Life Dme

Initial Business Response /* (1000, 8, 2016/05/19) */
Customer gave verbal authorization for Life DME to send replacement supplies to him in December Customer did not inform us that his insurance had changed to Medicare until Feb Claim for supplies was billed to the commercial policy we
had on file, which had termed on 10/31/Since we are not a contracted provider with new insurance (Medicare) and are unable to bill for the supplies he received, he was informed that he would be responsible for the cost of the suppliesIn April 2016, after receiving an invoice for the cost of the supplies, the patient called the office threatening to "sue us in small claims court" as he does not feel that he should be responsible for the cost of the suppliesResolution was not made as patient hung up the phone
I would like to have this issue resolved as soon as possible
Initial Consumer Rebuttal /* (3000, 10, 2016/05/28) */
(The consumer indicated he/she DID NOT accept the response from the business.)
Revdex.com Case # XXXXXXXX
According to statement of DME I request supplies Dec Customer did not inform DME that insurance change to Medicare until Feb See authorization letter for tubing and heating element Ref # XXXXXXXXXX date 10/26/DME contacted me to send supplies, which I said ok" whatever the insurance will pay for"When they called in Dec they stated I was responsible because insurance change which show discriminate against senior citizens .Received Medicare Oct and had supplemental Blue Cross policy if ever had chance to inform DME their representative stated we do not accept MedicareSince supplies where not needed stated would return to DME their representative stated that could not do that?
In Dec they sent bill for *** stating that if I did pay DME would send out to collection agencyThat's why I contacted them in Dec Please find enclosed previous bills to anthem blue crossFor cost of supplies one for *** claim # XXXXXXXbeSecond claim XXXXXXXXbcfor ***
Why I do not receive the same discount as the insurance companyThey over charge insurance to receive *** If they ask for what they received in the pass, that would be reasonableSince I do not need equipment because PVC does not go bad in yearsI will send back supplies in hermetically seal bags that they got from their supplier and call evenWhich was stated in Dec
When the new representative contacted me in April my only way of possibly receiving justice was to go to small claims court for the lost when they return chip not workingSee doctor letter when he check it in Nov Also new representative state she would check with "boss" to see if supplies could be return, still waiting answer?
Again Consumer does not have return policy with almost all equipmentHope Revdex.com can resolve situation
Final Business Response /* (4000, 12, 2016/06/08) */
I have reviewed the documents that were sent by consumer and those documents are for supplies that were previously dispensed and were covered by the insurance (Anthem) that the customer had on the service dates listedWhen customer granted permission for Life DME to send supplieson 12/18/15, he did not inform Life DME that his insurance had changed to MedicareHis statement to send "whatever the insurance covers" gave Life DME no indication that his insurance had changed and Life DME has no liability in thatIt is the consumer's responsibility to inform the supplier of any changes in insurance and location
In response to consumer's concern about pricing, Life DME has usual and customary charges that are billed to the insurance companyIf Life DME is contracted with the insurance and accepts the insurance company's allowed amount, then a discount is givenThis is procedure and Life DME not done anything wrongSince consumer no longer has the previous insurance, he is being charged the usual and customary amount
In response to customer's concern about "lost chip", consumer was given a replacment chip by his physician, not Life DMEAccording to document sent in from his physician, a download was done and showed that consumer was compliantly using his machineI am not sure as to why consumer feels need to hold Life DME liable for medical costs from testing he had done prior to receiving his equipment from Life DME
Life DME does not discriminate against senior citizens, as consumer statesWe are unable to service Medicare beneficiaries for sleep apnea equipment as part of the Competitive Bid Contract, in which we were no awardedHowever, we do business with Medicare for oxygen and other respiratory productsConsumer's statement that he is still waiting to hear from boss is not true as I spoke with him on 5/19/and he hung up on me as stated in my original response
Consumer has been referred to an outside collection agency due to non-payment, as per Life DME policyConsumer notified Life DME of change in insurance coverage on 2/1/16,after Life DME received notification that insurance listed had been terminatedSupplies were dispensed to him on 12/21/Life DME should not be held liable as consumer is responsible for notification of changes in insurance coverage as policy that was on file with Life DME was found to have terminated on 10/31/15, unbeknownst to Life DME
My solution for resolution to consumer's complaints are to reduce balance owed to *** and to remove from further collection activityThis amount is the amount that his previous insurance would have paid if he was still coveredReturns are not accepted past days as per Life DME policyCopy return policy is attachedI hope consumer agrees to accept this offer