Cornerstone Medical Services, LLC of Columbus

After reviewing our records and the patient provided information, we identified that proper procedures were not observed during the dispensing of the equipment According to a standard practice for rental equipment a “Medicare Capped Rental and Inexpensive or Routinely Purchased Items Notification for Services on or after January 1, 2006” form is presented to the patient for signatureThis was not presented to the patient at the time of delivery, therefore patient was not aware that this equipment would be rented with a month cap as specified in the Medicare guidelines.Pricing for rental equipment is based upon the [redacted] Medicare allowable fee schedule Aetna Medicare does not provide for the outright purchase of such equipment Cornerstone is required to follow such guidelines.Solution:After further review, Cornerstone has determined that the patient and [redacted] Medicare will be refunded in full, due to proper procedures not being followed [redacted] P: ###-###-#### / F: ###-###-####

I DID NOT ORDER (5) or any additional large nasal pillows since I already have a large nasal pillow on hand and a large nasal pillow comes with the Swift Nasal Pillow System w/ headgearMy review of my ordering parts over the years shows that I have never ordered additional large size nasal pillowsIn fact when I complained that Cornetrstone did not call me for vover months to reorder parts (they use to call every months) I went over to Cornerstone, they gave me enough parts for years, but later I returned about pillown nasals to them Regards, [redacted] ***

On June 16th, 2016, Mr. [redacted] was called by our automated system IVR and there was no answer. On June 20th, 2016 patient was reached via IVR however no response to the questions and hung up. Shortly thereafter, Patient called us back and placed an order over the phone with the... Fulfillment center. Patient ordered Mask, HG, Tubing, Filters both foam and fine and Large pillows. Order was placed on 6/22/16 with and shipped the same day. Patient has not called into our office since this day, nor has he spoke with any other department. These calls are documented at the time the patient places the call. Explanation as to why the equipment was billed separately was that we had a Certificate of Medical Necessity(CMN) on file for everything except the Nasal pillows. We had to obtain a CMN before we could bill, therefore we billed the other supplies and waited for the signed CMN which we received 7/27/2016. We then billed this to the insurance and subsequently billed the patient as of 8/8/16 for the balance. Patient can refer to their EOB for insurance payment and patient responsibility.

On June 16th, 2016, Mr. [redacted] was called by our automated system IVR and there was no answer. On June 20th, 2016 patient was reached via IVR however no response to the questions and hung up. Shortly thereafter, Patient called us back and placed an order over the phone with the...

Fulfillment center.  Patient ordered Mask, HG, Tubing, Filters both foam and fine and Large pillows.  Order was placed on 6/22/16 with and shipped the same day.  Patient has not called into our office since this day, nor has he spoke with any other department.  These calls are documented at the time the patient places the call.    Explanation as to why the equipment was billed separately was that we had a Certificate of Medical Necessity(CMN) on file for everything except the Nasal pillows.  We had to obtain a CMN before we could bill, therefore we billed the other supplies and waited for the signed CMN which we received 7/27/2016.  We then billed this to the insurance and subsequently billed the patient as of 8/8/16 for the balance.  Patient can refer to their EOB for insurance payment and patient responsibility.

After reviewing our records and the patient provided information, we identified that proper procedures were not observed during the dispensing of the equipment.  According to a standard practice for rental equipment a “Medicare Capped Rental and Inexpensive or Routinely Purchased Items...

Notification for Services on or after January 1, 2006” form is presented to the patient for signature. This was not presented to the patient at the time of delivery, therefore patient was not aware that this equipment would be rented with a 13 month cap as specified in the Medicare guidelines.Pricing for rental equipment is based upon the [redacted] Medicare allowable fee schedule.  Aetna Medicare does not provide for the outright purchase of such equipment.  Cornerstone  is required to follow such guidelines.Solution:After further review, Cornerstone has determined that the patient and [redacted] Medicare will be refunded in full, due to proper procedures not being followed.
[redacted]P: ###-###-#### / F: ###-###-####

I DID NOT ORDER (5) or any additional large nasal pillows since I already have a large nasal pillow on hand and a large nasal pillow comes with the Swift Nasal Pillow System w/ headgear. My review of my ordering parts over the years shows that I have never ordered additional large size nasal pillows. In fact when I complained that Cornetrstone did not call me for vover 9 months to reorder parts (they use to call every 3 months) I went over to Cornerstone, they gave me enough parts for 2 years, but later I returned about 6 pillown nasals to them.
Regards, [redacted]