Hearts Desire

On 1/8/2018 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 occurred. We did not disclose or discuss any health related information...

with the individual that answered Mr. [redacted]’s phone when a call was returned regarding oxygen delivery. Ms. [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 choice. She would also need to contact his MD to request orders to be faxed over to the new company. This 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 dispensed. She 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 provider.. This is a Medicare Regulation. The medical records release form was mailed to the patient by certified mail  on 1/8/2018 . On 1/25/2018 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 Mr. or 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 account. Although multiple copies of the medical records release form has been mailed to Ms. [redacted], Gould’s has yet to receive that signed document or a request from the physician to switch providers. Gould’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

SEE ATTACHMENT FOR ORIGINAL RESPONSE.
Here are the facts regarding the process for Ms. [redacted]'s power chair.
Ms.. [redacted]'s seating evaluation was done at[redacted] on 9/22/14. Her Face to Face evaluation was done 2 months later w/her doctor on 11/20/2014.
On 12/17/2014 we...

received the Face to Face notes but they didn't meet criteria for [redacted] so we contacted Dr. [redacted]'s office to let them know and to request amended notes. By 1/20/15 we were still trying to receive the updated office notes but had not been successful. Again on 1/27/15 we contacted the physician's office about sending the updated/corrected notes but again nothing arrived. All the while Ms. [redacted] was kept in the loop but of course assumed, unfortunately, we were not being completely honest with her.
Sometime within a month's period of time we had gotten the notes we needed and had sent the last of two documents to the doc for signature. On 3/2/15 we were waiting on the last document, the DPD, to be signed by the doctor. It was returned to us on 3/3/15. It was during this time that Ms. [redacted] thought we had already submitted our paper work to [redacted] and that I was lying to her. I was not lying and can only imagine that when I told her we had received information it meant to her that we received all that we needed. It's stated as such in [redacted] (our computer notes) on that date. It was Ms. [redacted]'s misunderstanding and I assure she was NEVER lied to or misled. I apologized to her but she would not take my word or my apology. She asked me what good would my apology do for her? On 3/4/15 we had submitted all documents to [redacted] ADMC (prior approval department) for review. We received a preliminary decision letter from them on 3/23/15 and they wanted additional information from the physician. I contacted the physician the same day and explained what was needed. The physician didn't return the document until April 17, 2015. On 4/27/2015 I resubmitted the new information to ADMC but did not hear back from them. I called and was told they never received the documentation from us (although I had proof of my fax cover that 45 pages went through on 4/27/2015). I resubmitted w/my fax cover sheet as proof hoping they would expedite faster!
Currently I am waiting on ADMC's final decision since re-submitting the amended information. [redacted]/ADMC only gives providers 2 attempts at getting the documentation correct. If we don't, the consumer is forced to wait 6 months to even try again. No other vendor in the state of KY can attempt to get him a wheelchair!!!
Hope this helps,
Thank you [redacted]

I spoke with on 2 occasions and have straighten** out his problem.   Thank you,  [redacted]

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 circuit. Thanks to this complaint we were able to repair the circuit. Mr. [redacted] has since received his supplies and will be called every 3 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