Degen Berglund Pharmacy

My management team reviewed our records and here is their response: “ [redacted] called and ordered stockings on 3/25/ [redacted] took the orderI contacted [redacted] , she does not remember the call since it was almost a year agoIt appears she did not ask about insurance (it was so long ago she could not remember) nor did she do an insurance verification but is positive that [redacted] did not tell her to make sure everything was the same and that [redacted] needed to verify the stockings would be covered at 100%The claim was sent and denied, then sent again and deniedThat is when it was discovered that she had UMRThe claim was sent to UMR in August 2014, processed and applied to deductible [redacted] received a bill in OctoberOur notes indicate she called on 10/15/and said she was working with her insurance to get the claim paid and that she was not ignoring her statementShe called again on 12/4/and said she did not have a deductible and the stockings should have been covered at 100%She called again on 12/10/and was informed by our biller that DB is out of network with UMR [redacted] stated she had called the insurance and they did not tell her we were out of network and that she was going to call them again [redacted] called again on 1/7/and said it was our responsibility to verify her insurance and said since we did not check, she is not paying the billShe said she pays to much for her insurance and they need to pay more [redacted] was informed that she did need to pay her billCollection letter was sent to her on 2/3/15, we received payment from [redacted] on 2/25/DB staff should have asked if there was an insurance change however, the patient also has a responsibility to provide us with updated insurance information“ Based on the information submitted, reviewed and the length of time involved, we will not be issuing a refund We appreciate having this complaint brought to our attention Please let me know if you need any additional informationRespectfully, [redacted] , DirectorDegen Berglund, Inc

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and have determined that this does not resolve my complaint.  For your reference, details of the offer I reviewed appear below.
[To assist us in bringing this matter to a close, we would like to know your view on the matter.]
Regards,
[redacted]  [redacted]
 
They state that it was discovered that I had UMR insurance, no I've had UMR since doing business with D&B.  This is not the first time I ordered stockings from them. They should remember because the first time I ordered, a few  years ago, it took them 3 times to get me the right ones.  It was all covered then.  This was the third time I've ordered from them and they did tell me there were no changes.   Later they tell me that UMR made changes and they weren't in network as of April. Well I ordered them in march so it appears to me that they were just pokey about submitting the claim to the insurance.    -[redacted]

My management team reviewed our records and here is their response: “[redacted] called and ordered stockings on 3/25/14. [redacted] took the order. I contacted [redacted], she does not remember the call since it was almost a year ago. It appears she did not ask about insurance (it was so long ago she could...

not remember) nor did she do an insurance verification but is positive that [redacted] did not tell her to make sure everything was the same and that [redacted] needed to verify the stockings would be covered at 100%. The claim was sent and denied, then sent again and denied. That is when it was discovered that she had UMR. The claim was sent to UMR in August 2014, processed and applied to deductible. [redacted] received a bill in October. Our notes indicate she called on 10/15/14 and said she was working with her insurance to get the claim paid and that she was not ignoring her statement. She called again on 12/4/14 and said she did not have a deductible and the stockings should have been covered at 100%. She called again on 12/10/14 and was informed by our biller that DB is out of network with UMR. [redacted] stated she had called the insurance and they did not tell her we were out of network and that she was going to call them again. [redacted] called again on 1/7/15 and said it was our responsibility to verify her insurance and said since we did not check, she is not paying the bill. She said she pays to much for her insurance and they need to pay more. [redacted] was informed that she did need to pay her bill. Collection letter was sent to her on 2/3/15, we received payment from [redacted] on 2/25/15. DB staff should have asked if there was an insurance change however, the patient also has a responsibility to provide us with updated insurance information. “ Based on the information submitted, reviewed and the length of time involved, we will not be issuing a refund.  We appreciate having this complaint brought to our attention.  Please let me know if you need any additional information. Respectfully, [redacted], DirectorDegen Berglund, Inc.

Review: I've gotten medical supplies from D&B about once a year for the past few years but I've always called first to make sure nothing has changed with my account and my insurance and that everything should still be covered 100%. The last time I called they told me nothing changed but failed to inform me that they were no longer in network with my insurance. So what should have been covered 100% is now only about 20%. I called them on the matter and they told me they don't check that every time. Well that's kind of an important thing to check and why I called them first before ordering. I can't believe this is something they wouldn't check and feel they didn't inform me b\c they knew I wouldn't have ordered them. I didn't even know they weren't covered until about 6 months later, to late to return any of it. If this is how they are conducting business, well then I can't be the only unhappy customer. With constant changes to insurance these businesses should have to tell you their status with your insurance company every time you ask.Desired Settlement: I feel a full refund is in order and that they take the time to actually check their status with insurance companies before telling people that there have been no changes. This could have been easily avoided. It is clearly neglect on their part.

Business

Response:

My management team reviewed our records and here is their response: “[redacted] called and ordered stockings on 3/25/14. [redacted] took the order. I contacted [redacted], she does not remember the call since it was almost a year ago. It appears she did not ask about insurance (it was so long ago she could not remember) nor did she do an insurance verification but is positive that [redacted] did not tell her to make sure everything was the same and that [redacted] needed to verify the stockings would be covered at 100%. The claim was sent and denied, then sent again and denied. That is when it was discovered that she had UMR. The claim was sent to UMR in August 2014, processed and applied to deductible. [redacted] received a bill in October. Our notes indicate she called on 10/15/14 and said she was working with her insurance to get the claim paid and that she was not ignoring her statement. She called again on 12/4/14 and said she did not have a deductible and the stockings should have been covered at 100%. She called again on 12/10/14 and was informed by our biller that DB is out of network with UMR. [redacted] stated she had called the insurance and they did not tell her we were out of network and that she was going to call them again. [redacted] called again on 1/7/15 and said it was our responsibility to verify her insurance and said since we did not check, she is not paying the bill. She said she pays to much for her insurance and they need to pay more. [redacted] was informed that she did need to pay her bill. Collection letter was sent to her on 2/3/15, we received payment from [redacted] on 2/25/15. DB staff should have asked if there was an insurance change however, the patient also has a responsibility to provide us with updated insurance information. “ Based on the information submitted, reviewed and the length of time involved, we will not be issuing a refund. We appreciate having this complaint brought to our attention. Please let me know if you need any additional information. Respectfully, [redacted], DirectorDegen Berglund, Inc.

Consumer

Response: