Complaint #***The patient is upset about a specific item that her Medicare plan does not pay for to our organization specificallyThis item is known as a TENS unit that provides safe voltages of electric current via electrode pads applied to the bodyThe device provides therapeutic relief
for aches, pains and strainsMedicare is a very complicated health insurance plan to provide forOur organization can bill Medicare for certain items but not for everythingMedicare on covers items to certain providers who are awarded "bids" for specified productsOur organization was not awarded a bid to TENS units within the Albuquerque Metro area, so therefore, we cannot provide one to her unless she pays out of pocketFurther, Medicare does not cover bath safety equipment and Mrs*** did have to pay for that as well out of pocketOur organization does not make the rules of reimbursement that Medicare sets forthWe merely have to abide by themFor the confusion and dismay that this has caused Mrs***, the company is going to allow her to keep her TENS unit at no chargeI believe that Mrs*** was not fully conveyed the coverage limitations of her health policy by the employee who assisted herThis employee is still rather new and will be trained further on insurance coverage limitations by managementPlease contact me for any further correspondence in this matterJesus M***, MBA, GMA&R Medical Supply***
This note is per the Santa Fe branch manager, Harold A***, who oversees all matters in the Santa Fe branch It should be noted that A&R Medical Supply does not rent bedside commodeThose are strictly a purchase option so renting one is not an option, nor was presented as an
option the patient's familyOn the matter of the wheelchair, the patient's family did not try to rentThey proactively chose to rent the wheelchair of their own accord on the 30th of December, The patient's family was well aware of the day return policy at the time of purchase. It should be noted that A&R was only Closed Saturday, 1/30/for the holiday and is always closed on Sundays (1/31/17)Even with the holiday the patient's family were still well beyond the return period of days as they came in on 1/10/2018 to try and get a refund days past the purchase dateThey were told we do not return bath equipand the day return was pastDespite all of this I told them that I would make an exception but would have to at least charge a re-stocking feeThey refused to accept those terms and demanded that they get both items returned "no questions asked"I told her we could not and that was our policy that is clearly displayed on the counter and I would be making an exception to the day rule on the transport chair but would not take back the commodeThey turned around and leftHarold A***, Santa Fe branch manager Upon review of this I believe that the Santa Fe branch manager's decision was of just reason and within the parameters of company policyHowever, I will allow the commode and wheelchair to be returned with a 15% restocking fee upon inspection of the devicesBasically A&R Medical Supply is agreeing to refund 85% of the sale if the product is in perfectly new conditionThank you, Jesus M***, GM
RE: ***, *** * / Complaint of wheelchair delivery timeTo whom it may concern at the Revdex.com,I concur with Mrs*** * *** (Mrs***) and her claim of the timeline regarding the receipt of an order for a wheelchairUnfortunately when billing health insurance for coverage of Durable
Medical Equipment (DME) the process is always complex and drawn out due to no fault of our organization, Calmar Inc dba A&R Medical Supply (A&R)The order that A&R received initially was missing quite a bit of pertinent information that is required to be on file PRIOR to A&R being allowed to dispense the equipmentThis includes:- A valid diagnosis (the only diagnosis sent was "pain" which is not a qualifying diagnosis based on insurance coverage)- Qualifying clinical notes from the physician(None were attached whatsoever and this is a requirement) Medicare is this patient's primary payer and A&R is required to abide by the standards set forth by the Centers for Medicare and Medicaid Services (CMS)Failure to do so could result in recoupment of payment, loss of contract and even jail time if convicted of fraudAttempts were made via phone and fax to attain this information from the patient's ordering provider, however, no response has been provided even as of yet (today 8/15/2017)Fortunately, A&R did dispense a wheelchair to Mrs*** this past Saturday 8/13/We did so in the good faith that Mrs*** and her health provider will provide A&R with the necessary information that we require in order to bill appropriately and timelyMrs*** has received what she requires in a wheelchair, now it's time for A&R to receive what is necessary for payment and that has not occurred yetRegards, Jesus M***, MBA, GM
Complaint #***The patient is upset about a specific item that her Medicare plan does not pay for to our organization specificallyThis item is known as a TENS unit that provides safe voltages of electric current via electrode pads applied to the bodyThe device provides therapeutic relief
for aches, pains and strainsMedicare is a very complicated health insurance plan to provide forOur organization can bill Medicare for certain items but not for everythingMedicare on covers items to certain providers who are awarded "bids" for specified productsOur organization was not awarded a bid to TENS units within the Albuquerque Metro area, so therefore, we cannot provide one to her unless she pays out of pocketFurther, Medicare does not cover bath safety equipment and Mrs*** did have to pay for that as well out of pocketOur organization does not make the rules of reimbursement that Medicare sets forthWe merely have to abide by themFor the confusion and dismay that this has caused Mrs***, the company is going to allow her to keep her TENS unit at no chargeI believe that Mrs*** was not fully conveyed the coverage limitations of her health policy by the employee who assisted herThis employee is still rather new and will be trained further on insurance coverage limitations by managementPlease contact me for any further correspondence in this matterJesus M***, MBA, GMA&R Medical Supply***
This note is per the Santa Fe branch manager, Harold A***, who oversees all matters in the Santa Fe branch It should be noted that A&R Medical Supply does not rent bedside commodeThose are strictly a purchase option so renting one is not an option, nor was presented as an
option the patient's familyOn the matter of the wheelchair, the patient's family did not try to rentThey proactively chose to rent the wheelchair of their own accord on the 30th of December, The patient's family was well aware of the day return policy at the time of purchase. It should be noted that A&R was only Closed Saturday, 1/30/for the holiday and is always closed on Sundays (1/31/17)Even with the holiday the patient's family were still well beyond the return period of days as they came in on 1/10/2018 to try and get a refund days past the purchase dateThey were told we do not return bath equipand the day return was pastDespite all of this I told them that I would make an exception but would have to at least charge a re-stocking feeThey refused to accept those terms and demanded that they get both items returned "no questions asked"I told her we could not and that was our policy that is clearly displayed on the counter and I would be making an exception to the day rule on the transport chair but would not take back the commodeThey turned around and leftHarold A***, Santa Fe branch manager Upon review of this I believe that the Santa Fe branch manager's decision was of just reason and within the parameters of company policyHowever, I will allow the commode and wheelchair to be returned with a 15% restocking fee upon inspection of the devicesBasically A&R Medical Supply is agreeing to refund 85% of the sale if the product is in perfectly new conditionThank you, Jesus M***, GM
RE: ***, *** * / Complaint of wheelchair delivery timeTo whom it may concern at the Revdex.com,I concur with Mrs*** * *** (Mrs***) and her claim of the timeline regarding the receipt of an order for a wheelchairUnfortunately when billing health insurance for coverage of Durable
Medical Equipment (DME) the process is always complex and drawn out due to no fault of our organization, Calmar Inc dba A&R Medical Supply (A&R)The order that A&R received initially was missing quite a bit of pertinent information that is required to be on file PRIOR to A&R being allowed to dispense the equipmentThis includes:- A valid diagnosis (the only diagnosis sent was "pain" which is not a qualifying diagnosis based on insurance coverage)- Qualifying clinical notes from the physician(None were attached whatsoever and this is a requirement) Medicare is this patient's primary payer and A&R is required to abide by the standards set forth by the Centers for Medicare and Medicaid Services (CMS)Failure to do so could result in recoupment of payment, loss of contract and even jail time if convicted of fraudAttempts were made via phone and fax to attain this information from the patient's ordering provider, however, no response has been provided even as of yet (today 8/15/2017)Fortunately, A&R did dispense a wheelchair to Mrs*** this past Saturday 8/13/We did so in the good faith that Mrs*** and her health provider will provide A&R with the necessary information that we require in order to bill appropriately and timelyMrs*** has received what she requires in a wheelchair, now it's time for A&R to receive what is necessary for payment and that has not occurred yetRegards, Jesus M***, MBA, GM