Cape Medical Supply

Revdex.com: I have reviewed the response submitted by the business and have determined that the response does not satisfy or resolve my issues and/or concerns in reference to complaint # [redacted] Please add your rejection comments below [If you are rejecting the business's response please enter your rejection comments here They keep claiming they did not lie to meI have already forwarded the email they sent to me explaining how they send the claim to my insurance company to determine my deductible before the women came out to fit me with the machineAfter I was displeased they lied again to trick me to send back the machine which they knew they would keep trying to Bill me forThey promised me on the phone that after sending back the machine I would owe nothingI have already agreed to pay even though I feel I'm not obligated due to them being dishonest and deceitful but I require them to send me back the machineI'm not paying them for something they still haveSend me the machine and I'll pay the balance of the $but I won't pay any interestI feel this is more than a fair resolution Regards, [redacted] ***

On November 24, we called the patient and left her a voicemail and noted her chart as followsCalled the patient left a message on her machineapologized that she had to take time out of her work day to make calls to us to deal with thisAdvised that I did in fact review her authorizations on file, all of which were for one nasal pillowAdvised I also had documentation from her Insurance Company that stated we are not to exceed billing for more than one nasal pillow per six months and that's why she received the same response from everyone she spoke with at CMSApologized for the delay in receiving her last order(looked like a B/O issue) and requested she call me back if she would like to talk about any issuesFor your convenience we have included a copy of her Insurance company's regulationsOur business is in providing products and services to our patients, we Never benefit from not providing or with holding produccompromises revenue and profitability, not to mention patient careThe issue here is with what her insurance plan will authorizethey have a "utilization management" program in place to reduce expenses and it is causing her significant issuesWe understand well which Insurance companies allow which products in which quantities at which intervalsWe have seen several situations, apparently this one included, where patients are given bad information by call centers at Health Insurance CompaniesAs stated, it is in our business and clinical interest to provide these products to our patients as frequently as their insurance allows for, in this case the complainant needs to take issue with her Insurance plan if she feels their schedule is not sufficient for her care

Tell us why here..This patient filed a complaint regarding his financial responsibility for products and services he received from our organizationHe acknowledged when he received the products initially he would honor his financial responsibility, he has notWe never advise patients that they will not owe money, they are always directed to their insurance plan for questionsThe individual had a deductible on his plan that was not met when we billed his insurerHe has demonstrated a clear pattern of not meeting his personal financial responsibility with our organization.This complaint is specious and results from someone simply not wanting to pay a bill they acknowledged they would be responsible forAny complaints regarding the deductible or amount should be directed at his health insurance plan, who determines the amount of both

We have repeatedly worked with this customer on their concerns, including a three way call with her insurance company to explain the deductibleShe is free to return the machine at any timeWe do not set the plan rules or deductible amounts, the plan does and we are simply following the rules of the plan she is enrolled inThe customer has repeatedly offered to return the machine and purchase a device online, if she is to do this we will entertain a discount of her open balances, understanding she will no longer have clinical coverage for her therapy or access to basic troubleshooting for the device

Our billing team is in the process of contacting him to refund the amount and process a return of the goods he requested, but no longer wants