Vita Care of Southwest Virginia Reviews (1)
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Vita Care of Southwest Virginia Rating
Description: PHARMACY
Address: 305 Old Kentucky Turnpike, Cedar Bluff, Virginia, United States, 24609
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Review: I was misrepresented on the cost of my infusion therapy.They stated that my insurance would not cover any of the cost of my 6 weeks of infusion therapy. My prescription plan would and in fact covered the medication part of the therapy, which I paid for up front and they filed the claim for the medication and received payment for even though they had full payment from me for all the cost of the infusion therapy.Desired Settlement: I desire to be reimbursement for the total amount of the medication that they received from my prescription plan. I need to be reimbursed for the excessive supplies that I have on hand. I advised them that I did not need any more supplies weeks into my infusion therapy and they continued to send supplies anyways.
Business
Response:
RE Case: [redacted] This letter is in response to the comploint filed with the Better Business Bureou on
08/12/2014.
We do not feel we owe reimbursement to the patient. The amount the patient paid
out of pocket was for the per diem charges for our services, as explained in detail
below. We did explain this thoroughly with the patient upon admission and again on
the phone call we received on 08/12/2014.
When we originally received the referral from [redacted] I contacted the
patient directly on 06/17/2014 and discussed pricing and payment options for
[redacted] service. The patient stated they would rather have the antibiotics in a
Skilled Nursing Facility - where their insurance would pay for the services, than to pay
out of pocket to have the antibiotics at home. Then on 06/19/2014 the patient
contacted me and stated they would like to receive the antibiotics at home and
agreed to pay out of pocket. When receiving your first dose at [redacted] Medical Center
on 06/20/2014 - the nurse in The lnfusion Center reviewed the patient's need for two
antibiotics - [redacted] and [redacted]. I gave the patient it additional cost for
receiving two antibiotics - and the patient agreed to pay the out of pocket amount
quoted. The patient also agreed to contact our pharmacy after receiving first dosing
and arriving home, so we could make our delivery that evening. We prepared the
medication that day during our normal operating hours, so when the patient
contacted our pharmacy, we could make a prompt delivery. When the patient
contacted our pharmacy late that evening the patient informed us that another
pharmacy had delivered the medication to their home, even after the patient made
the verbal agreement to receive the services from us. The patient also stated they
were going to use the other pharmacy's medication instead of receiving our delivery.
On Monday 06/23/2014 we spoke with the patient again and the patient requested to
switch to our services and be reimbursed for the days the patient used the other
pharmacy's medication (a total of 3 days). On behalf of the patient, we contacted
Pikevílle [redacted] Community Home Health, and [redacted] Pharmacy and
informed them the patient would be receiving all medications and pharmacy services
from our pharmacy, starling 06/24/2014.
Most commercial insurances pay a daily rate for our services between $100 and $215.
For this patient the first antibiotic charge was $45.00/day for the per diem and the
second antibiotic charge was $22,50/day for the per diem, total of $67.50/day for the
per diem. As a courtesy, we discounted services an additional 15% when the patient
agreed to pay the balance in full. The patient did pay by Credit Card on 06/20/2014 in
the amount $2409.75, for a total of 42 days. Because the home health agency sent the
antibiotic order to another infusion pharmacy and the patient received 3 days of
medication and pharmacy services from [redacted] pharmacy, we issued a
reimbursement check in the amount of $172.12 on 06/23/2014. The amount paid in full
by the patient is for our per diem service (mixing of medication, monitoring and dosing
medication by our pharmacist, delivery/shipping of medication, supplies and
equipment for administration of antibiotics). This amount was for a total of 39 days for
those services for the two antibiotics dispensed and delivered/shipped to the patient
on a weekly basis.
Upon admission to our services, the signed an admission agreement. As a standard
procedure, when this admission agreement is signed, we give a copy to all our patients.
Our delivery driver gave this patient a copy on 06.24,2014, with Patient Copy written in
highlighter at the top of the page. I am enclosing a copy of this admission agreement
for your records. Under Section l: Acceptance of Services and Agreement to Pay, the
third section to initial is that the patient has been informed of their estimate of the
portion of charges for which they are responsible to pay: $2237.63 for 39 days antibiotics
(and our records do reflect this was paid in full by credit card - as stated above).
l am also enclosing a copy of the Advance Beneficiary Notice of Noncoverage (ABN).
This is a form issued by Medicare that gives an explanation of why Medicare does not
pay for the supplies and equipment and what the patient's estimated cost will be. The
patient also signed this form on 06.24.2014.
I have enclosed our records from billing the patient's Medicare Part D plan ([redacted]).
The patient should have also received an explanation of benefits from [redacted] with this
information, [redacted] did pay a total of $452.80 for vials of medication. Since the patient
paid the per diem cost up front, in full, we discounted your supply cost in an amount
equal to the copay responsibilities as a courtesy. The copays would have been an
additional $79.90. If the patient did not have a Port D plan for us to bill the vials of
medication, this patient would have incurred an even higher out of pocket cost, than
the $2237.63 paid in full.
We also have record of speaking with the patient on a weekly basis, but have no
record of the patient requesting we send fewer supplies. we dispense supplies based
on what each patient should be using to be in compliance with their therapy. Supplies
are sent as part of the daily per diem - there is no separate additional charge, as we
do not line item bill. Once supplies are dispensed to a patient's home, we cannot take
those back into our pharmacy, per federal regulations.
I hope this letter has addressed your concerns. Please do not hesitate to contact me
with any additional questions.
Sincerely,
[redacted]. LPN
Patient Care Coordinator