Chartwell-Midwest Wisconsin

Review: I was referred from UW hospital to contact Shar of Chartwell Midwest Wisconsin in Middleton to order a box of 25 plastic syringes and a set of extension tubes in November of 2013.

1) At that time, I asked Shar about the details of pricing in the email. She didn't say anything about it. Since I was usually charged for $100~$150 (a co-pay of $30) from UW hospital, I didn't pay too much attention about it at that time.

2) Later, they charged me for $881.47 (a co-pay of $100). Shar explained that the charge was based on a daily service for a 30-days period. It's very ridiculous, since I never received any daily service from any Chartwell person. I only received a UPS-delivered package AT ONE TIME containing both items .

3) I have tried to contact Shar and Brian from the customer service department to discuss this issue several times since April. However, up to now, I haven't heard any reasonable explanations for this ridiculous charge of a non-existent service.

4) Other than charging me and my insurance company for an overpriced service that I did not receive, their customer service is horrible. Since I am unable to contact them over the phone from a throat damage, I contacted them 3 times by emails in the past 3 months. However, they just ignored my emails without any responses.Desired Settlement: -Adjustment to my own bill

-Provide honest pricing to future customers

-Provide better customer service.

Business

Response:

My name is [redacted], I’m a nurse and the manager of the Chartwell Enteral Program as well as the manager at Chartwell responsible for all incoming complaints. Your concerns regarding charges for your supplies and our lack of response to those concerns have been brought to my attention through a letter from the Revdex.com and I’m reaching out to you first and foremost to apologize. I’ve been a nurse with Chartwell for the 20 years of our existence and a manager here for many of those years. We’ve established high standards for patient care and customer service and have a long standing track record of high patient satisfaction scores and customer service performance. That being said, after reviewing the circumstances of your case it appears that we didn’t live up to those standards. As the enteral department manager, oversight of our processes, policies and staff are my responsibility and resolution of your complaint rests squarely on my shoulders. The two major areas of concern you shared are product pricing and customer service. I offer the following information in response to those concerns:

1) Pricing for the product you received

· The contract between your insurance company and Chartwell reimburses for products and services by HCPCS code which is an industry standard. However, The HCPCS code used for billing the syringes you received is actually a “kit” code used for reimbursement of daily kit fees when such services are needed and provided to a patient.

· We were accustomed to the complex care required by our infusion patients who receive daily services and our enteral billing system was set up with a similar type of charge in anticipation of the needs of the UW Home Nutrition transition patients. However, you as one of those transition patients didn’t need that level of care and we didn’t have a billing code or process in the system set-up to accommodate billing for patients that only needed occasional supplies.

Resolution to your concerns

· We adjusted the charges for the products you received and wrote off your co-pay balance on 7/11/14. We will provide a refund to the insurance company based on the reduced charges. Once the refund is processed, you should receive an explanation of benefits from the insurance company reflecting this adjustment.

· We’ve since established a process to identify and bill for patients who need minimal supplies and should not be billed for a daily kit fee, but for specific DME and supplies only.

2) Improved Customer Service

· Your e-mails to Chartwell expressing your concerns came through individual staff e-mail and were forwarded to various individuals. Although some efforts were made to address the situation, the process took far too long to resolve. In addition, when we made the adjustment to your account on 7/11/14, we didn’t send you any follow-up communication indicating that we took this action. Chartwell has a formal performance improvement program in place to manage challenges in process and concerns reported by patients, caregivers and customers. However, the concerns you reported by e-mail were passed on via e-mail without being documented in our occurrence reporting system as a complaint which is our double check system for complaint follow-up. Consequently, appropriate follow-up to you fell through the cracks.

Resolution to your concerns

· Currently we have a number of patients who also need or prefer to communicate their needs by e-mail instead of by phone and are doing so via one of our staff members specific e-mail in boxes. We are currently implementing an enteral team e-mail in box that will be used to manage all communication with these patients so that their e-mails can be viewed and accessed by multiple team members to reduce the risk of missed communication.

· Our lack of response to you was unacceptable and not in accordance with our customer service standards. Chartwell’s performance improvement program and occurrence reporting system have a long standing, documented success rate and I attribute our customer service failure in your case to a new program with new staff, products and processes. We did a review of our processes, made adjustments where applicable and did immediate re-educated for the enteral team. We will also review the circumstances of your case at our next team meeting so that we can use it as a learning opportunity moving forward.

I offer my sincere regret and apology for our poor follow-up to you and greatly appreciate the efforts you went through to have your concerns addressed. This feedback to our organization gave us an opportunity to identify opportunities to implement change that will help us improve our processes and also attempt to make your specific situation right. Please contact me directly with any additional questions or concerns you may have.

Sincerely,

[redacted], RN

Program Manager

Chartwell Midwest Wisconsin

Consumer

Response:

[A default letter is provided here which indicates your acceptance of the business's response. If you wish, you may update it before sending it.]

I have reviewed the response made by the business in reference to complaint ID [redacted] and find that this resolution is satisfactory to me.