Friends and Family Hearing Health Care

We had sent in the application to Omin care for my brother in law [redacted] and were told he was denied due to he was not eligible for medicare or medicaidI had attached a copy of the application that they said the did not receive and a copy of the original notice telling them who at Omni care we spoke to and they said they had the application and it was deniedThe last message here I received was from Omni care stated they have the application I attached through Revdex.com and they would get back to usWe have not heard back anythingThey has been no agreement or conclusion to this issue

At Omnicare, we strive to meet all customer's expectationsI have spoken to [redacted] regarding this account on several occasionsOmnicare has billed the customer's insurance correctly and the customer is being billed for her copays and OTC medicationsThe customer has been receiving an invoice monthly with all the detailed charges listed but has yet to make a paymentI also spoke to the facility regarding this customer and they have spoken to [redacted] as well and advised her that she is responsible to pay the balance due to Omnicare If there are any further questions, please let me know

[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 If you and the business have reached an agreement and compliance is set for a future date, we trust the business will comply Please contact us after that time if the matter is not resolved as agreed and we will review the complaint and proceed accordingly.] Revdex.com: I have reviewed the response made by the business in reference to complaint ID [redacted] , and find that their proposed resolution is satisfactory to me Thank you.The information they require is as follows: Patient name: [redacted] Account Number: [redacted] Regards, [redacted]

At Omnicare we strive to provide the service to a customer as possible We apologize you are not satisfied at this time Upon reviewing the account, the resident has a third party commercial insurance plan and Medicaid, thus opting out of a Medicare Part D plan Unfortunately, due to the resident opting out of a Medicare Part D plan, Medicaid will not pay for the copays Also, for this reason, the nursing facility is not responsible for the copays either If you would like more information regarding this, or have any other questions, please feel free to contact out billing center at 1-800-644-or myself at heather.g***@Omnicare.com

We, at Omnicare, appreciate the opportunity to provide pharmaceutical care for you or your loved one We are committed to continually improving our processes in order to better serve you We apologize for the inconvience this may have caused you We have set this account up to be written off If you have any other issues or concerns, please contact me immediately Thanks for choosing Omnicare

Thanks for contacting Omnicare We take great care to ensure that each and every one of our customers are satisfied I have reached out and asked for your name to be removed from all future concerns on this account due to you not being the responsible party If you have any other concerns, please feel free to contact us

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] Again the reason for the complaint was because we were never given any directions on what the requirements were of policy on eligibility ( which I still have not received)You denial that you have only recently produced to me after stating you had never received an application ( which I provided to you a few messages ago) shows two reasons for denial ( which when I called to your home office in the area of [redacted] residency stated the reason for denial was because he did not get health coverage through medicaid)The fist is that you found assets which were not disclosedAll information was provided to you at the time of his applicationAt the time of application he was going through a divorce and the house ( Property) was being foreclosed in bankruptcy, 15317-ME-DE-file numberBut at know time did you request any information on the "assets" you had found and asked about themThe question was and still is answered correctlyThe second reason for denial was because he was not eligible for MedicaidIf [redacted] was eligible for Medicaid he would not need to have your help covering medication through your hardship program because Medicaid would have covered the medicationAlso if you had provided program and eligibility requirements this would have been stated, I find denying someone a hardship because they cant find another way to get it is an oxymoron Medicaid is a federal and state program which I'm very family with since I work for the program as a state employee in another state than to what [redacted] and I had applied for him This website will give you a little back ground in case you are not familiar with the programMost people think just because you have no income you are automatically eligible for Medicaid and the is not trueYou must first and foremost be categorically eligibleIf you don't meet any of the categories the you go no furtherSo of course he was not eligible he was a man without dependent not disabled or elderlySo to deny a hardship because he can get other insurance is ridiculousThat is what a hardship is because you cant assess other benefitsBut again if you had given us the requirements at the time of the application if that was your policy we would have known but we did not and still have not received your eligibility requirements or any policy an procedure about your hardship programI was told by the person on the phone that I spoke to and shared her information in past messages that you decided on a case by case bases and there are no written rules to go by so as far as i'm concerned based upon what she has told me and the fact that you still have not provided any policy on your program and for the most ridiculous reason for a Hardship denial I have ever heard that you don't truly have a program in place that you offerhttps://kaiserfamilyfoundation.files.wordpress.com/2013/05/mrbeligibility.p...⇄ Medicaid which is a federal and state programs means you have to fit into category first Child, Pregnant, Adults with children in house, Disabled, and elderly !!!!!!! Step one [redacted] does not qualifySo the buck stops there go don’t move on to income or any other eligibility requirements because you didn’t make it past the first requirement Unlike your program which gave no steps Medicaid denied himHence he could not get health coverage and this is why we applied for your hardship You have a hardship program that denies people for a hardship because they could not get other means to payIs there not something wrong with that? Categorical Eligibility Medicaid eligibility is limited to individuals who fall into specified categoriesThe federal Medicaid statute identifies over different eligibility categories for which federal matching funds are available.These statutory categories can be classified into five broad coverage groups: Children Pregnant WomenAdults in families with dependent children;Individuals with disabilitiesElderlyOf course, many of the elderly also have disabilities and could potentially meet the categorical eligibility requirement for Medicaid on the basis of their disabilities However, in order to avoid the administrative cost and burden associated with disability determinations, state Medicaid programs generally establish categorical eligibility for an elderly individual based on ageThe federal Medicaid statute also establishes some eligibility categories based on a particular disease or condition (e.g., tuberculosis, breast cancer.So in closing as I have stated in the beginning, there was no direct or correct communication given on your hardship program either by a written policy or by eligibility requirements ( which I have requested and still have not received), we completed the application accurately at the time and was truthful and that no one from Omnicare contacted us about assets or medicaidYour denial of a hardship to help pay for medication based upon not having other coverage to cover medications defeats the point of you having a hardship program at allAlso the fact again that you have no written rules or regulations on requirements to be eligible for the Omnicare hardship program leads me to believe that the program is only there as a front and does not service any clients or members I would like an explanation to the requirements to your program and the written policy and eligibility requirements to be accepted for your hardship programI do plan on sending this and all other other information I have gathered on your company in the unethical and unfair practice of the program you state you offer to the state level not only here in my state but in the state of Maine to make sure there is not insurance fraud in this process or insurance or civil rights violations Brenda ***

[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 If you and the business have reached an agreement and compliance is set for a future date, we trust the business will comply Please contact us after that time if the matter is not resolved as agreed and we will review the complaint and proceed accordingly.]
Revdex.com:
I have reviewed the response made by the business in reference to complaint ID ***, and find that this resolution is satisfactory to me.
Regards,
*** ***

Hello,
We have researched the complaint, and have resolved the situation for the customer. We apoligize for any and all inconvience they have incurred.
We have authorization from the facility to bill charges to *** *** *** for the time period of Jan
to June that *** *** *** had received. We have confirmed that she is set up to not receive any further medications from our pharmacy in Houston Tx
Thank you,
Holly V***
SrManager, National Billing Department

After reviewing the account and the medication return list from the facility, this was not credited due to the timeliness of the returns from the facility. Due to the inconvenience this has caused the customer, this account has been set up for write-off. This can take up to days to complete. If you have any further questions or concerns, please feel free to contact me

[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 If you and the business have reached an agreement and compliance is set for a future date, we trust the business will comply Please contact us after that time if the matter is not resolved as agreed and we will review the complaint and proceed accordingly.]
Revdex.com:
I have reviewed the response made by the business in reference to complaint ID ***, and find that this resolution is satisfactory to me.
Regards,
*** ***

Dear *** ***,
I am responding in regards to the concern filed on *** thru the Revdex.com with ID number ***. After reading the concern, I reviewed *** ***'s account thru Omnicare. The account was noted with the call you made to our collections department
on 1-4-asking for the balance due. We did receive payment in the amount of $on 1-12-and posted this to account number ***. In regards to the additional amount noted in the collection letter of $that you received on 3-11-16, this amount was for medications that were not timely billed to ***'s account upon the rebill to the *** insurance in November of 2015. These medications were rejected by *** for prior authorization at that time. Due to the untimely billing on Omnicare's part, our collection department is processing a write off of this account in the amount of $311.43. Collection efforts have also been ceased at this time. I apologize for the inconvenience this has caused
If you require any other assistance, please do not hesitate to contact Omnicare

Upon review of the hardship application, the customer was denied due to the following reasons:The resident was denied for Medicaid.The facility did not have him listed as a charity case.Found property listed under the residents name There are several factors that are considered when reviewing the hardship applications. Some of these factors include - income below 133% of the Federal Pverty level, monthly expenses in excess of income, Medicaid prescription coverage, cost-sharing obligations. If you have any further questions, please do not hesitate to contact us.Thanks!

At Omnicare we strive to offer the best customer experience possible. Our internal collections manager has been reviewing your account in regards to the comments on this request. She has reached out to the facility in regards to their medication return log to identify if the medications
were returned to Omnicare. Once this information is received, we will review the information and identify if the medications were returned and if a credit for returned medications needs to be issued. Once a decision has been made, I will reply to this concern

*** ***,
We have applied the appropriate adjustment of $to *** ***’s account. This should reflect the original settlement agreement that you entered into on her behalf during your conversation with our customer service representative on September 20,
Thank you for
bringing this issue to our attention
Respectfully,
Holly V***
National Billing Department
Omnicare, Inc

I have no desire to speak with them, I want everything in writing as they gave you information to begin with. And let me add I have not received a monthly statement again, so here we go as always, no statements and then they will send me a demand letter that they are stopping her medication which results in death. As I stated previously I want a written audit of the costs vsthe amount paid by ***, *** and *** *** *** so that I can verify each co-pay. Speaking with them is not going to solve anything other than they will fax me the statements that they neglected to mail and then we will repeat that same process never getting results or answers. Again, I have a concern when a Company in two years refuses to send monthly statements and has recently paid the Federal Government a million fine for overcharging *** and Consumers, as well as is under investiagation for kickbacks. As a person that worked in Finance in Banking for over years, presented financial seminars to Government Groups I take seriously my role in paying ***'s bills and especially in the verification of the charges

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,
*** ***I have no desire to speak with them, I want everything in writing as they gave you information to begin with. And let me add I have not received a monthly statement again, so here we go as always, no statements and then they will send me a demand letter that they are stopping her medication which results in death. As I stated previously I want a written audit of the costs vsthe amount paid by ***, *** and *** *** *** so that I can verify each co-pay. Speaking with them is not going to solve anything other than they will fax me the statements that they neglected to mail and then we will repeat that same process never getting results or answers. Again, I have a concern when a Company in two years refuses to send monthly statements and has recently paid the Federal Government a million fine for overcharging *** and Consumers, as well as is under investiagation for kickbacks. As a person that worked in Finance in Banking for over years, presented financial seminars to Government Groups I take seriously my role in paying ***'s bills and especially in the verification of the charges

[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 If you and the business have reached an agreement and compliance is set for a future date, we trust the business will comply Please contact us after that time if the matter is not resolved as agreed and we will review the complaint and proceed accordingly.]
Revdex.com:
I have reviewed the response made by the business in reference to complaint ID ***, and find that this resolution is satisfactory to me.
Regards,
*** ***

Ms***, Once again, I apologize that you were told in error that the application was denied. As far as the Director of Credit and Collections department could see, they had not received the application. I want to thank you for sending me the application so that it can go thru the review process appropriatelyI have forwarded the application on to our credit and collections department for review. This is the department that reviews Financial Hardship applications. I have asked them to inform me if the application has been approved or denied once they review the document. If additional information is needed, I will let you knowAlso, you will receive a letter in the mail if either the application is approved or deniedAs soon as I receive a response, I will contact you with the decision. I will also supply you the reason if the application is denied. I will outline the requirements for financial hardship also in my responseThanks, *** *** Tell us why here

Her reply said it all, I get statements sent to me after I call, that is correct, as I have been stating, I get a demand letter stating medication will stop unless payment is received, then I call, then they send me months of statements and of course since I have to make payment immediately, I have no time to review the statements or verify the balance. Calling their call center which is where I have to call also is time consuming and difficult to hold when I am at work. As I stated previously, since they have lied about having conversations with me, I want all communication with them in writing, as well as an audit of ***'s account