiratory equipment. After a review of your records, we confirmed your delivery was inadvertently left off route in error. This was discussed with all the employee involved. Also,...

we confirmed you received your delivery on February 16, 2017.   Again, we sincerely apologize for any inconveniences and/or challenges this has caused you. We greatly appreciate you for taking the time to bring your concerns to our attention. We welcome all patient feedback as this provides us with a valuable insight into our services from the patient’s perspective which allows us to make service improvements, as it has done in this case.   Sincerely,   Apria Healthcare LLC

We have confirmed that the patient received a cpap machine April 25, 2016 with Humana as his insurance. The contract agreement with Humana requires a thirteen-month rental then maintenance with no charge. If the insurance changes before the equipment is purchased or if it doesn’t convert to...

ownership, then the rental starts over with the new insurance’s agreement which was Medicare. Medicare became effective December 1, 2016 and requires a thirteen-month rental before equipment is purchased. The patient was billed $44.48 for service date December 26, 2016 due to no valid insurance coverage as the patient did not update his insurance until January 5, 2017. Once the insurance was updated we did not have all required clinical documentation to bill Medicare and the balance was sent to collections October 15, 2017. We have acquired all documents needed and in the process of submitting claims for January 26, 2017 through October 26, 2017 to Medicare for payment and have removed the collection balance as a one-time courtesy. All invoices that are still available has been mailed to the patient. We believe that all appropriate steps have been taken to resolve this issue.   Sincerely,   Apria Healthcare, LLC

Yesterday, my husband received a phone call from Apria.  They finally had his new CPAP machine ready for pickup.  He went to the Apria office in [redacted] and picked it up.  They apologized for all that he had to go through to finally get his new machine.Thanks for your help.  We appreciate it. 
Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and find that this resolution would be satisfactory to me.  I will wait for the business to perform this action and, if it does, will consider this complaint resolved.
Regards,
[redacted]

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and have determined that this proposed action would not resolve my complaint.  For your reference, details of the offer I reviewed appear below.
[The business must contact me via email as requested. See attachment (April 7, 2017) for new developments.]
Regards,
[redacted]

RESPONSE: We have reviewed Mr. [redacted] account and confirmed that he received his CPAP unit and Cpap supplies from Apria on October 15th, 2014. At that time he signed the Sales, Service and Rental Agreement authorizing his credit card to be placed on file for any charges not covered by the...

insurance. Claim for date of service November 19, 2014 for CPAP supplies received was billed to [redacted] and denied as being applied to Mr. [redacted] deductible and his credit card was charged $497.84. We also billed [redacted] insurance for dates of service January 15, 2015 through July 15, 2015 for the monthly rental of his CPAP unit and for dates of service January 15, 2015 - May 15, 2015 claims were denied as being applied to Mr. [redacted] deductible and claims for dates of service June 15, 2015 - July 15, 2015 were denied as no coverage.   At this time there is no updated insurance information on file in order to request that claims be reprocessed and the open balance for all claims is $629.30 and he also has an outstanding balance in collections in the amount of $269.70 for dates services October 15, 2014 through December 15, 2014 for the monthly rental of the CPAP unit that were also denied as being applied to his deductible. We do apologize for the miscommunication as our goal is to ensure customer satisfaction as well as accurate billing.         Sincerely,   [redacted]   [redacted] Billing Center Quality Specialist

We have reviewed patient account and confirmed that our Customer Service Team have shipped his supplies at no charge and have communicated that information to the patient as well. We do apologize for the miscommunication as our goal is to ensure customer satisfaction as well as accurate billing.

We would like to apologize for the level of customer service you recently experienced. After a review of the patient’s records, we confirmed there was a delay in receiving the [redacted] Medical Equipment due to the facility not having the correct attachments to fit the [redacted] Medical Equipment....

While attempting to reorder the attachments, the patient’s advocate at the hospital called Apria to cancel the order, as they have found a different provider. Apria’s Customer Service and General Managers used this opportunity to provide coaching and retraining for their staff regarding the delay in providing the equipment and/or feedback to you.   We greatly appreciate you for taking the time to bring your concerns to our attention. We welcome all patient feedback as this provides us with a valuable insight into our services from the patient’s perspective which allows us to make service improvements, as it has done in this case.   Sincerely,  Apria Healthcare, LLC.

We have once again reviewed the patients account, we have re-verified the patient’s insurance information using his social security number to ensure we are getting the most accurate/up to date information and as of January 4, 2016 the patient still does not have durable medical equipment coverage with [redacted]. Per the information provided by [redacted], the patient has a premium assistance plan which covers [redacted] Part B premiums only. Per [redacted] the patient has no durable medical equipment coverage. The patient will need to contact [redacted] directly for more information via the number located on the back of his insurance card.
The patient may refer back to his explanation of benefits from [redacted] for more information regarding the denials being sent to Apria Healthcare. We do apologize for the miscommunication as our goal is to ensure customer satisfaction as well as accurate billing.

ITEM # 1:  
Mr. [redacted] states that the way Apria went about getting his credit card information was inappropriate and was without his authorization.
RESPONSE
We have reviewed Mr. [redacted]’s account and found that we received an order to set Mr. [redacted] up with a CPAP unit and supplies on...

May 1, 2014. On May 9, 2014, Apria verified Mr. [redacted]’s insurance with Medicare and spoke to him about his appointment on May 14, 2014 and collected his 20% co-pay amount of $64.44.
Medicare has specific requirements in order to qualify certain types of claims for reimbursements. These typically involve test results of a certain nature, statements from the physician regarding “medical necessity’, and other specific types of documentation. Although Apria may assist patients in the process of obtaining specific documentation in an effort to qualify a claim for reimbursement, the Responsible Party remains ultimately responsible for obtaining documentation and information necessary to meet such requirements. In the event a Payor’s specific requirements are not met, the Responsible Party may be required to pay for charges that otherwise should have been covered by the Payor.
Apria sent a request to the physician on May 19, 2014, to sign the initial Certificate of Medical Necessity to be submitted with the Medicare claim. On June 19, 2014, Apria verified that Medicare requires a qualifying sleep study test without using a CPAP device. We were not able to obtain a copy of the actual test documentation. Therefore, we cannot determine if the test was performed in accordance with Medicare guidelines.
Apria had not been able to obtain the needed sleep study, therefore on August 14, 2014, mailed a 60 day letter to request help in obtaining the needed documentation. Mr. [redacted] came into the office on August 27, 2014 and picked up heated tubing and returned the signed Advance Beneficiary Notice and Sales Service and Rental Agreement. Mr. [redacted]’s credit card information was placed on the Sales Service and Rental Agreement in which was placed on his account to charge his co-pay, deductible or any non covered charged by Medicare once signed.   
On August 29, 2014, Apria reviewed Mr. [redacted]’s account again and found that we still needed a new sleep study. Apria received and loaded the signed Advance Beneficiary Notice and Sales Service and Rental Agreement on September 15, 2014. Apria made adjustments
to the insurance portions of the claims in the amount of $387. 88 for the May 15, 2014 – August 14, 2014 claims before the Advance Beneficiary Notice was signed by Mr. [redacted]. 
Mr. [redacted] called and spoke with Apria on October 20, 2014, regarding the Assignment of Benefits letter he had received. The Apria representative explained to Mr. [redacted] that the CPAP unit rents for 13 months , then converts to sale and that no claims had been submitted to Medicare because of missing documentation.
On November 3, 2014, Apria received a call from Mr. [redacted] regarding the recurring credit card attached to his account and requested to have the credit card removed. The representative did explain to Mr. [redacted] that he would need to send a written request per the agreement in the Sales Service and Rental Agreement. However, as of today we have removed Mr. [redacted]’s credit card information on file per his request.
We have spoken to Mr. [redacted] on November 12, 2014 and explained that we needed a repeat sleep study and asks if he wanted to return the CPAP unit. He stated no and was upset and stated that he was going to contact the Revdex.com and did not want any more calls from Apria. We placed Mr. [redacted] on our do not contact list per his request.
As of today Mr. [redacted]’s balance is $7.50 for the November 14, 2014 date of service. There are pending claims from August 28, 2014 – November 14, 2014 under Medicare. We do apologize for the miscommunication as our goal is to ensure customer satisfaction as well as accurate billing.
Sincerely,
[redacted]
Billing Center Quality Specialist

I still do not understand why they:1.  Admit that their computer system indicates I cancelled my order yet they sent it anyway2.  Their system shows that the mask was in fact send on 26 December, yet for some reason it was not3.  I find it hard to believe that an item this common was out of stock for such a long period of time4.  I could not contact ANYONE from this company that could answer any question for several weeks.The level of incompetence this company maintains is staggering for a medical supply company.

ITEM # 1: Patient wants setup on the CPAP machine ASAP RESPONSE: The original CPAP order was received by Apria Healthcare on February 11, 2015 but did not meet the [redacted] documentation requirements: Face to face chart or progress notes missing facility address and signature illegible Written...

order prior to delivery missing the physician’s NPI number   Apria requested a new written order prior to delivery, [redacted] billing prescription and an attestation form from the physician on February 11, March 25, March 30 April 6 and April 13, 2015. On April 21, 2015, we identified an error made by an Apria agent on the original attestation form. Apria corrected this error on the same day it was identified and notified the physician’s office to explain why a corrected attestation form was needed to process the order. An updated form was received on April 24, 2015 and the order was processed. Apria attempted contact to the patient on April 27, 2015 to review benefits and to schedule an appointment for the setup of the CPAP machine; the contact was unsuccessful. In follow up, the Apria Healthcare Clinical Assistant ([redacted] branch) left a voice mail message on April 29, May and May 8, 2015. The primary phone number on file is for the patient‘s daughter. We also called a second number listed and left a message to contact Apria to schedule an appointment for the set up. The physician’s office was contacted on May 8, 2015 to in the event they could provide assistance with patient contact. We continue to attempt to contact this patient to schedule an appointment for setup. ITEM #2: Employees to be sanctioned for lack of resolution and incorrect information provided.   RESPONSE: Apria will provide the proper coaching and education to address any errors made by Apria agents/opportunities for improved customer service. Apria strives for high quality customer service and continuously evaluates quality and the performance of our agents to drive improvements.   Sincerely, [redacted] Escalation Desk Manager

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and have determined that this proposed action would not resolve my complaint.  For your reference, details of the offer I reviewed appear below.
Regards,
[redacted]. Apria has still not contacted me about this. Also They have never addressed why I was told when picking up machine that supplies that would be covered at no cost for RENTAL period were no longer covered after first few months. Yes I would like my overpayment,but this company has a long way to make a satisfied customer. I also plan to complain to my insurance for doing business with them.

I received the check today, Thank you so much for your assistance in getting this resolved. I really appreciate it. [redacted]
[redacted]