Americare Respiratory Services Inc

The complainant signed a Sales Agreement contract with *** *** *** *** on 10/8/ The contract specifically states "Patient in turn may be liable for any amounts not covered by Patient's insurance" The patient also signed a CPAP Supply Plus Program contract
stating any agreement made is contingent upon the current benefit plan See attached documents for review.The complainant insurance *** of V*** policy requires the member to abide by certain utilization management rules in regards to continued coverage of CPAP supplies The member must have an authorization on file for payment of supplies by submitting compliance data from the CPAP device to determine minimum usage of hours have been met on an annually basis ARS in good faith provided the complainant with his quarterly supplies on 12/30/13, 3/28/14, 6/27/14, and 9/26/ We have logged numerous calls and had mailed letters to the patient to obtain the necessary compliance data to submit to his insurance plan for payment of his supplies Since we were unable to get a hold of the complainant by phone or mail the balances for the supplies was forwarded to the complainant The complainant then contacted our office on 2/9/because of receipt of his bill.The complainant then submitted his compliance data card and according to his compliance data card the last usage of his device was on 8/9/ The complainant did not contact us during that time to stop his CPAP Supply Plus Program Because the complainant did not provide his compliance data card in a timely manner prior to his supply orders his insurance plan will not cover his supplies therefore he was held financially responsible for the unpaid CPAP supplies.The complainant however did agree to return unopened items to be credited to his open account Since these items were not purchased by the insurance company or the complainant they were eligible for return The items were received on 5/15/and his balance was adjusted and his current balance is now zero ($0.00) The complainant account has been satisfied

Hi Mr. ***, We have found the paperwork showing your signed agreement to order the supplies deliveredPlease call 866-344-extension *** and speak with ***She has your fileand will try and resolve the situation. Thank you!

Please review attached records in regards to patient history with Americare, thank you.10/29/Patient was informed of Check policy,12/1/Supply order shipped12/10/*** (Care Specialist) confirmed with patient supplies were received in good conditionPatient did not state he received
supplies he did not order.12/15/Patient advised us, check was received from BCBS for amount $924.002/26/Patient cashed check on 1/20/16, advised patient he is responsible for $Patient stated for the first time he received items he did not order.4/27/Patient CC was charged $(See agreement signed per patient) as it had been over business days from when the patient received BCBS checkPatient stated he returned supplies4/28/Return shipment received, items returned nasal pillows, tubing, water chamber and heated tubing which totaled amount $292.00Per Americare Respiratory Services contract agreement (signed by *** ***) states the patient has days to return items or a $25,restocking fee will applyIn order to resolve this issue we are notifying the patients Insurance of items returned, Americare will issue a refund check upon receiving an accurate Refund request from BCBS

Hi Mr. [redacted], We have found the paperwork showing your signed agreement to order the supplies delivered. Please call 866-344-2774 extension [redacted] and speak with [redacted]. She has your file. and will try and resolve the situation. Thank you!

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.I am pleased with the end results but would like something in writing from them indicating my balance of 0.00 dollars on my account is final. Thanks, [redacted]

The machine was returned to us not only open but still had water in the humidifier! The customer was told there was no returns on cash sales for machines. We filled the prescription as the Doctor ordered as he did not order a particular brand.

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] Hello,
Thank you for taking the time to help me.
When I received the item in question I contact my doctor and he may me aware that this is not what I need.
before I placed the order I ask the sale person [redacted] if I could return it without any problems, he said yes.
I currently return the item and they are still charing me for it.

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]  Their phone tracking notes are fabricated. They had agreed to take back unopened items, that is why they were returned. I repeatedly called the them to inform them of the over shipment. If you look at their notes on 4/27/16 it is stated that it was the first time I spoke of returning items...review 2/29/16 it states that I did...I immediately stated that I received items I did not order. They also stated that I received  an insurance check in December...it was January.I was dealing with [redacted] (She over shipped) I left repeated messages for her, no one returned my calls. When I finally got to a person they told me she did not work there, and then the stalling, dodging began. Now they admit they have the returned items and will not process a refund or send them back. I do not agree with them at all.

Complaint was called and discussed with patient. There was a miss-understanding between Americare and the patient. This issue has been resolved between patient and ourselves. Patient is aware of his financial obligations with Americare and patient is satisfied.

Review: I was told after checking my Insurance [redacted] that I would only have to forward the check from my insurance co. and they would accept this as full payment for service and supplies. I started with them 11/5/11 and sometime in 2014 I made a call and they forwarded me to shipping and I requested that my supplies be stopped because I had been switched over to Oxygen and was not using the machine. Then I did have a change in my phone # but never had a change in my address and they said they sent me a letter which I never received and also a request to send my chip in to see usuage which I had already done and they should have seen mu usuage had dropped. All of a sudden they sent me a bill for $1350.00 for 3 shipments from 1/14-7-14 for supplies. After contacting them I spoke with April I explained that I had already called and asked for the shipments of supplies to stop and that I was told from the beginning that I would not be liable for any charges that they would accept what my Insurace would pay as long as I forwarded the check that was issued to me. I have a copy of the form sent to me that states as of 9/21/11 your out of network responsibility is $0 and annually thereafter effective 7/1/12 your out of network responsibility is $0. Then I told them that I would gladly return my machine which is in great shape and all supplies I still had that were unopen. They called back and left me a message that I could keep the machine that it was mine but to go ahead and ship the supplies back and they would give credit towards the bill. It is funny that they told me to return the supplies because the form I have it clearly states in bold print PLEASE NOTE NO SUPPLIES CAN BE RETURNED on the CPAP supply plus Program form they sent me. In addition I checked my records an I have forwarded 16 checks that ran from 1/11-1/13 for a totall of $8,429.13 and I am sure that has covered all they sent me to date.Desired Settlement: Since I sent all the supplies that they told me to return at my cost which was being shipped all the way to CA. and the information I have given you that they do not even stick to the agreement they issued to me to close my account and the final bill they sent me for $1350.00 which they only gave me 5 days to pay it as well because the money they have received as well as the supplies returned should be ample payment.

Business

Response:

The complainant signed a Sales Agreement contract with [redacted] on 10/8/2011. The contract specifically states "Patient in turn may be liable for any amounts not covered by Patient's insurance". The patient also signed a CPAP Supply Plus Program contract stating any agreement made is contingent upon the current benefit plan. See attached documents for review.

Review: A sale me told me if there was anything wrong with the machine I purchased I could return it. Afte I got the machine it was not the one my doctor said I need.

The company does not want to return my money back. they are keeping the machine and my money.Desired Settlement: I will like the refund

Business

Response:

The machine was returned to us not only open but still had water in the humidifier! The customer was told there was no returns on cash sales for machines. We filled the prescription as the Doctor ordered as he did not order a particular brand.

Consumer

Response:

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] Hello,

Thank you for taking the time to help me.

When I received the item in question I contact my doctor and he may me aware that this is not what I need.

before I placed the order I ask the sale person [redacted] if I could return it without any problems, he said yes.

I currently return the item and they are still charing me for it.

Review: I used the little to no money down as advertized got what I needed now they say I owe 300.00 + even though I specifically ask if the insurance was going to be eligible for the no money down and was assured it would be. now two years later they are coming after me I also have a invoice for what I received with a 0 balance [redacted]Desired Settlement: quit billing me and threats

Business

Response:

Account will be discounted the $300 as the bill was sent in error to patient. Attempted to reach out to patient and LM on telephone number on file. also Emailed patient to email on file.

Review: I currently have a Bill that is for rental and services 9 months after make a direct purchase for a cpap machiene.

In January of 2013 I attempted to procure a cpap machiene through Americare, they told me that it was denied through my insurance company and that I would have to purchase. They charged me over $400. for a cpap machiene, I recieved it all fine. 9 months later they send me a bill that I was renting the machiene and owed over $1000. After 2 months of trying to contact the Billing manager to correct the bill that it was an oversight. I argued that I purchased the machiene and on the paperwork that they sent me it clearly stated in the section that had the additional installment amount it had a $0. The manager said "Oh no you just purchased an upgrade". I had many arguments to this..1- There was not one upgrade avaiable to me for over $250 even if I requested one-which I didnt. 2. When looking at choosing a machiene I asked them not to send any choices that required a fee even if the insurance company would accept the claim. 3. Why would it take 9 months to inquire and send billing. 4. The particular machiene is not on any upgrade in your system. 5. It clearly states that I would own no additional fees on my paper work. 6. I signed no rental agreement, and I was never mailed or informed or educated about rentals with your company.

So after I purchased the machiene They continued to file against my insurance company until I met my deductable well into the year. Then began this schrade for more money. I believe this is Insurance fraud and I have little recourse unless I hold out for processing which would send me into collections. Being the companys in California and I live in maryland the Litagation avenues would cost me as much to fight in court.Desired Settlement: They sent me a service kit the contained replacement hoses etc for the machiene. I was under the inpression that it was part of the purchase price. That totaled almost $400. I have no issue paying for that as I did keep it and I didnt call to follow up. But I have huge issue with the rental fees for an item that I paid for. I would like to see the rental fees removed from my account and the account closed. I will pay the $356.20 for supplies.

Business

Response:

Attempted to reach out to patient and LM, Also sent email to patient.

Consumer

Response:

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.

In regards to this timely response from American Respiratory. The issue at hand is the company is exploiting a loop hole for a non verified vendor. In which They mis represented themselves repeatedly.

The first misrepresentation was that they were an approved vendor of Blue Cross Blue Shield, they are not.

Review: I was contacted by an Americare Respiratory sales rep asking me if I wanted a new CPAP machine because I was due. I explained that the machine I had worked fine, but the sales rep encouraged me to consider it since I'd have a backup if my other machine failed. At that time she said that I would only have to pay a small co-pay for the machine. I advised the rep that my insurance plan was going to be changing so if my current plan wouldn't cover it then I would need to wait and see what kind of coverage I would have with the new carrier. I was already aware that my benefits under the new plan had been cut compared to the current plan I was on. The sales rep said she would check on my insurance and get back to me. When she called me back she said that Id have to pay a higher co-pay because the machine I use is a higher end model and my insurance would cover the rest. I paid my co-pay, received the new machine and didnt think anything else about it until I received a bill for over $700. I was told that my insurance plan didnt just cover the machine outright, but that they covered payments on a rent to own contract. A rent to own contract was never discussed and it's not something I ever would've agreed to knowing about my insurance change. I contacted billing and spoke to [redacted], who escalated my concerns to her manager. I did not speak to her manager but was advised they would be willing to lower the bill by $177. I did not sign a rent to own contract and therefore am refusing to pay the bill. It is not my responsibility to ensure that sales reps are properly quoting rates that apparently only billing knows about. This was actually the second time Id had an issue with the sales team of Americare not communicating with billing. When I changed jobs in early 2013 I contacted my sales rep and told him to hold off sending any new shipments because I wanted to see what my insurance was going to cover. About a month later I received another shipment with a full charge bill. I called Americare and advised them I would no longer be doing business with them and that I wanted the packaged picked up and returned to them. The billing person I spoke with checked into my new insurance and let me know that my payments would be the same or very close to my prior insurance and if I would be willing to continue being a customer they would get it all sorted out.Desired Settlement: I want my account settled at $0 due and confirmation in writing that this has been done.

Business

Response:

According to our notes there was a change in your insurance. Your insurance company dictates

to us whether the machine is a rental or a purchase; thus our company then billed the cash price

for the machine. Our sales representatives have been educated to improve communication.

We apologize for all this inconvenience so we are crediting you the total amount of $710.13

with $0 due. This is the confirmation to that effect in writing that you have requested.

Consumer

Response:

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,

Consumer

Response:

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.

I filed a complaint against this business in July 2014 because they were attempting to charge me for a machine that I'd been told was being paid outright by my insurance company along with my co-pay. Their reasoning was that I'd agreed to a rent to buy plan, which I didn't as proven by the contract I signed. The response from the business is that they were going to educate their sales representatives and that my bill was being credited for the balance due of $710.13. This response was provided formally to both the Revdex.com and the California Attorney General's Office. I am now receiving a bill for the same device, with the amount due being $1250, broken out into monthly payments over the last 10 months at $125 each. I sent an email to [redacted] on Thursday, 3/26 as he is the person who responded to my original complaint and agreed to close my account with a $0 balance. He has not responded.I want my bill adjusted to $0 again and my account completely removed from their system, with an agreement that they will pay me $500 per instance that I am contact whether it be by phone, in writing or electronic communication. I've waste enough time on this and to receive a second bill after this was resolved is infuriating.