Kinex Medical Company

My name is Terry. I'm a disabled vet. I had a heart issue and went into a local emergency room on July 22, 2022. There I gave them both my VA insurance card and my Wellmark insurance card and was told, as always, all bills would go through the VA. I have been getting an invoice from Kinex for $16.38 for "ABDUCTRESTRAINER CANVAS &WEB OTHER PR" .
I have called their billing department several times. I always wait on hold, but no live person ever picks up. I always leave a message on their voice mail. I have, as of yet, never received a return call. My messages always include my phone number and account number and I also state that they need to contact the VA, but the still do not call me. I'm waiting for information and proof that I authorized Kinex to bill me directly.
Seems like a scam to me!

I had a shoulder procedure done & my Dr ordered a machine for me to use after the surgery. When Amy there representative delivered the machine I read the contract & it stated that if I hadn;t met my out of pocket & deductible that there could be a fee of 250.00 that I would be accountable for. I called my insurance & they admitted I had met my out of pocket & and deductible amounts and I would not owe anything but Kinex needed to get a pre-approval on the equipment. The representative called the home office and stated they had got the pre approval. I had the machine picked up in December & then got a bill from Kinex in February stating I owed 250.00. I called my insurance company & they stated they billed the machine under 1 code and the device you put on your shoulder for the machine to work was not covered on my insurance plan. This is very deceitful because you could not use the machine if you don't have the part to put on your shoulder. I called Kinex and they agreed to accept 200.00 settlement so I paid that amount. I just wanted to warn people to be careful doing business with this company because they do not make you aware that you will be billed for 2 different components and you will have to pay the expense.

I wish I had investigated Kinex more before accepting the CPM. Kinex is harassing me for the $250 "deductible" expense also.
-Why didn't they contact me prior to the "$250 out-of-pocket" expense started?
-When the CPM stopped working, why did the technician wait a few days to call? Why did the technician tell me over the phone how to fix? Do I get a refund for the days the CPM did not work? Do I get $50/hour for doing the technician's job?
-The USB plug to power the iPad controller fell out because screws came loose, do I get a refund for those days of in-operation? The USB plug is enclosed and the CPM needed to be disassembled to gain access to the USB plug.
-Basically, the Kinex CPM is poorly designed and has numerous points of failure.

Working with Kinex looks like a losing cause. I think I will report Kinex to TriCare and OrthoCarolina. Hopefully they will put discuss Kinex's fraudulent behavior or at least warn future customers of their unscrupulous business model.

Before I even was a customer I got the run around Robo CALLS , BLOCKED calls AND THE COMPANY MUST PUT YOUR NUMBER ON SOLICATION CALLS IF YOUR A SENIOR FOR " We buy houses solicitors " Nobody is held accountable that works there in delivery and set up appointments. I actually called my doctor's office and requested another company- but, was told I would not have to deal with the main office anymore and "Joe B" would make the delivery. He arrived on time - but the knee/hip machine made "growling" noises- Joe explained as being in Sub zero temperature for two days in his van. I had my surgery on a Friday and one of the leg compression socks ( prevents clots - which I had) malfunctioned while fully charged and made alarm and turned off. After I called Joe who said he didn't have socks in his van and told me to call the 24/ 7 hot line or he could bring them Monday. Then I attempted to use the hip machine and the tab wouldn't turn on/ off to reset and none of the apps accepted touch except the start button with no level of exercise. I called the 24/7 line 1800-845-6364 when I finally found the number in paperwork the first time at 5 pm - a girl called me back BLOCKED call - 25 minutes later and said she would swing by Brookfield ( 8 to 11 minutes from where I was recovering) and bring new items that were not damaged in Sub zero temperatures for days. 7 calls later and 3 1/2 HOURS later still no delivery or call - I called one final time and told the company never to call or go to my house EVER again and I would take the equipment to my doctor's office where they could pick it up there. It wasn't bLroken ,cracked , dropped or damaged just left in cold for two days and did not work and I was sick of being abused,stood up and harassed by this company. Also, the company writes in a $250 " deductable" fee - so even if your insurance pays the full expense - you signed a contract that you would pay $250. I crossed that out and put ZERO - as that is not what I agreed to. Boy, was Joe upset! Beware my friends this is not a honest company and your great doctor is unaware.

If that is how he would prefer to handle this then that will be our stance as well If he will not provide the information that was sent, we cannot further try to resolve the situation

Hello, To address the first part of the compliant, we have a note in your wife's account of which she called in on 6/2/to let us know that she used the equipment from 5/11/- 5/30/that is why the claim is being sent for those days The pickup was called in on 6/2/and we had a representative out there the very next day to pickup the equipmentI do not feel there is any timely issues hereAs for the claims; Medicare covers the equipment for days from the date of surgerySince you wife had surgery on 5/7/that meant that they would cover the equipment through 5/27/And having a secondary insurance covers the co-pays associated with this usageThe reason that your wife is responsible for the bill is for the time she used the equipment past the daysWe have a script on file indicating that the physician felt that the equipment was medically necessary for weeks which is what your wife used the equipment forThe time beyond the days is what the bill is forMedicare does not cover the equipment beyond days and the secondary insurance follows suit in stating that if Medicare deems that time not medically necessary they will follow Medicare's guidelines and also deem it not medically necessaryWe also have a signed Advanced Beneficiary Notice of Non-coverage on file which the patient did sign instructing us that if she did use beyond the days of coverage that she will be responsible for any out of pocket costWe are not defrauding anyone we are simply billing for dates used based on the script we have on file as well as the wishes of the patientAlso, there is an Assignment of Benefits form that the patient signed which states that if the equipment is not covered for any reason there will be a $charge for the usage, again we are within our rights to deem the non-covered time the patient's responsibility The patient has the right to appeal Medicare's decision for the time that is non-covered and see if the decision can be over turnedThank you for contacting us regarding your issues

Dear Mr***, I have reviewed your chart and our benefits department did in fact reach out to obtain pre-authorization for your medical equipmentRecently your insurance policy has changed and as of 2/27/when we were able to obtain the benefits, the durable medical equipment you received is no longer a covered benefitOur 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 setupThere is no "contract" in which you enter in to and certainly does not require a lawyer to decipher the verbiageThe form is an Assignment of Benefits which is a 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 $out of pocketI would be happy to send you a copy of what was signed on 2/4/which explains the items listed aboveWith 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 describingWe are not trying to be deceitful in any way but trying to provide you with the most information regarding your coverage as we canThank you

The equipment was an essential piece of the puzzle for my rehab The CPM made getting full motion back easy The cold therapy felt incredible after a tough therapy session I could not imagine going through surgery without either

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 If this is an integral and necessary component of the cooling pad, then I do not accept that it is billed separately in a manner that is not approved by insurance, when they do in fact approve charges for the cooling pad and the cooling unit that attaches to the cooling padThe insurance company has stated that you billed a generic code for the orthotic device (I still don't agree that I received it), and that my insurance does not cover orthoticsYou are evidently not billing correctly, because you have billed for the same device in three different ways (I received ONE item that wrapped around my ankle and you have billed for it in three different ways) Regards, [redacted]

Looked into the chart for this patient and per the correspondence and recorded phone conversation; patient called in on 11/21/and spoke with our billing departmentHe questioned the $amount which is his estimated out of pocket costThis was due to the fact that both his primary and secondary did not pay for some of the rehabilitation equipment he was prescribedHe was sent another copy of his Assignment of Benefits in which he read and signed for the $amountHe then asked if he could setup a payment plan to take care of the balance in which our billing department told him yes, he could make payments over the phone or mailThis is a straight forward account in which the issue was resolved and the patient agreed to understanding the balance and his responsibilities

Dear Mr***,
I assure you if you have never had a surgery and was not provided any rehabilitation equipment, we would not have your information nor be sending you any type of invoiceThat also does not go without saying that this might be a surgery that was
cancelled in which no invoice should have ever been sent
I will be following up with our billing manager to look further into thisPlease await an additional followup to this compliant
Thank you for your patience with this matter and I assure you that if this is an error we will correct it
*** *** ***
Compliance Officer
Kinex Medical Company

Dear Mr***,
In response to the first part of your concern, since we have a patient responsibility letter from your primary there will not be one generated by your secondaryYou can feel free to call your secondary insurance and verify that informationThe days paid by Medicare is from the date of surgery and not from the date the equipment was deliveredThis puts the coverage period from 5/7/- 5/27/What that means is the claim portion after 5/27/is considered not medically necessary by both the patient's insurance and there for is the patient's responsibility.
Our company is not defrauding anyone, we are simply providing what was requested to you from your physician and following standard billing processes based on the paperwork signedThe patient had signed a form stating that if there was use beyond the days from surgery that she would be responsible for $112.50/day for the use of the unitAgain, we are more than happy to provide you a copy of what was signed in order to eliminate any confusion

Patient is correct that they are receiving a bill for $Per the Assignment of Benefit form signed by Mr*** (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,*** ***Operations Manager

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
I will pursue this with the insurance companyI am also filing a complaint with the attorney general for fraudulent billing practicesI have called an attorney and after speaking with them, I will also pursue this issue in small claims court.
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,
*** ***
The response from Kinex is not accurateOur primary is medicare and our secondary provided EOB's to us which you have failed to addressOnce again I will provide this infoCode - Your Health care provider has agreed to accept assignment of medicare benefits-this means you are NOT responsible for the difference between the medicare approved amount and the actual chargeDates of service 5/to 5/30/Claim number ***Kinex states in the last message that payment is per day yet all their people I talk to on the phone claim it is per dayEOB's refer to per day. When we contacted Kinex back in May their representative claimed we would not be billed because of double coverageKinex further, has not addressed the payment of my secondary insurance for the dates in question that they have paidAlso another EOB states: code - the submitted charges exceed our allowable charges for these servicesOur allowable charges are the submitted charges less any non-covered chargesBecause the provider is a preferred or participating network provider, you are NOT responsible for the difference between the submitted charges and our allowable charges

Mr***,
Yes, this is not a covered item and your insurance knows that as well because we must bill using the code that comes from the manufacturer which translates roughly to "non-covered durable medical equipment." You also signed the paper stating that if something was not covered you would be held responsibleNo, we did not bill codes for the same productAs I've been trying to explain there is a bladder, a wrap and the stabilization orthotics that were all prescribed in order for you to use the ThermoCompThis is how the manufacturer has instructed us to bill as has the FDAWe are following legal billing procedures for the items receivedYOU had also admitted in writing that you did not receive the products but now you are claiming that you did? No one had every told you that just because we are an in-network provider that all items received would be coveredAlso, you had admitted that you never signed the paperwork and someone did on your behalfWe never tell patients that every item is covered that's why we provide an estimated out of pocket cost (which in your case was $150)We have honored that and you have received a bill for less than the estimated amountI encourage you to reach out to your insurance company and they will verify that over the hundreds of thousands of claims we bill to them, they are all the same and they have processed this claim correctly based on the codes.
At this time, there is nothing more we can do for you as you have accepted the assignment of benefits for the equipment received and will continue to receive a bill for $If you feel your insurance should cover it because we are an in-network provider, please address it with them

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
Yes the company did send a letterIn the letter it did show a *** *** with a different middle name, SSN, and DOBI will give all further correspondence from the company its due attention, in short I will ignore them, they are not looking for meThere are over 25,other *** *** they need to talk toI wish them luck
[To assist us in bringing this matter to a close, we would like to know your view on the matter.]
Regards,
*** ***

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.

If that is how he would prefer to handle this then that will be our stance as well.
 
If he will not provide the information that was sent, we cannot further try to resolve the situation.

My Dr. has sent orders to this company for after surgery equipment needs. I have researched this provider on my BCBS In network and do not find where this provider is covered. I have contacted the Dr. to inquire about the available options as to whether the equipment can be obtained from another provider that is in network but did not receive a response. Timing could not be anymore of an inconvenience since the surgery is schedule tomorrow and they company called the day before the surgery and said they were on their way. We do not feel we have been explained to about the options. I called the Kinex company and spoke with a William P[redacted] in the WI main office and I was ASSURED that I would never have to pay any more than $250. He mentioned after I paid my deductible. I explained that our insurance does not Cover out of network providers therefore their would not be a deductible. I was ASSURED that even if someone does not have insurance they will only charge us $250 and the most. I explained that anything more than that would cost more out of pocket than the actual surgery itself and that would be ridiculous. Again he explained that they would not charge more than $250 and we could pay $25 today and pay the rest out on a payment plan. I asked for the company to provide something in writing that we had this conversation and that the most we would pay is $250 and they refused to back their statement up. This makes the entire pre-surgery day a big big concern as to what we need to do just because of this run around. VERY BAD BAD Customer service so we just sent them away and told them to take it back.