Friends and Family Hearing Health Care

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,
*** ***

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.With that in mind, upon reviewing the information on the account referenced in the complaint, I do not see
that the financial hardship application was received from the customer. In order for a member of management to review the application for hardship, please fax the applicaiton to *** or mail to *** ** *** *** *** *** ***. Upon receiveing the application, a member of managment will review and the customer will receive a letter in the mail explaining if the application was approved or denied.I apologize for the incorrect information that was received and it has been addressed with the management team.If you have any further questions, please contact Omnicare

Omnicare has adjusted the account to zero and has no intentions of reporting this matter to the credit bureaus. We consider this matter closed with no action to be taken further

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 belowI have attatched the so called application you have stated was not submitted to your Maine Omnicare office and in my complaint I was clear on who I spoke to in that office about the application and the complaint on was the reason of denialSo your response states clearly that you have not done your homework in making statements that the application was not receivedHere is a copy of the applicationCan you now explain your requirements for an application of a person with no income, no job, no health coverage at the time would be denied a hardship waver on medications? What are the eligibility requirements to be eligible for this hardship? Who would be eligible? Why was there no denial notice sent with the reason for the denial.Please completely read my complaint it clearly states we applied, I called after hearing nothing, was told it was denied, was told your company doesn't send out notices, was told he was denied because he was not eligible for Medicare or Medicaid ( This we knew because he is not old enough for medicare and he does not meet the category for eligibility for medicaid) that is the reason why people ask for hardships because they can't get health coverage, I was told that there is not policy for eligibility with Omnicare it is a case by case basesWhich means you pick and choose who you want to give it to with no rymhem or reason just a persons feelingThis is discriminationIf you offer a service then there should be a policy and procedure to go alone with the service so everyone follows the rule.So now that you have the application and I'm assuming you will read the complete complaint now so that you have all the facts straight so that you might be able to track down the application and find out the information within your own company to fix the issue.
[To assist us in bringing this matter to a close, we would like to know your view on the matter.]
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 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,
*** ***
I will keep these e-mails in case they try to attempt to try to send anything to the credit bureau Thank you for your assistance, *** ***

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,*** ***
Reponse: Were never sent a formal denial explaining any of the rules or eliglibity with income, assets, needed to be accepted for medical somewhere else first, When applied no documents were given to provide informationAs clearly as you can see on the application provided no question indicated to provide any of the information you have stated was the reason you had denied hardship and company sent no written information requestion this information nor did the company request to see if this information you denied applicate on was correct
Members property is in forclosure he owns nothing but then again this was not a questionasked on your application nor was it verified by your company to ask member and to verify this information found out by omnicare
Member did not meet catagory for Medicare or medicaidIncome is not the first eligibility requirment for medicaid it is a catorgory first such as pregnant, disabled, child, elderlyApplicatent did not meet those critiera and as again stated not rules or eligiblity was giiven to apllicated to no the rules of approvial with omnicare
If member could have had outside health coverage or receied medicaid they would not have to request a hardship from omnicare because they would have health coverage
Again the complaint was and still is you gave no written instructions with your applications, answers on application were answered at the time with the correct and currect information you requested, no followup mail or denial or request for information was requested and uintil this moment other than a verable denial in which we his family had to iniseant a call to the has been no communication from omnicare in any of this process
Omnicare has no policy and procedures, omnicare makes up the rules as they go along and does not giver accurate information to an applicatent and follows no communication at all in reguards to a programAn applicate is told to apply aND ANSWERS THE QUESTIONS ASK AND THEN they have no foundation on how what or where this application goes
By not haveing a clear policy and procedure in place about their hardship program their applicates are unformaed, unduly put through this type of stressful guessing game to determine what is going onAs first communication the company stated they didn't receive the application and if I did not keep a copy what proof would I have that they did receive it other than when I finally called I was smart enough to ask for the names of the people who I spoke to and yes they did have the application
This company is nothing but a sham and offers no help to applicates who apply for a hardship because there are no rules to follow and the rules change and you have no way of disputing because you didnt know what the rule was when appliying so they can deny you for any reason because not meeting eligibity but you never knew what the eligiblity was in the first placeAgain you application does not mention assts as a house not does it say have you applied or denied medicaid,
I'm still looking for a written statement on a denial or any communication from omnicare on the statusThe reason they don't send out denial notices is because they don't want written proof on why the were denied so that people cant come back on them to appeal and ask then how they can deny based on whatever the denial was because they have no policy or proceddure that they can say the applicate had when applying
I'm still waiting for a copy of a written deniual letter with the reasons *** ***s Hardship application was deniedYou can attach it to your next coraspondence to the reply along with the written eligibilty requirements for applicates who so aplly for your hardship programA copy of the policy and procedure on how and why on how a applicated is approved or deniedYou gave reasons in this communiocation on why he was denied so there must be information proved to the consumer providing them with the requirements of your program

I don't understand why they are not telling the truthI am really shocked by the response they gave. I only receive notices that they are terminating Pat's medication, then I have to call and ask for months and months of statements that represent the bill. I have to pay the bill immediately or face *** going without her medication which would result in death, in other words, no time to verify anything. They just paid a million fine assessed by the Federal Government for overcharging *** and consumers and are now being investigated by Congress for kickbacks. I am very concerned that *** is being over-charged. I would like an audit of her account to reflect what Omnicare submitted to each of her three (3) insurance companies to include what was covered by her Insurance Company. I am not the only person who has been involved with OmniCare, there are three of us, that can verify to this practice, three that have experienced the same exact practice by this company. Again, I want an audit of the charges, I want verification pf records as to the charges and payments or correspondence of co-pays from her three (3) Insurance Companies. I want to balance her account to verify the accuracy of the charges. I worked on Capitol Hill for years as the Vice President of a Financial Institution. I am very suspicious when a Company continues to send a Demand Payment Letter but never sends the monthly statements and again has recently had to pay a million settlement for overcharging *** and consumers, as well as outright lie about conversations with me and that they have always provided monthly statements. I certainly would not waste my time contacting Revdex.com if I was receiving statements. Sadly, one of my other concerns is the patients at various facilities that do not have someone assisting them. I feel strongly that an investigation into their charges and practices needs to be addressed

I have spoken to the customer on several occasions regarding her concerns. I tried to verify the address on file (which is the same address the collection letters gets sent to as well as the statements) and she did not have time for me to verify that information with her. Omnicare has sent her billing summaries when requested as to what was billed to the customer. As for what the insurance paid, that information is available to the customer on her EOB's from the insurance company. I have advised the customer when I have spoken to her, I would be glad to go over the billing information with her, and she has not taken the time to do so as of this date. Please let me know if there any further questions regarding this account

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,
*** ***

[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]

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 disclosed. All information was provided to you at the time of his application. At the time of application he was going through a divorce and the house ( Property) was being foreclosed in bankruptcy, 15317-ME-DE-028234305 file number. But at know time did you request any information on the "assets" you had found and asked about them. The question was and still is answered correctly. The second reason for denial was because he was not eligible for Medicaid. If [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 medication. Also 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 program. Most people think just because you have no income you are automatically eligible for Medicaid and the is not true. You must first and foremost be categorically eligible. If you don't meet any of the categories the you go no further. So of course he was not eligible he was a man without dependent not disabled or elderly. So to deny a hardship because he can get other insurance is ridiculous. That is what a hardship is because you cant assess other benefits. But 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 program. I 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 offer. https://kaiserfamilyfoundation.files.wordpress.com/2013/05/mrbeligibilit...⇄     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 qualify. So 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 him. Hence 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 pay. Is there
not something wrong with that?
Categorical
Eligibility Medicaid eligibility is limited to individuals who fall into
specified 5 categories. The federal Medicaid statute identifies over 25 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 age. The 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 medicaid. Your 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 all. Also 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 program. I 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 [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 1-800-644-1759 or myself at heather.g[redacted]@Omnicare.com.

I apologize I have not met your expectations.  The Director of Credit and Collections is now reviewing this case.  Can you please provide a telephone number you may be contacted at to discuss this in more detail?

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.

[redacted],
Thank you for bringing this to our attention.  We will gladly adjust off the $25.00 [redacted] fee on your mother's account and provide the credit for the returned medication.
However, we do not have your mother's name or account number to complete the process.   Please...

provide same so we can reconcile this matter.
Thank you,
Holly V[redacted]

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.

Omnicare values their customers and appreciates the opportunity to respond to the concerns forwarded to us from you on behalf of [redacted].
 
Omnicare of Northern IL provided medications to her Mother [redacted] at [redacted] in 2014.  Omnicare billed all applicable...

prescription drug coverage since her admission at [redacted].
 
Since [redacted] has asked us not to contact her regarding the outstanding balance and has provided us with updated information that indicates the patient had no estate or assets, we will adjust the account to zero.  In addition all written and verbal communication to [redacted] will cease.

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.They have not addressed the issue of price gouging and the return of on used medication 
[To assist us in bringing this matter to a close, we would like to know your view on the matter.]
Regards,
[redacted]

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]

I HAVE TALKED TO THEM BEFOR  AND SO HAS THE NURSING HOME.  THE NURSING HOME ALSO HAS NOTIFIED THEM THAT SOME SERVICE WITH THE COUNT PAY'S THE MEDICINE  AND ( HAS PAID IN THE PAST.   AGAIN  SHE  IS  94  YRS OLD  AND IN A MENTIAL HEALT UNIT.  MEDICARE AND MEDICADE AND  ( ?? )  ALL HER MONEY  (  S.S. ) GOES STRIGHT TO THE NURSING HOME.      "  NO OTHER MONEY IS AVAILABLE TO PAY ANYTHING "  OMNIE HAS BEEN TOLD THIS BY ME  AND THE NURSING HOME.I FEEL THAT  THIS IS JUST   THEM  HARRASING  ME .>>>>>>