Compression Management Services, Inc

01/01/2018*** *** The Revdex.com Holiday Drive, Suite Pittsburgh PA 15220Dear *** ***:This letter is in response to the complaint ID# *** mailed to us on 01/24/2018.Upon receipt of this complaint, Compression Management Services (CMS) has completed a full
investigation on this matter.The patient came into our office on 12/28/requesting to be measured for maternity compression garments, CMS called United Healthcare, Provider Services on 12/28/to verify the coverage of the product and we were given conflicting information by United HealthcareWe were initially told that the compression garments were covered and then we were told by the supervisor that the compression garments weren't coveredThe Supervisor specifically told us that if the patient has a diagnosis of lymphedema due to breast cancer then the compression garments would be covered otherwise they are not a covered product under this patient’s planWe were given the Ref# *** for the call.We informed the patient that the compression garments were not covered due to her NOT having the diagnosis of lymphedema and if the patient was interested in still receiving the product she would have to pay for the product up front and once she receives the product we would be able to bill her Insurance and if her Insurance decided to pay for her compression garments then we would refund her.On 01/15/the patient informed us that she spoke to Member Services and they told her the compression garments were covered We explained to the patient that our policy is to follow the information that Provider Services has given us however if she wanted to still receive the product we would be able to bill her Insurance and if they pay for the product she would be refunded.On 01/22/2018, we received a voicemail from someone stating they were calling from United Healthcare however they did not give a name and that they were calling to inform us that there was an authorization on file for the patient's compression garments and left the Ref# *** *** ***On 01/22/2018, we called United Healthcare Provider Services to confirm the information we received on the voicemail and the Supervisor in the Care Notification Department stated that she was able to see the phone call but did not see an authorization on file and apologized for the confusionThe Supervisor stated that she will call the patient and explain the situation.In conclusion, Compression Management Services stands behind the decision to request the patient pay up front for the product and if the patient's insurance pays for the product Compression Management Services would refund the patient CMS is a family owned business and we appreciate the fact that paying for a product up front can present some difficulty to the patient initially and so that is why we do everything we can to expedite the claims processing in a timely manner so if the Insurance does pay for the product the patient can be refunded immediately.ProfesKevin E*** Vice President, CIOCC: *** *** *** *** *** *** *** *** ***

I have reviewed the response made by the business in reference to complaint ID [redacted] and find that this resolution is satisfactory to me. 
The statements sent to me were addressed by me with phone calls speaking to different people each time.  Discussion of payment was accepted each time by each party.  A lump payment was made on account but did not cover entire money due.  My supplemental medicare insurance was processing information to again see if the rental of the pump could and would be covered.  I always kept in touch with Compression when I realized there were internal problems within their system of handling payments.  I have returned the equipment.  Received the duplicate payment back which was put into my account and then made a final payment of $95 to close out my account.  They apologized and I was pleased with this.  I do like the employees there that fitted me with my compression arm bandage.  Dee and Alex.  I plan on refilling my order when I need additional arm bands which is covered by my Medicare Supplemental insurance.  Thank God!Regards,
[redacted]

3/8/2016Claim ID# [redacted] Dear [redacted], As a result of our investigation, we agree that our usual high standards of customer service were not met in this instance. After further review, the problem with the automatic payment not being withdrawn was due to a miscommunication on our staff...

member's part and this has been addressed with the staff. As a result, we have implemented a system to ensure this information is correctly documented and communicated to the appropriate staff members in a clear, concise and secure manner in the future. In regards to the duplicate payment that was taken at one point, we take full responsibility that was an error on our part and was rectified immediately after it was brought to our attention. As we realize that an expected monthly payment was not automatically drawn, we did send the patient three consecutive monthly statements showing the accumulated balance and the amount due. After 90 days the balance was not paid in full so consequently the process of sending the patient’s account to an outside collection agency was put in place. We do encourage our patients to appeal to their insurance companies and when possible we appeal on the patient’s behalf however due to this process being very lengthy at times the patient is responsible for the payment of the product and would be reimbursed if and when the Insurance Company overturned the denial. We would like to extend our apologies for any undue stress or inconvenience this situation may have caused you and assure you that we have taken the necessary steps to remedy the situations.Please contact us with any questions.Professionally,Kevin E[redacted]Compression Management Services, Inc.

Review: I was seen May 2nd, I had requested to get leg pumps they did not attempt to get authorization until the 14th, I called my insurance company and they show no record of this, I had talked to compression Mgnt today appears the had wrong insurance information. If I had not called it would have sat there another week or more, I talked to [redacted] today they said prior permission is not needed for durable medical equipment under my current policy. I realize they deal with thousands of customers but it has been 12 working days since my request. And they are telling me they should have authorization within a week or so.Desired Settlement: I just want the pump my doctor has authorized that I get and my insurance has also made the requirements clear, if they deal with thousands of patients I know they would have delt with [redacted] which is sponsored by[redacted] with 40,000 employees and as many spouses children on this policy Also stop lying to me just to smooth it over.

Business

Response:

Compression Management services assessed the patient on May 6th 2014. After the appointment

Review: Since Aug. 2015 I have been renting to possible own of a Lymhedema compression pump for my left arm to take/keep swelling down on my left arm. It was being processed with my medicare supplemental company to find out if it would be covered by them. It was pending. The rental was denied by the insurance co. and I agreed to make monthly payments as long as I rented to machine. I was told I was not obligated to buy the machine. The rent/own fee per month of $95 was decided upon whereby the $95 was to be taken on auto pay from my checking account until it would be paid for the total amount approx. $1,200. Unfortunately, the $95 was not being taken from my checking account and had not been paid for 3 months. A total of $285 was due immediately. I called when I realized the money was not on auto pay and said I had resubmitted the claim to my insurance co in hopes that they would start to pay the rental fee and I paid $125 against the $285 due and said I would pay the remainder once I heard back from the insurance co. Then on 2/3/16 Jodie from their billing office called and demanded in a commanding voice that I pay the remainder due of $160 saying that they never do auto pay, that it was illegal to do so and she demanded that I go get my checkbook right then and there to give her my bank account numbers so she could have the amount due from my checking acct. withdrawn immediately. I explained that I was again requesting the insurance co to start to pick up the monthly fee. She kept yelling at me saying that I needed to resolve the amount due with her immediately. I would have except I found I could not at that minute because of the traumatic way that she was addressing me for the money. I had to hang up on her. She kept phoning me back at least 5 times in a row. I did not answer. She reported it to a [redacted] Credit Control bill collector immediately and I got a notice on Feb 5th in the mail. I called the debt collection company and talked to a [redacted] and she was understanding of the whole situation and told me to contact a [redacted] head of Collections and explain what happened and the entire rude, crude verbal accosting by Jodie over the phone. I did and she was concerned about the bad behavior that was used in requesting the remaining fee. I paid the $160 over the phone with [redacted] immediately and I told her I would be returning the machine to Compression Management Shadyside where I obtained it. She said fine and hoped that I would return it within a few days. Upon looking at my checking account online Compression Management took $160 out twice totaling $320. I am reporting this inept handling of their payment methods.Desired Settlement: Reprimand and correction method of requesting payment and the return of one of the $160 overpayment back into my checking account.

Business

Response: