Best Care Home Health

We are no longer providing services to Ms ***She does not owe us anything, nor do we owe her anythingThe client never went a single day without service, nor was the services she received deficient in any wayThe confusion concerning the co-pay was hers and hers aloneHer statement concerning HIPPA and billing demonstrates her lack of knowledge concerning long-term careA service break does not occur until a client has gone days without service not hoursShe is correct that we billed for minutes instead of hours and that is why the initial claim was rejectedHowever we do not know the reason for the rejection until the claim is finally processedAt first we thought that it was either because the client lost their medicaid eligibility or that the client was outside the service areaTwo scenarios which occur from time to timeIn actuality it was a billing error because of the new billing system under EVV began 6/1/16. So for a few hours we were under the impression that we might have to suspend services, but this turned out to not be the case and the provider never missed one day.Therefore since the client never went one day without service and now money is owed to either party and the client is now with another Agency it is still my opinion that these actions are being taken out of spite and vindictivenessI, have the letter in my possession stating that it is her intent to pursue legal action despite the fact that there are no damages of any kind nor was anyone adversely affectedIf her confusion surrounding her insistence on their being a co-pay adversely affected her well there is nothing we can do about thatLets not convolute the issue here this was about her continued insistence on their being a co-pay associated with the services we provide and there is notWho is harassing who? It has been more than a month since we parted ways and she is still at itWe did nothing wrong and as I stated before it is impossible to be in business for as long as we have and not have one substantiated complaint against your agency unless you operate it with high ethical standardsI, did not contact the Revdex.com to become a member they contacted me wanting me to join them because of my excellent record and reputation in the communityI, will not comment or respond to this matter further I believe that *** *** suffers from anger management issues that need to be addressedI, could care less if she rejects this rebuttal she is irrational and if she wants to contact her attorney go aheadIf you want to reach out to my attorney go ahead her name is *** *** at *** she has all the pertinent facts concerning this bogus complaintGet a life and leave me aloneHow you like them apples

Complaint: [redacted]
I am rejecting this response because:Mr. [redacted] comments are not truthful and are uncalled for.  When I first contacted Best Care I told Mr. [redacted] of the Qualified Income Trust (QIT) and co-payment but I had not yet been notified of the $ amount.  I also told him the process for the Star+Plus Waiver had taken 1 year and we, her son and I are anxious and concerned to have more hours covered with caregivers as soon as possible to keep my 92-year-old mother in law safe at home as her dementia was getting worse.  Superior Health Plan case worker at first and Mr. [redacted] assured me I didn’t owe a co-payment saying they never charge for this type of service.  But the Medicaid Eligibility people told me otherwise.  This co-payment is rare I have come to find out because she makes a little too much money but not enough to pay for the hours needed.  A QIT was set up and out of that amount a monthly co-payment is payable to the agency.  A month after services started with Best Care I was notified by Superior of the co-payment $ amount, but this is where the ball got dropped and the right paperwork never made it back to Dept of Aging and Disability to send out a corrected form.  I had already received 2 forms that were incorrect and the caseworker with DADS admitted this was her first QIT.  Please &see attached copy of the H-2065D letter from Texas Health & Human Services Commission dated July 15, 2016.  Please see the comments section at the bottom which spells out everything that I have been telling Mr. [redacted] was right, that we did owe a co-payment.  But why does he continue when this complaint he received confirmed the co-payment paperwork is in place and he continues with text and written remarks that I need professional help? Mr. [redacted] is awfully defensive, what is he afraid of?  Mr. [redacted] says he received prior communication from Revdex.com stating and I quote “That is was unsubstantiated and no action was required.”  I received the same communication after I forwarded the Revdex.com a copy of the certified letter sent to him July 1st.  The Revdex.com letter I received says ….it does not appear you are requesting assistance in the resolution of your dispute but only wanted to make us aware of the situation.  As a courtesy, we will send your information to the company for their records, but will not request a response. If the company chooses to respond, we will send you a copy for your records. It goes on to say the information will remain in Revdex.com files for the next 36 months and used to assess the overall performance of the business….  This is not even close to what Mr. [redacted] explanation would lead you to believe. It’s not hypothetical communication as he says now, when the words POSSIBILY or MIGHT have to suspend services were never used by him in his text.  Mr. [redacted] threatened this helpless woman’s wellbeing and she could have had an accident or even died if she had been left alone.  He first notified the caregiver around noon for her shift starting at 4:00pm and I quote “….do not work with that client again….”  Thankfully the caregiver immediately contacted me. If this had been the local home health agency the caregivers are not even allowed to communicate by text or phone with the client and we would have found this helpless woman alone some 2 hours later when we arrived. I was shocked the day the first text was received since I had never been alerted to a problem. I immediately called Best Care and the call was returned by a staff member.  I told her I have never been billed the monthly co-payment, that I will gladly pay but I just needed a bill. I also told her they needed to communicate with me and not the caregiver regarding payments.  The staff member said they are having billing errors within the system, the EEV System is new and not in sync together.  She said a few bills were wrong that she re-billed & should go through.  She also said the bills were not “Rejected, Pending Approval or Denial”, and they researched more and found a few errors and resubmitted.   She said she would update Mr. [redacted] on the errors.  Then in a conversation I had with Mr. [redacted] I told him also he needs to communicate with me in the future, but he said he didn’t want to disturb me.  Well it is disturbing to be treated in this disrespectful manor when I did nothing to provoke it.  I told him also I have not been billed for the co-payment and he said again I owed him nothing.  Best Care staff’s billing errors are why the claim payments were “Denied” by Superior and the only reason they were not getting paid was because they billed too many hours, which I found out after talking with Mr. [redacted].  I didn’t share the information about the overbilling with him until I sent a certified letter.  He has yet to respond directly to me regarding the matter.  Although he did text the caregiver the day he received that letter and I quote “…. because you’re not smart enough to understand how stuff works.… what she needs to do is hire a psychiatrist have a nice life” “…. it’s been a couple weeks and she still fixated on this yeah she’s got some issues…”.  It is not a fixation it’s a fact as you can see from the attached H2065-D form. I did say in the letter I may have to consult an Attorney because of his disparaging comments he made.  But no one else was ever threatened with attorneys and certainly not from the first day as Mr. [redacted] said. I was never irrational and what verbal abuse - catching he and his staff in lies regarding the billing and make up an excuse that we are outside the service area!  I put my comments in writing and he is mistaken again. By the way, Superior never would have signed him up to handle this if he was outside the service area much less paid him!Why was I told one thing and the caregiver was being text something entirely different?  This has nothing to do with me being spiteful or vindictive like Mr. [redacted] believes.  It was our concern for the care we expected for an elderly family member.  These mistakes resulted in his threats to withhold care for my mother in law and also threaten to not pay the caregiver as his text reads, and I quote “they did deny that claim we built for $1,600.00 they haven’t paid us anything so I’m not sure whether you should continue to work or not until we resolve this because I will not be able to cut another paycheck until we receive payment we have not received one red cent and we started April 20th.”  There were no verbal threats on my part to Best Care, the State Agencies or the Revdex.com.  I only stated the facts and continued contact with supervisors with the 3 divisions associated with the Star+Plus Waiver to ensure this would be taken care of.  Superior Health Plan suggested we transfer to another agency.  But this man’s threating text continued even after we transferred.  The Superior supervisor was the only person in contact with Best Care after my initial contact when the text started.  She handled all the details of the transfer to another agency.  I did not continue to call or threaten the Best Care staff, Mr. [redacted] is mistaken again. Once Best Care’s errors were corrected and he received payments from Superior Mr. [redacted] still continued to send text to the caregiver.   I guess trying to apologize and I quote” and it’s not that big a deal that we had one simple misunderstanding or miss-communication in the real world these things happen…”  The caregiver transferred with us to the new agency immediately and she has never commented to Mr. [redacted]’s text.  But he continues to harass her by text saying” tell [redacted]……”.  Isn’t this a breach of confidentially, a Hippa violation?  Now finally after 3 months all is in place and the co-payment is set up for the new agency.  Mr. [redacted] should have been a had a little more [redacted]ience and understanding instead of name calling. We have a helpless 92-year-old woman dependent on this service and its concerning that he talks and acts like this when we have been working so hard to insure he be paid and nothing more.  We are wondering how many of the people are out there that Mr. [redacted] has abused for no reason in the same manner. Please read all the prior text comments in my complaint and you will surly understand what this man has put our family through.
Regards,
[redacted]

Ms [redacted] behavior was rude and irrational from the minute we started. She immediately started complaining about superior and the state and how much of a hassle it was to get these services. She insisted that there was a co-pay and called the office and verbally abused our office manager...

indicating that we did not know how to do our job. Her continued insistance on there being a co-pay caused our staff to erroneously believe that there was something wrong with the clients authorization. Either she lost her mediciaid or she was outside our service area. We brought this up to the provider [redacted] in a text message because we could not reach her by phone. We mentioned that there is a POSSIBILITY that we MIGHT have to suspend services. However the billing issue was resolved and the provider's pay was never late, nor was the client deprived of one single day of service. Despite this Ms [redacted] kept calling and making threats and acting irrationally. Finally after the client transferred to a different agency and after Ms [redacted] had called to threaten us and verbally abuse my staff, I texted the provider in a private text stating that we are not interested in providing services to clients who are going to act abusive, irrational and uneducated.The provider chose to forward those private communications to ms [redacted]. If she got her feeling hurt well that too bad.....grow up. She was threatening our agency and the state from day one with lawsuits, she was pushy aggressive rude and mean. Read the initial letter she sent it threatens a lawsuit in the last paragraph. The client never missed one day of service nor were they charged any money. How was anyone adversely affected? I already received a communication from Revdex.com concerning this complaint. Stating that it was unsubstantiated and no action was required. I, guess she kept calling and harassing the Revdex.com and you changed your mind and decided to pursue it further or she threatened you with a lawsuit also...go figure. I still stand by my statement that anyone who would make such a huge ordeal over a hypothetical comminacation stating the POSSIBILITY that we MIGHT have to suspend services but never actually did is irrational. Neither the client or Ms [redacted] were negatively impacted in any way yet here we are months later. Ms [redacted] is doing this out of spite and vindictiveness and it is for this reason that I believe she should speak with a mental health professional to resolve her anger management issue. I, have a masters degree in Public Administratio, twenty years in the field  and that is my firm belief and opinion.