Dependable Medical Equipment

Complaint: [redacted] I am rejecting this response because: I have now received invoices, one in the amount of $290, the original invoice, and one in the amount of $ I have not received any other written correspondence as of today I still find it very concerning that DME did not involve me or provide me with any information regarding the problems with my account until I received an invoice for the full amount of $ As I am sure DME can understand, my initial reaction was to call and explain that I did not owe this amount because of DME telling me in writing it was covered in full by my insurance Yes, I am aware there are numbers on the back of my insurance card where I can call and discuss benefits coverage myself I find this argument silly, since DME assured me at the time I placed the order that I did not need to contact the insurance because part of their customer service is to do to that for me I have now sent DME written letters (including this one I am mailing today) with an offer to return the equipment or pay 25% of my bill This offer has not changed since my first written correspondence with them on 7/21/ I have not received any written offers, despite DME claiming in their Revdex.com response that they offered to reduce my bill to 50% of the total I understand they sent an offer for $on 9/9/and I wait to receive that in the mail It will be the FIRST written offer I have received, other than being mailed invoices asking for the full amount due My insurance is still investigating the phone call reference numbers provided by DME once the Revdex.com correspondence began Again, this is information that should have been provided to me when this dispute began in the summer I will be rejecting the offer of $ Regardless of the outcome of the [redacted] investigation, I can understand the position that DME is in, that they believe they were provided information by the insurance company Even though I disagree with the unprofessional manner and lack of written informative correspondence provided to me, my offer continues to be 25% of the total billed When DME sends me an invoice in the amount of $I will be happy to mail them a check Until I receive an invoice in that amount, I request DME to stop calling me (as I have already asked times for everything to be put in writing) If DME wishes to continue this dispute over a difference of $30.16, then that is their choice This is my last and final offer, as well as my final correspondence regarding the matter Sincerely, [redacted]

[redacted] Please See Attached Documents [redacted] Revdex.comPO Box 1000DuPont, WA 98327Revdex.com Complaint # [redacted] Dependable Medical Equipment dba [redacted] was contacted by a customer to receive a breast pump and bill her insuranceWe are a durable medical equipment company who bills your insurance for medical equipment including breast pumpsWe contacted our customer’s insurance company and we were told she was covered for a breast pump up to the standard allowable amount, according to her planThe person we talked to was [redacted] on 2/26/and the call reference number was [redacted] .Later our customer emailed back to see if we were listed as in-network being based out of Seattle WA because she lives in TXWe called a second time to verify our contract status and asked if we were listed as an in network providerAgain we were told that because we were in-network with our local plan, we were in-network with themThe person we talked to this second time was [redacted] and the call reference number was [redacted] .After we conveyed this information to our customer, she decided to go ahead with the order and we sent her a breast pump and billed her insuranceWe received a denial on 5/15/and we called [redacted] of TX and was told they would honor the original quote based on the last phone call noted on her account saying we were in-networkThe person we talked to in the claims department was [redacted] and call reference number was [redacted] We were instructed to resubmit the claim and they would pay it We received another denial on 6/29/with the explanation: “Program requirements as identified by the member’s contract have not been fulfilled This is the patient’s liability” The denial amount was $and we billed our customer as the insurance directed us to.We again called her insurance company and gave them the reference number of the phone call where they assured us we were in-network They agreed to reprocess the claim (reference # [redacted] ) but only ended up paying $on 7/28/with the balance listed as patient responsibility due to the claim being processed as out-of-network The balance was transferred to our customer as it was listed on the Explanation of Benefits Our customer was sent an invoice for $on 8/10/[redacted] and Dependable Medical Equipment has offered to make a financial deal on with our customer several times but they were rejected We are happy to work with [redacted] on a reasonable financial arrangement.Sincerely,Sandra C [redacted] Customer Accounts ManagerDependable Medical Equipment

*** Please See Attached Documents ***
August 26, 2015Revdex.comPO Box 1000Dupont, WA 98327RE: ***To address the newest concerns from our customer:We cannot accept the return of a breast pump for sanitary reasons The manufacturer also does not accept returns for this reasonOur claim with our customer’s insurance was not denied until after her baby was born and she after started using the breast pumpThe “mistake” made in this case was by *** *** informing us that we were a network provider that could sell our product throughout the country through the BlueCard programFrom our website: “We’ll help to verify your insurance billing for breast pumps and give you a call or email you within business day to discuss all the different options with you.” Verifying insurance does not guarantee payment according to the insurance carrier We do not guarantee payment Verifying insurance is only as good as the information received by the insurance Customer Service personnel We have unfortunately found this to be widely varying in correctnessFrom our website: “Depending on the type of insurance coverage you have, your insurance company may cover the full cost of a single or a double pump.” This statement is not a guarantee of paymentOur customer has all the phone numbers for her insurance company on the back of her insurance card with a statement about the responsibility of the patient to verify with their benefit booklet for covered servicesOur website does not include a list of network insurance carriers We cannot be faulted for what is not on our websiteOur customer does not know what we discuss with other customersSince the problem arose with our out-of-network claims, we now always tell our customers to check with their insurance to verify for themselves their coverage for the product This was requested by our customer on her first complaint and we are doing this nowWe consider this matter closed as we have satisfied our customers request to inform our customers to “confirm their own insurance coverage as well”.Sincerely,Sandra C***Customer Accounts Manager

Complaint: ***I am rejecting this response because: *** *** *** *** of Texas is conducting an investigation of all correspondence/reference #'s provided by Dependable Medical Equipment to verify information exchanged. This is the first time I have been made aware of the series of events provided by DME of all their correspondence with my insurance company. Had I been given this information and phone call reference numbers before, I would have been able to communicate better with my insurance company while researching this matter. *** *** *** *** of Texas verified the phone calls were made (I was given incorrect information from a customer service manager previously), however, when checking the notes of the phone calls, there was no indication that "verification of in-network/out of network coverage" had been made. *** states that a provider should know whether they are in-network with an insurance company based on their contract. *** states that the information provided in the phone calls verifying my coverage was simply an explanation of benefits stating that I am allowed a breast pump at 100% coverage. This is a separate issue, I was told by ***, than verifying whether a provider is "in" or "out" of network. The claim, when resubmitted at the new price of $rather than the original $280, came back as "out of network" and my insurance paid the $contracted amount for an out of network provider
I understand per DME's response they tried several times to file the claim and were told several times they were in-network with my insurance. Because this is a matter of "who said what", *** agreed upon my request to review the claims and they will be pulling the recordings from the phone calls to verify what was discussed. This investigation will take several days and I will be contacted once the investigation and phone call recordings have been reviewed. If the phone call recordings indicate that *** gave the information that Dependable Medical Equipment is IN network, they will honor that quote and pay the remainder of the bill. If the phone call recordings indicate that *** did NOT give the information Dependable Medical Equipment claims they did, then Dependable Medical Equipment will be held liable for the balance. This balance will not be my responsibility because I ordered the pump based off information I believed to be true provided to me by Dependable Medical Equipment.
It is inaccurate for Dependable Medical Equipment to say I have rejected their settlement offers, because none have been made to me. I have sent DME letters, offering to either return the equipment or pay 25% of the remaining balance. I have now received statements, with no other accompanying letters, in the mail for the full balance due. No written offers have been made to me. DME did call my house phone and left a message for me to call their office. I have requested several times now through my written correspondence to do all correspondence with me in writing so that I have written documentation of everything discussed. I cannot verify information given over a phone call.
I am disappointed that DME did not choose to send me this written information prior to this dispute through Revdex.com. My offer still stands, pending the conclusion of the *** investigations of the phone call recordings.Sincerely,*** ***

We have settled this customers account She agreed to pay us a reduced amount and we agreed to accept it The matter is closed.Sandra C***Customer Accounts ManagerDependable Medical Equipmenttele*** ***fax *** *** This e-mail, including any
attachments may contain material protected and governed by the Health Insurance and Portability and Accountability Act (HIPAA) This e-mail and any files transmitted with it are confidential and are intended solely for the use of the individual or entity to which they are addressed The authorized recipient of the information is prohibited from disclosing this information to any other party unless authorized If you are not the intended recipient of this e-mail please note that you have received this e-mail in error and any use, dissemination, forwarding, printing or copying of this e-mail is strictly prohibited If you have received this e-mail in error, please immediately contact the sender of this message.CONFIDENTIAL INFORMATION:PLEASE NOTE: The information enclosed in this facsimile is privileged and confidential; and it is intended only for the use of the individuals named above, and others who have been specifically authorized by such individual(s) If you are not the named recipient or authorized by the named recipient, you are hereby notified that any review, use, dissemination, distribution or copying of this communication is strictly prohibited If you have received this communication in error, please notify the sender immediately by telephone *** ***

Complaint: [redacted]I am rejecting this response because:It is your duty as an accredited business to inform customers of potential lack of coverage due to, by your own admittance, multiple out of state insurances being out of network. Though you may have received exemplary provider status, it is not exemplary to blame and invoice the customer for a mistake made on the businesses behalf.
I do understand that there was a mistake made on the business, Dependable Medical Equipment’s, part in verifying insurance. I was told my insurance, [redacted] of NC, would cover the breast pump at 100% through Our perfect baby. This information was relayed to me from Angela R[redacted] from Our Perfect baby on Feb 16, 2015. Though it is an unfortunate mistake, I feel it is a mistake on the business, Dependable Medical Equipment’s, part. The company advertises that “We will verify your insurance and call or email you within 1 business day to discuss coverage, pump, and upgrade options.” There is no where on the website that states which insurance companies Dependable medical equipment is in network with or that the patient must double check with their own insurance for confirmation that Dependable medical equipment is in network. This lack of information on the website gives the appearance that Dependable medical equipment, through Our perfect baby, is knowingly, and willingly informing other patients of 100% coverage when they may be out of network as well.
As you pointed out, I did not return the pump because you told me it could not be accepted as it had been opened and used. This was relayed to me in July of 2015, when I received a $290 invoice for the pump I received in February of 2015. Had I received the invoice before May 2015, when my baby was born, I would have happily returned the unopened merchandise.Sincerely,[redacted]

[redacted] Please See Attached Documents [redacted]
Revdex.comPO Box 1000DuPont, WA  98327Revdex.com Complaint #[redacted]Dependable Medical Equipment dba [redacted] was contacted by a customer to receive a breast pump and bill her insurance. We are a durable medical equipment company who bills...

your insurance for medical equipment including breast pumps. We contacted our customer’s insurance company and we were told she was covered for a breast pump up to the standard allowable amount, according to her plan. The person we talked to was [redacted] on 2/26/2015 and the call reference number was [redacted].Later our customer emailed back to see if we were listed as in-network being based out of Seattle WA because she lives in TX. We called a second time to verify our contract status and asked if we were listed as an in network provider. Again we were told that because we were in-network with our local plan, we were in-network with them. The person we talked to this second time was [redacted] and the call reference number was [redacted].After we conveyed this information to our customer, she decided to go ahead with the order and we sent her a breast pump and billed her insurance. We received a denial on 5/15/15 and we called [redacted] of TX and was told they would honor the original quote based on the last phone call noted on her account saying we were in-network. The person we talked to in the claims department was [redacted] and call reference number was [redacted]. We were instructed to resubmit the claim and they would pay it.  We received another denial on 6/29/15 with the explanation:  “Program requirements as identified by the member’s contract have not been fulfilled.  This is the patient’s liability”.  The denial amount was $290 and we billed our customer as the insurance directed us to.We again called her insurance company and gave them the reference number of the phone call where they assured us we were in-network.  They agreed to reprocess the claim (reference #[redacted]) but only ended up paying $33.79 on 7/28/15 with the balance listed as patient responsibility due to the claim being processed as out-of-network.  The balance was transferred to our customer as it was listed on the Explanation of Benefits.  Our customer was sent an invoice for $256.21 on 8/10/15.[redacted] and Dependable Medical Equipment has offered to make a financial deal on with our customer several times but they were rejected.  We are happy to work with [redacted] on a reasonable financial arrangement.Sincerely,Sandra C[redacted]Customer Accounts ManagerDependable Medical Equipment

[redacted] Please See Attached Documents [redacted]
August 26, 2015Revdex.comPO Box 1000Dupont, WA  98327RE: [redacted]Dependable Medical Equipment, dba Our Perfect Baby was contacted by the Washington office of [redacted] to ask if we would start carrying breast pumps for their beneficiaries....

 We were informed that we could bill our local [redacted] as a Network provider including out of state beneficiaries.  Based on that information we sold hundreds of breast pumps to out of state beneficiaries.  9 months after we started submitting our claims and getting paid, we were informed that [redacted] had made a mistake and that we have to bill the state our patient lives in.  Once we began this process, we started receiving claim denials.  Upon inquiring we were told that each state must be separately contracted as a network Provider and that none of these states were open to new providers.  This was clearly not the information we were given up front when we started this business.  We have also been forced to refund [redacted] for thousands of dollars due to their misinformation.During the time we began billing out of state payers, a claim for our patient was sent to [redacted] of North Carolina.  It was denied as out of network with the balance as patient responsibility.  We billed our patient $290 but negotiated a discount with her when she called about the invoice which she willingly paid.  It is the responsibility of the beneficiary to understand their policy and verify for themselves what is covered.  We verified the eligibility for our patient and based on the incorrect information we were given by our local [redacted], we informed our patient that we believed it would be covered.  However there is no guarantee of payment until the claim is received, as the insurance plan will say.  We did not knowingly mislead our customers when we advertised and sent our products with free shipping.  Our client did not return the product she received.Dependable Medical Equipment is a licensed, fully accredited durable medical equipment provider with an “Exemplary Provider” status from our accreditation agency.Sincerely,Sandra C[redacted]Customer Accounts Manager

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

Complaint: [redacted]I am rejecting this response because:    I have now received 2 invoices, one in the amount of $290, the original invoice, and one in the amount of $256.21.   I have not received any other written correspondence as of today.     I still find it very concerning that DME did not involve me or provide me with any information regarding the problems with my account until I received an invoice for the full amount of $290.     As I am sure DME can understand, my initial reaction was to call and explain that I did not owe this amount because of DME telling me in writing it was covered in full by my insurance.     Yes, I am aware there are numbers on the back of my insurance card where I can call and discuss benefits coverage myself.   I find this argument silly, since DME assured me at the time I placed the order that I did not need to contact the insurance because part of their customer service is to do to that for me.   I have now sent DME 5 written letters (including this one I am mailing today) with an offer to return the equipment or pay 25% of my bill.    This offer has not changed since my first written correspondence with them on 7/21/15.    I have not received any written offers, despite DME claiming in their Revdex.com response that they offered to reduce my bill to 50% of the total.       I understand they sent an offer for $91.21 on 9/9/15 and I wait to receive that in the mail.    It will be the FIRST written offer I have received, other than being mailed invoices asking for the full amount due.
 
My insurance is still investigating the phone call reference numbers provided by DME once the Revdex.com correspondence began.   Again, this is information that should have been provided to me when this dispute began in the summer.
 
I will be rejecting the offer of $91.21.    Regardless of the outcome of the [redacted] investigation, I can understand the position that DME is in, that they believe they were provided false information by the insurance company.   Even though I disagree with the unprofessional manner and lack of written informative correspondence provided to me, my offer continues to be 25% of the total billed.
 When DME sends me an invoice in the amount of $64.05 I will be happy to mail them a check.    Until I receive an invoice in that amount, I request DME to stop calling me (as I have already asked 4 times for everything to be put in writing).     If DME wishes to continue this dispute over a difference of $30.16, then that is their choice.
 
 This is my last and final offer, as well as my final correspondence regarding the matter.       
 Sincerely,[redacted]