BrightStar Care of North Seattle

Response to Mr [redacted] complaintMr [redacted] daughter, ***, inquired if our agency could provide nursing services twice daily for antibiotic infusions that her father was prescribeWe inquired as to why she was requesting the services as it is customary for the hospital discharge planner or pharmacy to request nursing servicesThe daughter, [redacted] stated that the family was given the option of being trained to provide the infusions or have [redacted] admitted to a rehab facility for the duration of the antibiotic therapyThe family was not interested in either option and was pursuing alternative optionsI stated that we would be willing to provide the nursing care, however we are a private duty agency, a two week deposit would be neededWe normally do not bill insurance and we are NOT a [redacted] certified home healthWe would be willing to submit the claims even though this was not a part of our practiceGiven that it was out of the ordinary, the process would be lengthyAttached is the email that I sent the family stating it would be monthsServices were started on November 24, and completed on December 17, Due to the timing of the holidays and vacations, the information was sent to our third part billing company the week of Jan5th On January 5th, we received our first, of many, inquiries for the return of the deposit from the son, [redacted] ***The contacts were numerousWe learned that [redacted] must be billed and denied prior to submitting a claim to ***This information was share with Mr[redacted] ***We billed [redacted] and waitedAll billing was processed via paper claimsNot being [redacted] Certified, the claims process was not in the electronic systemWe shared this with [redacted] ***, however he did not like or believe our explanationIn addition, information was provided that [redacted] considers billing within months to be timely billingMr* [redacted] continued to escalate his requestsWe were unable to provide a resolution within his timeframeWe were following the protocols of submitting to primary insurance ( [redacted] ), get denied and then submit to the secondary insurance (***)BrightStar Care tried to accommodate the specific needs of the [redacted] familyIt became apparent that pleasing Mr [redacted] would be an impossible taskIn hopes to separate from what felt like harassment, contact with Mr [redacted] was limited [redacted] proceeded to submit complaints to every possible agencyThe Washington State Department of Health, our licensing agency, conducted an onsite investigationThe department of health findings stated that BrightStar did meet “ [redacted] Timely Filing Guidelines.” On June 12, 2015, BrightStar Care received the Insurance paymentsOf the initials $deposit, $was the patient’s responsibilityOn June 14, a credit was issued to the credit card and a copy was sent to [redacted] on June 14,

Response to Mr. [redacted] complaint. Mr. [redacted] daughter, [redacted], inquired if our agency could provide nursing services twice daily for antibiotic infusions that her father was prescribe. We inquired as to why she was requesting the services as it is customary for the hospital discharge planner or...

pharmacy to request nursing services. The daughter, [redacted] stated that the family was given the option of being trained to provide the infusions or have [redacted] admitted to a rehab facility for the duration of the antibiotic therapy. The family was not interested in either option and was pursuing alternative options. I stated that we would be willing to provide the nursing care, however we are a private duty agency, a two week deposit would be needed. We normally do not bill insurance and we are NOT a [redacted] certified home health. We would be willing to submit the claims even though this was not a part of our normal practice. Given that it was out of the ordinary, the process would be lengthy. Attached is the email that I sent the family stating it would be months. Services were started on November 24, 2014 and completed on December 17, 2014. Due to the timing of the holidays and vacations, the information was sent to our third part billing company the week of Jan. 5th 2015. On January 5th, we received our first, of many, inquiries for the return of the deposit from the son, [redacted]. The contacts were numerous. We learned that [redacted] must be billed and denied prior to submitting a claim to [redacted]. This information was share with Mr.[redacted]. We billed [redacted] and waited. All billing was processed via paper claims. Not being [redacted] Certified, the claims process was not in the electronic system. We shared this with [redacted], however he did not like or believe our explanation. In addition, information was provided that [redacted] considers billing within 12 months to be timely billing. Mr. *. [redacted] continued to escalate his requests. We were unable to provide a resolution within his timeframe. We were following the protocols of submitting to primary insurance ([redacted]), get denied and then submit to the secondary insurance ([redacted]). BrightStar Care tried to accommodate the specific needs of the [redacted] family. It became apparent that pleasing Mr. [redacted] would be an impossible task. In hopes to separate from what felt like harassment, contact with Mr. [redacted] was limited. [redacted] proceeded to submit complaints to every possible agency. The Washington State Department of Health, our licensing agency, conducted an onsite investigation. The department of health findings stated that BrightStar did meet “[redacted] Timely Filing Guidelines.” On June 12, 2015, BrightStar Care received the Insurance payments. Of the initials $6500 deposit, $5563.50 was the patient’s responsibility. On June 14, 2015 a credit was issued to the credit card and a copy was sent to [redacted] on June 14, 2015.