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Fred Bouma Company

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Reviews Fred Bouma Company

Fred Bouma Company Reviews (23)

[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.] Revdex.com: I have reviewed the response made by the business in reference to complaint ID 11754334, and find that this resolution is satisfactory to me Regards, Pamela [redacted]

After reviewing your account as well as all notes and talking with our billing supervisor we are past timely filing for your account and a claim will not be submittedBelow is a summary of our actions relating to your account;12/29/- Our benefits department contacted your insurance to obtain benefits and we were told that the insurance information we had on file was not correctA letter was sent as well as a phone call to you requesting updated insurance information1/8/- A follow up call was made an a message was left requesting a return call to provide updated insurance information1/9/- No reply was received from patient so a bill was sent to the patient requesting full payment as we cannot submit to insurance as the information we have is incorrect1/27/- Patient's husband called questioning the bill and he provided the same incorrect insurance info we had on fileWe had worked with BCBS for several months from this point in order to get the correct ID for the patient but we were still unsuccessful.8/13/- Another letter was sent to the patient requesting updated insurance information and we indicated that the patient would have days to respond with the correct insurance information or we would reach timely filing with BCBS and the balance would become the patient's responsibility9/15/- We had not received any reply from the patient and so a bill was sent with the full patient responsibility for the equipment10/13/- We received a voicemail to call the patient at the home numberWe called the home number and left a message for the patient to return our call.10/14/- Received a return call from the patient at which time the patient states she wanted an itemized billWe did inform her that if we had the correct insurance information she would not be responsible for the full billPatient stated she already paid this and needs an itemized bill to go over with her insurance before she pays us againPatient then provided an insurance policy number that started on 2/and what we were needing was the policy that was held during 12/when services were renderedPatient stated she would call BCBS and get the number and call us backAfter the call ended our benefits team contacted BCBS and was able to verify that the new insurance information provided was active and valid on 12/We are checking to see if we are within timely filing of patient's insurance to file a claimWe found out that per BCBS policy we are beyond timely filing and the claim will not be able to be submitted.10/20/- Patient called and wanted to know if her insurance paid, we explained that per her insurance policy we cannot submit the claim because it was after their timely filing period and that the balance of $ was now the patient's responsibility.10/28/- Patient called again and wanted to know if we would submit the bill even though it was past timely filing and per our policy and her insurance we would not be submitting itPatient stated that she had never received any phone calls or letters and she always answers her phoneWe apologized but informed her that we cannot submit a claim this late and that we will be sending her another bill today.11/2/– Patient’s husband called, he wanted to know the dates of service and the total billed, information was providedHe stated he was calling the carrier and would call us backLater that day a 3-way call from the Anthem provider service, Kinex and the patient occurred The situation was explained to the patient and AnthemThe patient’s husband was very upset and continued to argue with us and insisted that the policy numbers were given at the time of service and claims that they were valid and Kinex was at fault The dates and information were then given for when calls and messages were left as well as letters sent requesting the updated informationPatient’s husband was still arguing that we should resubmit to Anthem and Kinex explained that we will not submit untimely claims in this wayThe Anthem rep interrupted and informed the patient that he needs to either pay the bill or appeal with Anthem.11/3/– Another 3-way call with Anthem and the patient’s husband occurred; the Anthem rep said that timely filing was year however Kinex stated that in our contact is states daysKinex advised that we will not submit the claim because we did not get the correct insurance until October and the claim is now past timely filingPatient kept stating that he just doesn’t understand why we won’t submit the claimKinex advised that it was due to a lack of response within the window for which we are allowed to submit a claimKinex advised that if he wants to submit a claim to Anthem for reimbursement he is welcome to do soPatient’s husband requested Kinex mail a letter explaining why we won’t file and what timely is the Anthem rep also gave him instructions on how to file a member claimLetter was mailed to patient.After all of these documented incidents including calls with Anthem the patient was never denied speaking to a supervisor and we can gladly have one contact him if he prefers however, due to the timely filing window being closed we will not submit a claim to Anthem but the patient is more than welcome to do soInstructions were provided on 11/3/

Patient is correct that they are receiving a bill for $Per the Assignment of Benefit form signed by Mr [redacted] (attached) it stated that the Estimated Cost to patient is $if deducible has been metThe $was all applied to the patients in network insurance deductibleAlso noting that per #10, the patient understood that if their specific insurance plan requires any co-pays, co-insurance, or deductibles, they would be financially responsible for paying said balances.Per our BCBS contract, we are obligated to bill deductibles to the patients as it affects all other claims processing after.Thanks, [redacted] Operations Manager

[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.] 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. Regards, [redacted] ***

Hello Ms [redacted] ,I want to apologize for your situation and can tell you in all honesty that this confusion was not done on purpose and that our company is not in the business of "scamming the elderly." We have been in business for over years and pride ourselves in the high quality equipment we provide as well as the excellent customer serviceIn reviewing your account your service representative was correct in informing you that Medicare will cover your equipment for days however, she should have mentioned that this was from you date of surgery and not from when you started using the machine in your homeWe have employed your service representative for more than years now and this is the first time I have received any complaint from her regarding billing ethicsI can honestly say this was an honest mistake on her partHere is what we are doing to correct your issue;- We will be adjusting the billing dates and per our records you had called on 5/12/and spoke with our customer service department to schedule your pick up however, you did mention that you weren't finished using at this time but just wanted to make sure that it was scheduled so you would only be using for the covered period of time- In counting out days (including the day of surgery) this would bring your covered use time to 5/15/which is what we will use as your stop date since you had this conversation with our service representative regarding only using for the covered period of time.- We have also provided additional education to your service representative so that she is aware that coverage starts on the day of surgery and not when the patient starts using in homeThis will eliminate any similar situations going forward.I again apologize for the inconvenience and know that this was an honest mistake and we will ensure that it is corrected and prevented from occurring in the futureWe thank you for letting us be part of your post surgical rehab program and hope you have a speedy recovery

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID ***, and have determined that this does not resolve my complaint. For your reference, details of the offer I reviewed appear below.The fact that a Kinex medical sales person stated that the cost would be a MAXIMUM of $out of pocket and made NO mention of any other circumstances that would make that price change is clear case of bait and switch. A terrible sales tactic for a any company. After talking to a Kinex customer service representative, she stated that in fact that they have had MULTIPLE complaints because their sales people have been making these claims regularly. Please review our recorded phone conversation on 8/for proof. I can only hope that this will stop the company/sales people from making these claims and taking advantage of the elderly. This is truly a crime and needs to come to a resolution
Regards,
*** ***

[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.]
Revdex.com:
I have reviewed the response made by the business in reference to complaint ID ***, and find that It wasn't satisfactory to meExplanation followsi regret the decision Kinex reached. I would like to set the record straight.I have never been without insurance up until november 30,my husband and I were on the same policy for so many years, when he qualified for Medicare my insurance issued me a new policy number starting on December 1st2014just for me.I received the new card toward the end of December.I was never contacted to be told that they had problems with my insurance until months later.kinex claims that BCBS have a yearly policy that they do not accept a year old claims. My husband was on a three way phone call with Kinex rep and BCBS rep for the second time, BCBS agent requested that Kinex submits the claim since it hasn't been a year old case, then Kinex agent replied " it is our policy (Kinex) that we do not submit a claim after days" yet in their letter dated August 13'they requested from me an insurance update information before it reaching the timely filing with BCBS.I figured from December till August that would be months and not days, which contradicts everything Kinex said.also, at the end of their letter, they mentioned I was never denied speaking to a supervisor which is true, except that they were talking with my husband on the three way phone call with my BCBS repMy husband requested during that call to speak with a supervisor and the Kinex agent replied : " we have discussed this issue with our supervisor and there is no need to talk to a supervisor "This was said with BCBS agent on the line, which he heard everything.I am sure that this conversation was recorded from BCBS since it was a conflict.I hope that Kinex would treat their customers with better courtesy than they have shown methank you
Regards,
*** ***

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID ***, 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,
Shanon ***Dear Kinex Management, It is clear to me that you are not comprehending what I said about paying the difference. It was your employee who made that faults statement(Again listen to the recorded conversation.)I'm dissatisfied your employee clearly gave faults information from the beginning Employees I talked to lack the understanding of a non-covered waiver or an EOB and customer service. It is disheartening that Kinex won't take responsibility in the faults statements made by it's employees

Ms***, We have taken action and provided each person involved in your complaint additional training and educationThey are now all aware of how to properly explain the paperwork and process to each patientThis part has been addressedYou also were provided the paperwork and appended your signature which attests to you reading and agreeing to the standard terms.Please contact us to make a payment on the account at ###-###-#### or to setup a payment planThank you

Hello, I have looked into your account and the reason you are being billed is because there were non-covered products as well as co-insurance for covered products that were provided to youThe breakdown is as follows: $for co-insurance for covered items and $for the non-covered items
The $was also with us writing off additional dollars to honor the $estimated cost that was quoted to you at the time of equipment setupI checked with your service rep as well as her supervisor and they give each patient the same explanation of their insurance coverage and that is to let them know about the estimated cost of $after their deductible has been metI know you had emailed us on 4/12/inquiring about your account and you were sent copies of your signed paperwork. The $is correct and you can call us at ###-###-#### option and option again to make a payment or to setup a payment planThank you

I apologize for the inconvenience as I know it can take time for an insurance to properly and fully process a claimOnce we identified that a refund was to be issued we had attempted to process it on the card that
was provided however, due to the fact that it was beyond days we were unable to as those cards are wiped from our system for risk purposesWe attempted to call you on 8/and 9/in order to get the card number to process the refundWe had not received a return call with this card numberIn an effort to return funds we have chosen to issue a refund check which will be cut from our accounts payable department today 9/and you can expect this to arrive to you early next weekIf this is not received by the middle of next week, please call me back directly and I would be happy to work with you. Leann *** ***Direct Line ###-###-####

Hello,After having our *** *** look into your account I believe I can properly explain what is happeningWe submitted claims for the equipment your daughter used, the first was for the covered period of time she used the CPM and the second was for the non-covered items being providedWe
received the first EOB back and yes, you are correct that outlines that there is no patient responsibilityThe second EOB that came back from our second claim does outline that the claim was denied and that it's the provider's responsibility to obtain paymentWe are able to do that through the non-covered waiver you signed when the equipment was deliveredIt states that if the equipment is not covered by your insurance you would be responsible for an estimated cost of $You can feel free to call your insurance and provide them with the claim number I'm referring to: *** the item code is EThis is a non-covered code through your insurance provider and we did inform you of this by providing a non-covered waiver at the time the equipment was delivered.You can call us at ###-###-#### option 1, and option again in order to make a payment or to arrange for a payment plan

Hello, We have reviewed your son's account and we had submitted a claim to his policy through IA Medicaid within the timely filing periodThe issue was that it was denied incorrectly and we have been working with them to get it reprocessed so that it can be paid as we expect this code to be
paidThere is a current balance of $on the account and we will continue to work with IA Medicaid as this is where the issue is spawning from.I'm sorry for the confusion and frustration but I did speak with the *** *** on your son's account and can assure you can only members of the billing management staff will be handling this going forwardPlease allow days of reprocessing time by your insurance and then a new statement will be generated by our team here and sent out. Please let me know if you have any additional questions

After reviewing your account as well as all
notes and talking with our billing supervisor we are past timely filing for
your account and a claim will not be submitted. Below is a summary of our
actions relating to your account;12/29/14 - Our benefits department contacted your insurance to
obtain...

benefits and we were told that the insurance information we had on file
was not correct. A letter was sent as well as a phone call to you requesting
updated insurance information1/8/15 - A follow up call was made an a message was left
requesting a return call to provide updated insurance information1/9/15 - No reply was received from patient so a bill was sent to
the patient requesting full payment as we cannot submit to insurance as the
information we have is incorrect1/27/15 - Patient's husband called questioning the bill and he
provided the same incorrect insurance info we had on file. We had worked with
BCBS for several months from this point in order to get the correct ID for the
patient but we were still unsuccessful.8/13/15 - Another letter was sent to the patient requesting
updated insurance information and we indicated that the patient would have 30
days to respond with the correct insurance information or we would reach timely
filing with BCBS and the balance would become the patient's responsibility9/15/15 - We had not received any reply from the patient and so a
bill was sent with the full patient responsibility for the equipment10/13/15 - We received a voicemail to call the patient at the home
number. We called the home number and left a message for the patient to return
our call.10/14/15 - Received a return call from the patient at which time
the patient states she wanted an itemized bill. We did inform her that if we
had the correct insurance information she would not be responsible for the full
bill. Patient stated she already paid this and needs an itemized bill to go
over with her insurance before she pays us again. Patient then provided an
insurance policy number that started on 2/15 and what we were needing was the
policy that was held during 12/14 when services were rendered. Patient stated
she would call BCBS and get the number and call us back. After the call ended
our benefits team contacted BCBS and was able to verify that the new insurance
information provided was active and valid on 12/14. We are checking to see if
we are within timely filing of patient's insurance to file a claim. We found
out that per BCBS policy we are beyond timely filing and the claim will not be
able to be submitted.10/20/15 - Patient called and wanted to know if her insurance
paid, we explained that per her insurance policy we cannot submit the claim
because it was after their timely filing period and that the balance of $250
was now the patient's responsibility.10/28/15 - Patient called again and wanted to know if we would
submit the bill even though it was past timely filing and per our policy and
her insurance we would not be submitting it. Patient stated that she had never
received any phone calls or letters and she always answers her phone. We
apologized but informed her that we cannot submit a claim this late and that we
will be sending her another bill today.11/2/15 – Patient’s husband called, he wanted
to know the dates of service and the total billed, information was provided. He
stated he was calling the carrier and would call us back. Later that day a
3-way call from the Anthem provider service, Kinex and the patient occurred.
The situation was explained to the patient and Anthem. The patient’s husband
was very upset and continued to argue with us and insisted that the policy
numbers were given at the time of service and claims that they were valid and
Kinex was at fault.  The dates and
information were then given for when calls and messages were left as well as
letters sent requesting the updated information. Patient’s husband was still
arguing that we should resubmit to Anthem and Kinex explained that we will not
submit untimely claims in this way. The Anthem rep interrupted and informed the
patient that he needs to either pay the bill or appeal with Anthem.11/3/15 – Another 3-way call with Anthem and
the patient’s husband occurred; the Anthem rep said that timely filing was 1
year however Kinex stated that in our contact is states 90 days. Kinex advised
that we will not submit the claim because we did not get the correct insurance
until October and the claim is now past timely filing. Patient kept stating
that he just doesn’t understand why we won’t submit the claim. Kinex advised
that it was due to a lack of response within the window for which we are
allowed to submit a claim. Kinex advised that if he wants to submit a claim to
Anthem for reimbursement he is welcome to do so. Patient’s husband requested
Kinex mail a letter explaining why we won’t file and what timely is the Anthem
rep also gave him instructions on how to file a member claim. Letter was mailed
to patient.After all of these documented incidents
including calls with Anthem the patient was never denied speaking to a
supervisor and we can gladly have one contact him if he prefers however, due to
the timely filing window being closed we will not submit a claim to Anthem but
the patient is more than welcome to do so. Instructions were provided on 11/3/15.

[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.]
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. 
Regards,
[redacted]

I expect immediate corrective action with the refund credited back to my card.

Hello Ms. [redacted],I want to apologize for your situation and can tell you in all honesty that this confusion was not done on purpose and that our company is not in the business of "scamming the elderly." We have been in business for over 30 years and pride ourselves in the high quality equipment...

we provide as well as the excellent customer service. In reviewing your account your service representative was correct in informing you that Medicare will cover your equipment for 21 days however, she should have mentioned that this was from you date of surgery and not from when you started using the machine in your home. We have employed your service representative for more than 3 years now and this is the first time I have received any complaint from her regarding billing ethics. I can honestly say this was an honest mistake on her part. Here is what we are doing to correct your issue;- We will be adjusting the billing dates and per our records you had called on 5/12/16 and spoke with our customer service department to schedule your pick up however, you did mention that you weren't finished using at this time but just wanted to make sure that it was scheduled so you would only be using for the covered period of time- In counting out 21 days (including the day of surgery) this would bring your covered use time to 5/15/16 which is what we will use as your stop date since you had this conversation with our service representative regarding only using for the covered period of time.- We have also provided additional education to your service representative so that she is aware that coverage starts on the day of surgery and not when the patient starts using in home. This will eliminate any similar situations going forward.I again apologize for the inconvenience and know that this was an honest mistake and we will ensure that it is corrected and prevented from occurring in the future. We thank you for letting us be part of your post surgical rehab program and hope you have a speedy recovery.

Ms. [redacted], I had a chance to look into your account and I do see that originally the claim was denied but after reprocessing your insurance did pay the allowable amount of the claim which did leave a $0 responsibility to you. We have your account in our queue to issue a full refund of $250. My...

apologies that this has not been completed sooner as we are behind on our workload and are training new staff in that department. Please rest assured that you will receive a full refund for the $250 you had paid. Thank you and please let me know if you have any additional questions.

[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.]
Revdex.com:
I have reviewed the response made by the business in reference to complaint ID 11754334, and find that this resolution is satisfactory to me. 
Regards,
Pamela [redacted]

Dear Mr. [redacted], I have reviewed your chart and our benefits department did in fact reach out to obtain pre-authorization for your medical equipment. Recently your insurance policy has changed and as of 2/27/15 when we were able to obtain the benefits, the durable medical equipment you received is no...

longer a covered benefit. Our service representative who provided the equipment to you has been with our company for many years and has received proper education in explaining all paperwork to the patient at the time of setup. There is no "contract" in which you enter in to and certainly does not require a lawyer to decipher the verbiage. The form is an Assignment of Benefits which is a 1 page sheet that explains that we will submit a claim to your insurance on your behalf and if your insurance does not pay for the equipment being prescribed you may be responsible for the $200 out of pocket. I would be happy to send you a copy of what was signed on 2/4/15 which explains the items listed above.With that being said we have also worked with your local service representative to make him aware of the changes with the insurance policy and that he should never be telling a patient that their equipment is 100% covered and that they will not receive a bill based on the situation you are describing. We are not trying to be deceitful in any way but trying to provide you with the most information regarding your coverage as we can. Thank you.

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Address: 39 Fuller Ave NE, Grand Rapids, Michigan, United States, 49503-3642

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