Hearts Desire

On 1/8/Gould’s received a call from Ms [redacted] ***She spoke with our Sr Manager [redacted] was informed that she had reviewed all of the notes on her [redacted] ’s account and that a HIPAA Violation had not occurredWe did not disclose or discuss any health related information with the individual that answered Mr***’s phone when a call was returned regarding oxygen deliveryMs [redacted] stated that her [redacted] wants to change companies and was told she or Mr [redacted] would need to sign the proper release of medical documentation so we could send her [redacted] 's medical records to the company of their choiceShe would also need to contact his MD to request orders to be faxed over to the new companyThis new order would be required for a new setup of Oxygen with the new provider as in the State of KY as it is considered a drug and requires a prescription to be dispensedShe got very upset and stated we were trying to hold her [redacted] hostage [redacted] advised that all we required was the signed release form and again advised that she needed to call his MD for the new order to be sent to their requested providerThis is a Medicare RegulationThe medical records release form was mailed to the patient by certified mail on 1/8/On 1/25/A State Agency Representative, which we had summoned, came to Gould’s Dutchmans Lane location with a records release form, requiring us to provide them copies of all of Mr [redacted] ***s medical records and account notes for his Oxygen and Wheelchair request (W/C was still pending delivery due to need for Face to Face notes and Written Order Prior To Delivery as required by insurance) Gould’s Sr Manager, [redacted] printed all the requested patient records while the State Agency Representative waited in her office [redacted] handed him the printed records A copy of the Gould’s records request to be signed by Mror Ms [redacted] was also given to the State Representative so they could take that to the family It was explained and understood by the State Agency Representative that Gould’s could not provide a copy of the records to the family or any other DME provider without a signed release form from the family Gould’s retained a copy of the State’s request letter for our files and it has been scanned into the patient’s accountAlthough multiple copies of the medical records release form has been mailed to Ms***, Gould’s has yet to receive that signed document or a request from the physician to switch providersGould’s has continued to provide oxygen services to Mr [redacted] as requested by the family since the initial complaint and no services have been denied Sincerely, [redacted] ***Owner

Regarding the subject complaint, I spoke to [redacted] today, and apologized for the difficulty she had in getting the C-pap supplies for her husband Apparently we had a glitch in the telephone transfer system to our call center which handles our c-pap replenishment supply program Because of Ms [redacted] ’s complaint in trying to reach them, we looked into this and found that the telephone carrier had a faulty circuitThanks to this complaint we were able to repair the circuitMr [redacted] has since received his supplies and will be called every months by our call center for the replenishment of his c-pap supplies within the limits of his health insurance regulations Our aim is to make Mr [redacted] and every patient we serve a satisfied customer of Gould’s Thank you, [redacted] [redacted] ***, President

[redacted] I am in receipt of this complaint and I apologize for the oversight that our billing personnel made on this accountAs a result of the reduction of payments by Medicare and the Insurance Companies for equipment dispensed to patients, we have had to outsource our private pay receivablesAt the time of this particular transaction we were in the process of transitioning to this outsourced vendor, who is responsible for collecting our private pay receivables So when Mr [redacted] called to explain that he didn’t owe the $17.88, the message was not relayed properly to our outsourcing company, in spite of our personnel who took the calls thought that they were relaying the correct information Again, I apologize for this error and Mr [redacted] ’s inconvenience and his account has been properly credited and his balance is zero Thank you for bringing this to my attention [redacted] ***, President [redacted]

I spoke with on occasions and have straighten [redacted] out his problem Thank you, [redacted]

Revdex.com: I have reviewed the response made by the business in reference to complaint ID [redacted] , and have determined that this proposed action would not resolve my complaint For your reference, details of the offer I reviewed appear below I took my [redacted] to the Hospital today to have a procedure done, and since I had been told no problem on the return and to ask for [redacted] I felt all would be taken care ofI went in and still had my [redacted] in the car and parked where I could see ***As soon as ** [redacted] found out why I was there, she went around to every other customer and made me wait for minutes before I finally asked her againShe was hateful about it and made me feel awful that I had to bother herShe had a smart mouth and treated me like dirtI WILL never go back to that store again and I will make sure that all of my mother's friends don't make the mistake eitherCustomer Service with ** [redacted] was non existantWhat a horrible experience Regards, [redacted] ***

Revdex.com: I have review [redacted] the response made by the business in reference to complaint ID [redacted] , and find that this resolution would be satisfactory to me I will wait for the business to perform this action and, if it does, will consider this complaint resolv** Regards, [redacted] THANK YOU Revdex.comFor Revdex.com help, it's a shame it had to come to me filing an complaint to get help When I did ask [redacted] for help at the Gould's store on servile occasion/months I believe that Mr [redacted] Gould help fix the problem for me and others in the future in there stores.Also would like to point out I know Kentucky is a one-party state for Eavesdropping How ever this doesn't apply to a business Mr [redacted] Gould call [redacted] me on my cellphone and didn't advis [redacted] me the phone was being record [redacted] until haft way through the call it came up about me not getting a call form Gould's he said the had proof of a call to my house I had nothing on my caller ID of same Someone must have answer the phone on the first ring However their was no beeping noise/tone to let me know of same that is requir [redacted] by law ether see attachments I feel like their was an Eavesdropping violation occur during his phone call to me Please correct me if I wrong on this THANK You again Revdex.com and [redacted] Gould ***

To Whom it May Concern, Ms *** received a knee walker rental on 8/18/from our *** locationOn 9/7/the patient returned and rented a second knee walkerBoth items are a rental of $per month plus tax totalling $eachAt the time of the initial rental on 8/18/
Ms *** signed a Automatic Payment Authorization Form providing Goulds permission to process open invoice charges as they generate during the month rental cycleOn 10/31/both knee walkers were returned to the *** locationThe pickup ticket was keyed in the system but it did not process fully until hours laterIn the meantime the $charge for one of the knee walkers (original date of service 9/7/2017) automatically process out of the autopay system at 5:29am on 11/1/This withdraw was indicated to take place on this date on the statement mailed to the patient on 10/12/This charge would have been reflected on Ms Ames’s account on 11/3/The return of the product and the charge passed each other during that hour periodThe first rental that began on 8/18/which then makes the day date of the monthly billing the 18thMonths 8/18/to 9/17/= $and was paid on 8/18/in the office at the time of the rentalThe second month rental was 9/18/to 10/17/= $and was paid on 10/11/through autopayThe third month (consider the item return of 10/31/2017) was 10/18/to 10/31/The pro-rate of this item is $per day plus tax which equals $We orignally charged $for this item and on 12/1/refunded the difference of $The second knee walker began on 9/7/which then makes the day date of the monthly billing the 7thMonths 9/7/to 10/6/= $and was paid on 9/7/in the office at the time of the rentalThe second month (consider the item return of 10/31/2017) was 10/7/to 10/31/The pro-rate of this item is $per day plus tax which equals $We originally charged for this item via autopay $and on 11/8/refunded $The refund for this item should have been $total which means we additionally own the patient a refund of $This refund of $has been processedThe total refund provided to the patient on both of these items was $We greatly aopogize for this inconvenienceThere are no current outstanding charges on this accountSincerely, *** *** Billing Manager *** ***

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*** *** *** Patient received PAP/Humidifier with supplies setup on 11/5/at Dutchmans Lane. To Whom It May Concern,We spoke with Mr*** regarding his
complaintAlthough he has been a patient of Gould’s for many years he is frustrated with the recent customer serviceHe providing me with great detail that we will use to re-train and educate our team for the best customer service experience possibleI explained the billing processes and he understandsHe expressed that he is pleased with Gould’s Respiratory Therapists and has always had a good experience with themWe appreciate Mr***’s feedback and assistance in resolving this concern with Gould’s.Sincerely,*** ***Chief Financial Officer Goulds Discount Medical, IncDutchman's LaneLouisville KY

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID ***, and find that this resolution would be satisfactory to me. I will wait for the business to perform this action and, if it does, will consider this complaint resolved
Regards,
*** ***

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID ***, and have determined that this proposed action would not resolve my complaint. For your reference, details of the offer I reviewed appear below
[I am in receipt of your replyUnfortunately, I do not agree with you assessmentAs you know, on my behalf, my daughter tried to get in contact with you directly back in and was told that you were retiredI am glad to see you are back running the businessThere was a complaint filed with Revdex.com in about customer service at that time addressed to *** Gould.In reference to the bed bugs issue, I have witnesses that will sign affidavits that bed bugs were found in the wheel chair that was sent to me back in August As you know I sent *** Gould a letter back in December, with no reply (see attached).As far as the Medicare taking up to months....in reference to the new chair, it wounds untrue based on the circumstances around my caseAfter several calls to Gould's, I finally got in contact with *** stated that the paperwork had been sitting for weeks and did not understand why it had not been processedI had my daughter, ***, to call *** and the process starting moving forwardI'm not sure how long that I would have to wait, if I would not had my daughter to intercept. As you know, there have been several incidents around your personnel not following up around my old wheelchair.Lastly, after viewing the recent customer reviews on the Revdex.com website, there seems to be continual issues with you company.I respectfully decline your reply.Mrs*** ***
Regards,
*** ***see attachment for originals

From* ** *** *** *** *** *** *** *** ** *** *** *** *** *** *** *** *** *** * *** *** *** ** *** *** *** *** * *** *** *** ***
I just received your complaint about the walker tray that you wanted to return to our store without
having your receipt. Our store policy is that we will accept most ite** (except certain toilet-related ite**) for return of money within days with a proof of purchase receiptThe primary reason for this is that many people have purchased ite** elsewhere and have returned them to us for money back. The secondary reason is that our computer software requires a coded receipt of proof of purchase before a refund can be made However, we take each customer’s situation into consideration and our retail manager has authorization to make that exception in special cases where a return is warranted without proof of purchase Our retail team member should have called for the manager to make that decision, unless she wasn’t available at the time
Therefore, I will be happy to refund your money ($26.70) if you will return the tray to our *** Ln store and ask for our retail Manager, *** ***, who will take care of the transaction
I’m sorry for the inconvenience that this has caused you and hope that we can serve you better in the future
** ***, President
*** *** *** *** *** ** ***
502-491-

Goulds Discount Medical Patient: [redacted] Patient ID: [redacted] Complaint ID: [redacted] To Whom It May Concern, We have reviewed the complaint notice and the account with Gould’s for Mr. [redacted]. Mr. [redacted] was contacted by Gould’s in regards to supply replenishment for his PAP machine in February 2016....

He states he asked questions regarding the supplies and one of those was ‘were all supplies covered by insurance at no cost’. He said that he was told yes they would be covered at no cost.  When the claim billed to his insurance they applied the allowed charges of $62.32 to his annual deductible of $1,000.00. Although the insurance did cover the supplies the patient states he specifically asked if they would be covered with no charge to him and was told yes. We will be using this information as a re-education tool for our team to better detail the deductible and copay information to our patients. We have contacted Mr. [redacted] regarding this concern and after reviewing all information have agreed to adjust his account of the $62.32. Sincerely, [redacted] Goulds Discount Medical, Inc. 3901 Dutchman's Lane Louisville KY 40207   [redacted]
[redacted]  [redacted]
[redacted]  [redacted]

[redacted]  [redacted]
Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and find that this resolution would be satisfactory to me.  I will wait for the business to perform this action and, if it does, will consider this complaint resolved.
Regards,
[redacted]

Subject: Revdex.com Complaint # [redacted] Thank you for bringing this complaint to my attention.  After receiving this complaint I have conferred with my Service Manager, our Sanitation Personnel and our Power Wheelchair Technician in order to answer this letter.  [redacted] applied...

for a new Power Wheelchair in August, 2015.  The process of getting evaluated and approved by Medicare is a lengthy process which sometimes takes 5 to 6 months or more.  In the meantime, we , on occasion “ voluntarily lend” a Power Wheelchair to a patient while this evaluation process is going on to help them through the process.    Over the years we have worked very diligently with Ms. [redacted] to ensure her needs and comfort were being met.  In the past, we have exclusively loaned MS. [redacted] that same Power Wheelchair on four to five other separate occasions while her equipment was being repaired.  Because of her particular physical needs that particular loaner Power Wheelchair was the only one she could use and was not used by anybody else. Each and every time a piece of equipment comes to our facility from a person’s home it is thoroughly chemically cleaned, sanitized and exterminated for any living organisms.  We have been in business for over 25 years and we use a very effective means of sanitation and extermination process of any bugs encountered.    Ms. [redacted] loaner wheelchair was, indeed , properly sanitized and inspected each time prior to it being delivered to her home.  We know that bed bugs are a real problem in peoples’ homes today and that’s why we are so careful in our sanitation process. I am terribly sorry that Ms. [redacted] has had this terrible problem with bed bugs.  I do not see how the bed bugs emanated from our Power Wheelchair and will not take responsibility for them.   In the over 25 years that Gould’s has been in business and the hundreds of thousands of pieces of equipment that we have provided to patients we have NEVER encountered this complaint from a patient in the past.   We look forward to taking care of Ms. [redacted] and her needs in the future and wish her well. Very truly yours, [redacted], President 3901 Dutchmans Ln, Suite 100 Louiville, Ky 40207 [redacted]

Revdex.com:
I have review** the response made by the business in reference to complaint ID [redacted], and find...

that this resolution would be satisfactory to me.  I will wait for the business to perform this action and, if it does, will consider this complaint resolv**.
Regards,
[redacted]
THANK YOU Revdex.comFor Revdex.com help, it's a shame it had to come to me filing an complaint to get help.  When I did ask** for help at the Gould's store on servile occasion/months.  I believe that  Mr ** Gould  help fix the problem for me and others in the future in there stores.Also would like to point out.  I know Kentucky is a one-party state for Eavesdropping.  How ever this doesn't apply to a business.  Mr ** Gould call** me on my cellphone and didn't advis** me the phone was being record** until haft way through the call it came up about me not getting a call form Gould's he said the had proof of a call to my house.  I had nothing on my caller ID of same.  Someone must have answer the phone on the first ring.  However their was no beeping noise/tone to let me know of same that is requir** by law ether see attachments.  I feel like their was an Eavesdropping violation occur during his phone call to me.  Please correct me if I wrong on this.   THANK You again Revdex.com and ** Gould.   [redacted]

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and find that this resolution would be satisfactory to me.  I will wait for the business to perform this action and, if it does, will consider this complaint resolved.
Regards,
[redacted]

[redacted]
[redacted]
[redacted] The details of this matter are as follows: Complaint Involves: Billing or Collection Issues ...

      To Whom It May Concern,   I have reviewed the account and outstanding private pay balances due for Mr. [redacted], account number [redacted]. The patient received a brace, a BIPAP machine (rental) and BIPAP supplies (purchase) from Gould’s for services dates 11/6/2014 to 5/4/2016.  Mr. [redacted] has Medicare primary with a secondary insurance of Physicians Mutual. All medical equipment and/or supplies billed to Medicare on Mr. [redacted]’s behalf were assigned a billing code (by the manufacture of that product) that is identified as a HCPCS code. Medicare’s reimbursement on the approved HCPCS codes is 80% of their allowed amounts. The difference between Gould’s charge amount and Medicare’s approved allowed amount is never billed to the patient. That amount which is called a contractual adjustment is automatically adjusted once Medicare processes their payment. The secondary policy through Physicians Mutual has an annual deductible of $2,180.00 that has to be met before they will begin covering the 20% that is not covered by Medicare. Medicare covers 80% of durable medical equipment / supplies after their annual deductible which although it has increased slightly each year is currently $166.00 for the 2016 calendar year. When a claim is filed with Medicare they will automatically forward the secondary balance they deem payable to Physicians Mutual on the patient’s behalf. Physicians Mutual has process all of the secondary claims for Mr. [redacted] and applied them accordingly to his annual deductible.   I confirmed with Medicare on 9/7/2016 that the balances attached are accurate according to their policy guidelines for services rendered by Gould’s. Medicare states that Gould’s is only able to bill the patient the amount that is listed in PT RESP ( patient responsibility) section on the explanation of benefits unless there is a secondary policy that covers and reimburses those charges. As Mr. [redacted] requested I have cancelled the sales order that was recently generated for new BIPAP supplies.  At this time his total balance private pay due with Gould’s per Medicare is $267.81. There are no late fees associated with this balance due. Mr. [redacted] spoke with two employees from the Billing department at Gould’s that explained the reason for the private pay balances due. We understand the patient’s strong frustration with having to pay out of pocket for items that are covered by insurance but there are few insurance policies out there these days that do not have a deductible to meet before they begin to reimburse.  All of the Medicare EOB’s associated with the balance due were faxed to the patient on 9/6/2016 at 3:21 pm as requested by Mr. [redacted]. I emailed Mr. [redacted] on 9/7/2016 detailing his account information and attached his Medicare EOB’s that reflect what Medicare deems is the patient responsibility. I also mailed these to the patient for his records.   If any further information is required please feel free to contact me.   Sincerely,     [redacted] Billing Manager Goulds Discount Medical [redacted]

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID[redacted], and have determined that this proposed action would not resolve my complaint.  For your reference, details of the offer I reviewed appear below.
I took my [redacted] to the Hospital today to have a procedure done, and since I had been told no problem on the return and to ask for [redacted] I felt all would be taken care of. I went in and still had my [redacted] in the car and parked where I could see [redacted]. As soon as **. [redacted] found out why I was there, she went around to every other customer and made me wait for 20 minutes before I finally asked her again. She was hateful about it and made me feel awful that I had to bother her. She had a smart mouth and treated me like dirt. I WILL never go back to that store again and I will make sure that all of my mother's friends don't make the mistake either. Customer Service with **. [redacted] was non existant. What a horrible experience.
Regards,
[redacted]

To Whom It May Concern, The following is in response to complaint ID [redacted]  Gould’s received a referral from sleep lab for PAP setup on 9/26/2016. Insurance was verified and benefits obtained. When our CSR’s call Anthem for benefits/verification they are tal[redacted] to...

whatever state that patient’s group plan is out of. For example Mr. [redacted] has alpha pre-fix WMW which is [redacted]. [redacted] Anthem is based out of [redacted].Mr. [redacted] lived in Kentucky at the time of the setup. Anthem of Kentucky requires us to rent to purchase the PAP. If this patient lived in [redacted] and we were a DME provider in that state then yes we could rent or purchase the machine. Because this patient lives in Kentucky then these claims must process through Anthem Kentucky and adhere to the Kentucky guidelines of rent to purchase.  We cannot bill these claims directly to Anthem [redacted] as they will just kick them back to Kentucky. It can get really confusing especially for the patient. The patient will call the phone number on their card which is the state their plan is based out of. In this patient’s case it is [redacted]. Their customer service rep will give you their state’s guidelines not ta[redacted] into consideration that they live in Kentucky and must adhere to Anthem Kentucky processes. Not all reps at this payer realize that and therefore do not provide clear information. I contacted Mr. [redacted] and discussed this information and explained that our CSR also was not clear on this process with Anthem and therefore offered a rent or purchase option in error. I thanked him for reaching out as this allows us to re-educate our intake staff on exactly how to handle these specific referrals for Anthem PAP patients that have out of state group plans. I explained that after discussing with the owners, Gould’s will accept the payments we received thus far by the payer and patient’s copays as payment in full. Gould’s will honor this because according to the explanation our CSR provided and the signed documentation on file he had no expectation it would be anything except a purchase at the time his deductible was met in 2016.  A refund of $162.28 was processed to the patient. Mr. [redacted] thanked me for handling this situation and providing a resolution that we both agree with. Sincerely,[redacted]Billing Manager

[redacted] I am in receipt of this complaint and I apologize for the oversight that our billing personnel made on this account. As a result of the reduction of payments by Medicare and the Insurance Companies for equipment dispensed to patients, we have had to...

outsource our private pay receivables. At the time of this particular transaction we were in the process of transitioning to this outsourced vendor, who is responsible for collecting our private pay receivables.  So when Mr. [redacted] called to explain that he didn’t owe the $17.88, the message was not relayed properly to our outsourcing company, in spite of our personnel who took the calls thought that they were relaying the correct information.    Again, I apologize for this error and Mr. [redacted]’s inconvenience and his account has been properly credited and his balance is zero.   Thank you for bringing this to my attention. [redacted], President [redacted]
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