Kinex Medical Company

Hello,
To address the first part of the compliant, we have a note in your wife's account of which she called in on 6/2/14 to let us know that she used the equipment from 5/11/14 - 5/30/14 that is why the claim is being sent for those days. 
The pickup was called in on...

6/2/14 and we had a representative out there the very next day to pickup the equipment. I do not feel there is any timely issues here.
As for the claims; Medicare covers the equipment for 21 days from the date of surgery. Since you wife had surgery on 5/7/14 that meant that they would cover the equipment through 5/27/14. And having a secondary insurance covers the co-pays associated with this usage.
The reason that your wife is responsible for the bill is for the time she used the equipment past the 21 days. We have a script on file indicating that the physician felt that the equipment was medically necessary for 4 weeks which is what your wife used the equipment for. The time beyond the 21 days is what the bill is for. Medicare does not cover the equipment beyond 21 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 necessary.
We 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 21 days of coverage that she will be responsible for any out of pocket cost. We 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 patient. Also, 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 $250 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 turned.
Thank you for contacting us regarding your issues.

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 pad. The 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 orthotics. You 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]

[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.]
Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and find that It wasn't satisfactory to me. Explanation follows
I regret the decision Kinex reached. 
I would like to set the record straight.
I have never been without insurance 
up until november 30,2014 my husband and I were on the same policy for so many years, when he qualified for Medicare my insurance issued me a new policy number starting on December 1st2014just for me.
I received the new card toward the end of December.
I was never contacted to be told that they had problems with my insurance until 10 months later.
kinex claims that BCBS have a yearly policy that they do not accept a year old claims. 
My husband was on a three way phone call with Kinex rep and BCBS rep for the second time, BCBS agent requested that Kinex submits the claim since it hasn't been a year old case, then Kinex agent replied " it is our policy (Kinex) that we do not submit a claim after 90 days" 
yet in their letter dated August 13'2015 they requested from me an insurance update information before it reaching the timely filing with BCBS.
I figured from December till August that would be 9 months and not 90 days, which contradicts everything Kinex said.
also, at the end of their letter, they mentioned I was never denied speaking to a supervisor which is true, except that they were talking with my husband on the three way phone call with my BCBS rep. My husband requested during that call to speak with a supervisor and the Kinex agent replied : " we have discussed this issue with our supervisor and there is no need to talk to a supervisor "
This was said with BCBS agent on the line, which he heard everything.
I am sure that this conversation was recorded from BCBS since it was a conflict.
I hope that Kinex would treat their customers with better courtesy than they have shown me
thank you
Regards,
[redacted]

We will contact the insurance company about the patients response and processing of the insurance claims. We will also adjust down the balance to the $250 and provide additional training to the service rep to be quoting patients appropriate out of pocket. A new statement reflecting the adjusted balance to $250.Thanks,[redacted]

Looked into the chart for this patient and per the correspondence and recorded phone conversation; patient called in on 11/21/14 and spoke with our billing department. He questioned the $250 amount which is his estimated out of pocket cost. This was due to the fact that both his primary and...

secondary did not pay for some of the rehabilitation equipment he was prescribed. He was sent another copy of his Assignment of Benefits in which he read and signed for the $250 amount. He 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 mail.
This is a straight forward account in which the issue was resolved and the patient agreed to understanding the balance and his responsibilities.

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]
 
 
The response from Kinex states that the item was received on 5/11/14 and that 21 days is paid for by medicare. If I figure this right we should be good through 5/31/14. Why is Kinex still billing for the 27th thru 5/30? Why does my secondary insurance state that nothing is owed by me as stated in the original complaint which is not addressed by Kinex in their response. Furthermore, since writing the complaint I received another EOB from my secondary insurance stating the same detail and that they paid 5/27/14 thru 5/30/14. Kinex also sent a bill and noted this payment on the invoice but please explain to me why in February 2015 we received a bill for 240.00. Then again the same amount two months later and most recently they still want 240.00 for the dates 5/24 thru 5/30 when my secondary paid. Why is Kinex trying to defraud us? This leads me to believe that Kinex bills individuals with no concern and that elderly folks pay because of the confusing accounting that Kinex uses. Kinex applies payments made by my insurance company incorrectly. This complaint remains unresolved by 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.]
Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and find that this resolution is satisfactory to me. 
Regards,
[redacted]

[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.]
Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and find that this resolution is satisfactory to me. 
Regards,
[redacted]

Hello Mr. [redacted],
?
I reviewed your chart as well as all forms signed. I do see that you have already spoken with our billing department regarding this issue and I'm sorry that this couldn't be explained more clearly to you as to the items you received.
I can...

assure you that you did in fact receive a stabilization orthotic as the ThermoComp pad would not be able to stay on your foot without it. The pad itself is white and fits inside of the cold/heat pad (black Velcro responsive material). The stabilization orthotic is the hinges that go on top of the black Velcro responsive material and the stretchy black elastic straps that go on top. This is coded by the manufacturer to be a stabilization orthotic as it restricts the joint from having full motion and ensures that the limb is stable while it's in use.
I have included some pictures of the products for your reference so you can relate the products you received to what was actually billed.
Thank you for your understanding in this matter.

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.

I was not able to find this patient in our system whatsoever either by name, address or phone number. I had personally contacted this patient and asked that he send a copy of what he is receiving from us in order for us to resolve the situation.
I have not received a response back from him and there for there is nothing more I can do until he contacts us with the example.

Dear Mr. [redacted], I have reviewed your chart and our benefits department did in fact reach out to obtain pre-authorization for your medical...

equipment. Recently your insurance policy has changed and as of 2/27/15 when we were able to obtain the benefits, the durable medical equipment you received is no longer a covered benefit. Our 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 setup. There is no "contract" in which you enter in to and certainly does not require a lawyer to decipher the verbiage. The form is an Assignment of Benefits which is a 1 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 $200 out of pocket. I would be happy to send you a copy of what was signed on 2/4/15 which explains the items listed above.
With 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 describing. We are not trying to be deceitful in any way but trying to provide you with the most information regarding your coverage as we can. Thank you.

I received a statement from Kinex for a Rebound Air Walker Boot. The boots normal retail price is no more than $70.00. Kinex is billing me $495.00 for this same boot. I was told at the time I was fitted for this boot in my orthopedics office that Medicare would not have a problem paying this charge. Medicare did not pay this charge and I can understand why! Kinex is ripping off Insurance companies and the people that need medical equipment. I will inform my doctor about the scam company that they have doing business in their office space. I will also be contacting my local consumer advocate Clark Howard. The public needs to know and beware so as not be taken to the cleaners while they are trying to heal by medical vendors.
Thank you,
M Jackson

Review: led to beleive that equipment for home re-hab(shoulder injury) would be 100% covered by medicare. then billed 250.00 dollars for visit months later.

Business

Response:

Looked into the chart for this patient and per the correspondence and recorded phone conversation; patient called in on 11/21/14 and spoke with our billing department. He questioned the $250 amount which is his estimated out of pocket cost. This was due to the fact that both his primary and secondary did not pay for some of the rehabilitation equipment he was prescribed. He was sent another copy of his Assignment of Benefits in which he read and signed for the $250 amount. He 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 mail.

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.

I used equipment from this company in 2013. They waited over a year to bill me, and within 3 days of me receiving the bill Igot what I call a harassing phone call from them wanting to know when they would receive their money. I had already mailed them a check. I guess they were disappointed that I didn't use airmail. Never again.

Review: I filed a compaint to which Kinex responded. I could find no way to respond to their response, therefore I am submitting my response here.

First, Kinex stated they are not allowed to choose what equipment is delivered to eaxch patient. This is not a true statement. The doctor can prescribe a piece of medical equipment, however, the patiient can choose to reject it, especially when it will not be covered by insurance. They did apologize for their representative who delivered the equipment telling me he was sure it was covered by insurance, when in fact he did not know. I told him with no uncertainty that if it was not covered by insurance I did not want it. He assured me he would check it out and let me know. I never heard from him so I assumed it was covered. No matter, the representative who delivered the equipment was the "face" of the company and I therefore expect that the company will stand behind what he tells patients. Kinex further states in their response that they sent out pre-collection letters before sending this to collections. This is totally untrue. I did reveive invoices but no letters. In fact I sent two letters to Kinex in an effort to resolve this matter. No response was received to either of my letters. I made several telephone calls to Kinex in an effort to reach a resolution. No one seemed to be able to make a decision or help in any way. At one point a person named Lori told me that my account had a zero balance. Actually she left me a voice mail with that information. I still have the voice mail saved. After repeated telephone calls I then received a invoice from Assetts Management, which I presumed to be a collection agency. I recently wrote to them and told them there was no way I was ever going to pay this bill and that if they had purchase the account from Kinex they should just mark it up as a bad investment. In their response Kinex repeatedly states that they have spoken to their representative in Arizona regardiong the procedure that all employees must ashere to regarding patient follow up. I really could care less about them speaking to their representative; after the fact. They should have assured that their representative was aware of and following established procedures before this incident.

Further, a charge in the amount of $700.00 for a post operative brace was on my bill. I disputed this charge as the item was never delivered to me. This charge was removed, however; Kinex billed Medicare and Tricare for this item. Medicare and Tricare paid a total of $614.02 for this item. I recently received correspondence stating that re-embursement has not been received from Kinex for this charge. How dare Kinex continue to attempt to collect $300.00 from me when they are still holding $614.02 of the tax payers money received for services never provided.Desired Settlement: Delete the charge from my bill and withdraw the account from the collection agency. Send me a letter stating that the account is paid in full.

Business

Response:

The first portion of the complaint from Mr. [redacted] states "First, Kinex stated they are not allowed to choose what equipment is delivered to each patient. This is not a true statement." What was meant by this is when the physician prescribes equipment and sends the order over to Kinex to fill, we as service representatives, cannot pick and choose what equipment we bring to the patient as we are strictly following physician's signed orders.

Mr. [redacted] states "I told him with no uncertainty that if it was not covered by insurance I did not want it. He assured me he would check it out and let me know. I never heard from him so I assumed it was covered." It is Kinex policy not to discuss any coverage with equipment as none of our service staff is trained in that department and have always directed the patient to contact their insurance and specifically discuss coverage. I do apologize for this representative not returning his call even if it was to say he was not sure and that Mr. [redacted] would be able to get a more accurate answer if he contacted his insurance directly. Since our field reps are not trained with insurance, we do offer every patient an Estimated Cost policy in which if the equipment is not covered for any reason we will cap their account at $300.

Review: Kinex is billing me for a product that I did not order. It is a machine (Knee CPM) that was delivered to my house after knee replacement surgery. I did not know what it was and asked my Physical Therapist if it was necessary and he said "no". Apparently the hospital had sent it . So it was returned.

Kinex is saying I signed a document that told them they did not have to file Medicare for payment. I asked them to please file my Primary insurance, Medicare, and what they didn,t pay, my secondary, United Health Care would. They refused. Because this "supposed document" I signed says they don't have to. I apparently signed this document with discharge papers and do not recall it at all.

Now they are threatening to send this $300.00 bill to the collection agency. I have never had anything sent to collection and will do whatever I can to avoid it, short of paying for something I did not order nor use.

.. I've since found out Medicare does not recommend this machine because it has not proven to do any good., hence the reason for the documentDesired Settlement: Since the product was not requested or used Kinex should not expect to be paid for it.

Business

Response:

I do apologize for the headache this has caused and we will rectify the issue.

Review: My wife had knee surgery on 5-7-14. The doctor ordered the device and Kinex to provide. We had the device short of the 6-3-14 date specified by the doctor. The device was requested to be picked up on 5-30-14. It was not picked up till 6-3-14. Medicare paid their portion and Kinex keeps billing for 5-27-14 thru 5-30-14. I have a secondary insurance of Blue Cross Anthem and they have also paid their portion and on every EOB from Anthem they state I am not responsible for any other charge. Kinex had my wife sign a statement that we would be responsible for whatever medicare did not cover. My Anthem would then cover this. We talked to a representative from Kinex at that time and she said we should nave no charges for us to pay since we have two insurances. I have contacted Kinex 4 times and they called here on Thursday 4-16-15 rudely saying they were sending charges to collections. They are defrauding the public. I told them on every contact occasion that my insurance states I do not owe them and that they have agreed to accept assignment of medicare benefits. This means I am not responsible for the difference between the medicare approved amount and the actual charge. I sent them this info and they refused to answer me. On Thursday I called and talked to a rep of Kinex and he even had questions. He said he had to talk to his supervisor and he would have to call me back. They keep saying that my wife signed the form. Why do they even have this form? They know they will charge the customer more. They have continually charged me for $240.00 for the dates of 5-27-14 thru 5-30-14. This charge is in dispute and a company involved in healthcare should not be bilking the public.Desired Settlement: I should not have to pay this overcharge and not sent to collections.

Business

Response:

Hello,

Review: Never had any buisness with this company, and they keep billing me.Desired Settlement: bill taken out of his name and removed from his credit score

Business

Response:

Dear Mr. [redacted],