I am rejecting this response because: I seriously hope this small mom and pop has the ability to listen to the phone call [redacted] did not explain that was their policy but instead she gave me the phone number to Medi-cal and the codes and asked me to call and explain it to Medi-Cal and I did thatI spoke to a rep named [redacted] who said that I am not able to call because I don't have an account with Medi-Cal [redacted] was shocked that I was made to call in [redacted] said when they are similar there is an inquiry but not a rejection and I was told that since the DME equipment came from them then they can send over the information to prove that it was a toilet riser and not a shower chairI was told that the problem is when it's a new company that doesn't have the proof then it's hard for a new company to proveHowever, Pacific sold him the shower chair and has the proof and is just being lazy If I had known the company would hinder future DME equipment that this client needs then I would have never done business with them Now, before another company will do it I would have to have the billing approval and payment from the toilet riser It's a sad thing that one has to jump through hoops on something so easy I have other client's that have Medi-cal that live in Antioch and have had never had this issue before They have basically hindered my client from getting a simple shower chair due to being lazy I would like them to finish it so my poor client doesn't have to pay out of his pocket for something that can be had if the company did their job After this issue, I will just use the companies of whom I have worked with in the past I was trying to keep the business in Stockton and help the small mom and pop Please listen to the conversation and you just might grow beyond the Mom and Pop store Please finish the work you started
I believe this is simply a miscommunication. My employee *** was simply doing her jobAnytime we get an order for a patient with Medicare/Medi-Cal insurance coverage we check to see if the patient has already been dispensed the product within the last yearsIf the patient has received
same or similar equipment, in this case Medi-Cal, will reject payment when we billThus, leaving the patient with a bill from usI believe this is all my employee was trying to explain to Ms*** before she went off on angry tirade over the phoneI myself spoke with her, and found her to be just as aggressiveWe understand that people need these supplies and that it can be frustrating at times to deal with insurance and as a small mom-and-pop type DME supplier we bend over backwards for our patientsWith that said, I hope once Ms*** cools off we can have another conversation and earn her business back
I think we are a little too hung up on the toilet seat riser the patient receivedWhen we check for same/similar, we are not given a date or supplier where the same and/or similar equipment was dispensedAll we know is that the patient received the same (or a similar) piece of equipment within the past yearsWith that said, the equipment triggering the same/similar hit may not even be the toilet seat riserAt this point, the only viable solution would be to submit a treatment authorization request (TAR) to Medi-Cal and let them make the final decisionThe TAR would be populated with the same information, whether it came from us or a diff supplierAt this point it is up to the patientIf he wants us to submit the TAR on his behalf, we will do soIf not, we will forward all pertinent information to the supplier of his choice
I am rejecting this response because: When you find a good physician, it's important to stay with that physician because they know your medical history and it's easier to get the treatment you need because they already have all of your informationWhen a situation arises and you need services that is beyond the knowledge of your physician then he/she will refer you to a specialist but keep track of your treatment because he/she is your main provider The same rules apply to finding and keeping a good DME Supplier: If you use the same DME supplier, they know what you have because you have purchased it from themIf there is a piece of equipment that you need that they do not carry then a good DME supplier with make recommendation and send over information because they have your supply historyI have honestly never had this issue before and I have been in this business for a number of years and it's really upsetting to see that Pacific feels we are too hung up over a toilet seat riserTaking previous conversations and issue into consideration, I have decided to use an existing supplier for this client This client (like all clients) will need more equipment in the future and I simply just don't have the time to beg this supplier to care about the needs of my client and provide him with excellent services After sharing my issue, a supplier that I have used in the past (outside of Stockton) has decided to take over future services and even provided the chair that we needed Going forward, I will warn people of the horrible service and treatment (that I have never experienced with other suppliers) that this company has provided Since I have used your services before, it is unheard of to ask me to resend information that you should already have on file because the company is too lazy to look it upIt is completely unprofessional to call me and ask me to contact Medi Cal and do your job for you Although the previous owner is no longer there, it's a complete cop-out to blame laziness on the fact that they are a small companyMy client's insurance didn't change and so there was no reasonable explanation (other than unprofessionalism) to have me resend his insurance information by fax This issue has been resolved through another company and that should be disturbing and not a relief if this company truly wishes to stay in business and grow I would not recommend this company to anyone in the future and I would warn anyone who is on Medi-cal, to stay clear from this company I am sure the previous owner would have provided better services than this and would have made staff adjustments after listening to the phone conversation with one of their (supposably) supervisor
I am rejecting this response because: I seriously hope this small mom and pop has the ability to listen to the phone call. [redacted] did not explain that was their policy but instead she gave me the phone number to Medi-cal and the codes and asked me to call and explain it to Medi-Cal and I did that. I spoke to a rep named [redacted] who said that I am not able to call because I don't have an account with Medi-Cal. [redacted] was shocked that I was made to call in. [redacted] said when they are similar there is an inquiry but not a rejection and I was told that since the DME equipment came from them then they can send over the information to prove that it was a toilet riser and not a shower chair. I was told that the problem is when it's a new company that doesn't have the proof then it's hard for a new company to prove. However, Pacific sold him the shower chair and has the proof and is just being lazy. If I had known the company would hinder future DME equipment that this client needs then I would have never done business with them. Now, before another company will do it I would have to have the billing approval and payment from the toilet riser. It's a sad thing that one has to jump through hoops on something so easy. I have other client's that have Medi-cal that live in Antioch and have had never had this issue before. They have basically hindered my client from getting a simple shower chair due to being lazy. I would like them to finish it so my poor client doesn't have to pay out of his pocket for something that can be had if the company did their job. After this issue, I will just use the companies of whom I have worked with in the past. I was trying to keep the business in Stockton and help the small mom and pop. Please listen to the conversation and you just might grow beyond the Mom and Pop store. Please finish the work you started.
I am rejecting this response because: I seriously hope this small mom and pop has the ability to listen to the phone call [redacted] did not explain that was their policy but instead she gave me the phone number to Medi-cal and the codes and asked me to call and explain it to Medi-Cal and I did thatI spoke to a rep named [redacted] who said that I am not able to call because I don't have an account with Medi-Cal [redacted] was shocked that I was made to call in [redacted] said when they are similar there is an inquiry but not a rejection and I was told that since the DME equipment came from them then they can send over the information to prove that it was a toilet riser and not a shower chairI was told that the problem is when it's a new company that doesn't have the proof then it's hard for a new company to proveHowever, Pacific sold him the shower chair and has the proof and is just being lazy If I had known the company would hinder future DME equipment that this client needs then I would have never done business with them Now, before another company will do it I would have to have the billing approval and payment from the toilet riser It's a sad thing that one has to jump through hoops on something so easy I have other client's that have Medi-cal that live in Antioch and have had never had this issue before They have basically hindered my client from getting a simple shower chair due to being lazy I would like them to finish it so my poor client doesn't have to pay out of his pocket for something that can be had if the company did their job After this issue, I will just use the companies of whom I have worked with in the past I was trying to keep the business in Stockton and help the small mom and pop Please listen to the conversation and you just might grow beyond the Mom and Pop store Please finish the work you started
I believe this is simply a miscommunication. My employee *** was simply doing her jobAnytime we get an order for a patient with Medicare/Medi-Cal insurance coverage we check to see if the patient has already been dispensed the product within the last yearsIf the patient has received
same or similar equipment, in this case Medi-Cal, will reject payment when we billThus, leaving the patient with a bill from usI believe this is all my employee was trying to explain to Ms*** before she went off on angry tirade over the phoneI myself spoke with her, and found her to be just as aggressiveWe understand that people need these supplies and that it can be frustrating at times to deal with insurance and as a small mom-and-pop type DME supplier we bend over backwards for our patientsWith that said, I hope once Ms*** cools off we can have another conversation and earn her business back
I think we are a little too hung up on the toilet seat riser the patient receivedWhen we check for same/similar, we are not given a date or supplier where the same and/or similar equipment was dispensedAll we know is that the patient received the same (or a similar) piece of equipment within the past yearsWith that said, the equipment triggering the same/similar hit may not even be the toilet seat riserAt this point, the only viable solution would be to submit a treatment authorization request (TAR) to Medi-Cal and let them make the final decisionThe TAR would be populated with the same information, whether it came from us or a diff supplierAt this point it is up to the patientIf he wants us to submit the TAR on his behalf, we will do soIf not, we will forward all pertinent information to the supplier of his choice
I am rejecting this response because: When you find a good physician, it's important to stay with that physician because they know your medical history and it's easier to get the treatment you need because they already have all of your informationWhen a situation arises and you need services that is beyond the knowledge of your physician then he/she will refer you to a specialist but keep track of your treatment because he/she is your main provider The same rules apply to finding and keeping a good DME Supplier: If you use the same DME supplier, they know what you have because you have purchased it from themIf there is a piece of equipment that you need that they do not carry then a good DME supplier with make recommendation and send over information because they have your supply historyI have honestly never had this issue before and I have been in this business for a number of years and it's really upsetting to see that Pacific feels we are too hung up over a toilet seat riserTaking previous conversations and issue into consideration, I have decided to use an existing supplier for this client This client (like all clients) will need more equipment in the future and I simply just don't have the time to beg this supplier to care about the needs of my client and provide him with excellent services After sharing my issue, a supplier that I have used in the past (outside of Stockton) has decided to take over future services and even provided the chair that we needed Going forward, I will warn people of the horrible service and treatment (that I have never experienced with other suppliers) that this company has provided Since I have used your services before, it is unheard of to ask me to resend information that you should already have on file because the company is too lazy to look it upIt is completely unprofessional to call me and ask me to contact Medi Cal and do your job for you Although the previous owner is no longer there, it's a complete cop-out to blame laziness on the fact that they are a small companyMy client's insurance didn't change and so there was no reasonable explanation (other than unprofessionalism) to have me resend his insurance information by fax This issue has been resolved through another company and that should be disturbing and not a relief if this company truly wishes to stay in business and grow I would not recommend this company to anyone in the future and I would warn anyone who is on Medi-cal, to stay clear from this company I am sure the previous owner would have provided better services than this and would have made staff adjustments after listening to the phone conversation with one of their (supposably) supervisor
I am rejecting this response because: I seriously hope this small mom and pop has the ability to listen to the phone call. [redacted] did not explain that was their policy but instead she gave me the phone number to Medi-cal and the codes and asked me to call and explain it to Medi-Cal and I did that. I spoke to a rep named [redacted] who said that I am not able to call because I don't have an account with Medi-Cal. [redacted] was shocked that I was made to call in. [redacted] said when they are similar there is an inquiry but not a rejection and I was told that since the DME equipment came from them then they can send over the information to prove that it was a toilet riser and not a shower chair. I was told that the problem is when it's a new company that doesn't have the proof then it's hard for a new company to prove. However, Pacific sold him the shower chair and has the proof and is just being lazy. If I had known the company would hinder future DME equipment that this client needs then I would have never done business with them. Now, before another company will do it I would have to have the billing approval and payment from the toilet riser. It's a sad thing that one has to jump through hoops on something so easy. I have other client's that have Medi-cal that live in Antioch and have had never had this issue before. They have basically hindered my client from getting a simple shower chair due to being lazy. I would like them to finish it so my poor client doesn't have to pay out of his pocket for something that can be had if the company did their job. After this issue, I will just use the companies of whom I have worked with in the past. I was trying to keep the business in Stockton and help the small mom and pop. Please listen to the conversation and you just might grow beyond the Mom and Pop store. Please finish the work you started.