Liberty Oxygen and Home Care

[redacted] came into our Cn Rapids Store on 6/10/to see about renting a scooter Our company only has two rental scooters and we do not bill the insurance for used scooter rentals The patient made the decision to pay the self-pay rental, while she tried to obtain the necessary paperwork to get a scooter purchase approved Unfortunately, her insurance carrier never approved a scooter purchase [redacted] was notified with the final denialThe patient continued to press both the insurance carrier and Liberty Oxygen and Medical Equipment to get insurance to cover We give the patient the choice to go out the door as a self-pay, or wait for the authorization to confirm coverage before taking the equipment home [redacted] made the decision to take the equipment home with her on June 10, 2016, which made it a self-pay transactionMoving forward, we are implanting a new form that the patient will sign for a self-pay rental transaction The patient will be selecting the option that affirms their understanding that the rental is self-pay In this instance, the patient had a clear understanding that this was a self-pay rental Although if she had decided to purchase the scooter as self-pay, we would have applied any self-pay rentals to the purchase price

As of 11/1/15, Mr [redacted] became Medicare eligible We were not aware of this change until we received denials from BCBS in January stating there was another insurance Our billing office contacted [redacted] 1/28/to have him follow up with both insurances, as they were both saying the other was primary Mr [redacted] resolved the primary payer problem, leaving Medicare as the primary payer He was in Florida at the time but needed to see his MD in MN to obtain his Face to Face visit and saturation level testing to meet Medicare billing guidelines This left three months of service billing without the needed documents to bill Medicare While he did stop in the office and speak with Lori from our billing office, he was never told to disregard the three months of billing without the proper Medicare documentation was available for us to use to bill Medicare We checked with Mr [redacted] to make sure that he had not seen another physician that could provide the needed Medicare documentation When Mr [redacted] spoke with Lori on a monthly basis it was about the charges that were being billed to Medicare, from February and forward While obtaining the necessary documentation is ultimately the patient's responsibility, we do try to help whenever possible by contacting the physicians office to get the needed documentation In this case, when Lori spoke with him another time, She told him that she was having trouble obtaining the Face to FACE notes to support the PFT testing We had made many calls to the doctor's officeWhile we billed Medicare if there were ever to audit us, they could take the money back since we never did get the notes to support the PFT Additionally, Mr [redacted] signed an assignment of benefits and initialed the form acknowledging his financial responsibility Please feel free to contact me if there are further questionsSue ***, Corporate Operations ManagerLiberty Oxygen and Home Care, IncDirect: ###-###-####

I am rejecting this response because:There are two issues here, and Liberty Oxygen has only responded to one of themThey did not respond to this: A partial reimbursement of $from PreferredOne was sent to Liberty Oxygen instead of to meThis reimbursement was for rental fees that I already paid out of pocket to Liberty OxygenLiberty Oxygen was already paid in full for the scooter rental (by me) and had no money due to themI requested that they forward this reimbursement of $to me and they have not responded to my request Regarding the response they provided here, it does not address the fact that Liberty Oxygen is a contracted in-network provider for PreferredOne, and as an in-network provider, is contractually obligated to absorb the provider discountThat is what I have been told by numerous PreferredOne customer service representativesLiberty Oxygen never provided any explanation of "self-pay" other than to say that they would not bill the rental through PreferredOneI was very clear about my intention to file a claim for reimbursementWhether a purchase was approved or not has no bearing on this issue

I am rejecting this response because:I do not accept this apology I was told that the billing went for a month I was not told when I called after a month about returning the scooter then or at six weeks that I would be charged for the whole next month anyway Had I known I would very much have kept it for the whole two months I got charged for as I hobbled around the halls of my school Consequently you could get paid twice for the scooter for the two weeks I paid for but didn't have it You should have been more forth coming

I apologize for the confusion in the insurance billing that you experienced with your Knee Walker rental. There is a great deal more occurring in the background than patients see when they come in to rent an item. As a contracted provider with Health Partners/Homelink, we are
contractually obligated to bill the Knee Walker as a monthly rental whether you have it for a day or days Our contract through HealthPartners/Homelink dictates how we are to bill for each rental item, and when we don’t bill in that manner the claims are completely denied Due the chance for a denial, we bill HealthPartners/Homelink as we are obligated to do, to ensure best insurance reimbursement for the patient. I again want to apologize for this billing confusion and would be glad to speak with you on the phone regarding your concerns. My direct dial number is ###-###-####. Sue King, Business Office Manager, Liberty Oxygen and Home Care, Inc

[redacted] came into our Cn Rapids Store on 6/10/2016 to see about renting a scooter.  Our company only has two rental scooters and we do not bill the insurance for used scooter rentals.  The patient made the decision to pay the self-pay rental, while she tried to obtain the...

necessary paperwork to get a scooter purchase approved.  Unfortunately, her insurance carrier never approved a scooter purchase.  [redacted] was notified with the final denial. The patient continued to press both the insurance carrier and Liberty Oxygen and Medical Equipment to get insurance to cover.  We give the patient the choice to go out the door as a self-pay, or wait for the authorization to confirm coverage before taking the equipment home.   [redacted] made the decision to take the equipment home with her on June 10, 2016, which made it a self-pay transaction. Moving forward, we are implanting a new form that the patient will sign for a self-pay rental transaction.  The patient will be selecting the option that affirms their understanding that the rental is self-pay.  In this instance, the patient had a clear understanding that this was a self-pay rental.  Although if she had decided to purchase the scooter as self-pay, we would have applied any self-pay rentals to the purchase price.

As of 11/1/15, Mr [redacted] became Medicare eligible . We were not aware of this change until we received denials from BCBS in January 2016 stating there was another insurance.   Our billing office contacted [redacted] 1/28/16 to have him follow up with both insurances, as they were both saying...

the other was primary.  Mr [redacted] resolved the primary payer problem, leaving Medicare as the primary payer.  He was in Florida at the time but needed to see his MD in MN to obtain his Face to Face visit and saturation level testing to meet Medicare billing guidelines.  This left three months of  service billing without the needed documents to bill Medicare.   While he did stop in the office and speak with Lori from our billing office, he was never told to disregard the three months of billing without  the proper Medicare documentation was available for us to use to bill Medicare.  We checked with Mr [redacted] to make sure that he had not seen another physician that could  provide the needed Medicare documentation.    When Mr [redacted] spoke with Lori on a monthly basis it was about the charges that were being billed to Medicare, from February 2016 and forward.  While obtaining the necessary documentation is ultimately the patient's responsibility, we do try to help whenever possible by contacting the physicians office to get the needed documentation.  In this case, when Lori spoke with him another time, She told him that she was having trouble obtaining the Face to FACE notes to support the PFT testing.  We had made many calls to the doctor's office. While we billed Medicare if there were ever to audit us, they could take the money back since we never did  get the notes to support the PFT.   Additionally, Mr [redacted] signed an assignment of  benefits and initialed the form acknowledging his financial responsibility.    Please feel free to contact me if there are further questions. Sue [redacted], Corporate Operations ManagerLiberty Oxygen and Home Care, IncDirect: ###-###-####

I am rejecting this response because:I do not accept this apology.  I was told that the billing went for a month.  I was not told when I called after a month about returning the scooter then or at six weeks that I would be charged for the whole next month anyway.  Had I known I would very much have kept it for the whole two months I got charged for as I hobbled around the halls of my school.  Consequently you could get paid twice for the scooter for the two weeks I paid for but didn't have it.  You should have been more forth coming.

I am rejecting this response because:There are two issues here, and Liberty Oxygen has only responded to one of them. They did not respond to this:  A partial reimbursement of $98.96 from PreferredOne was sent to Liberty Oxygen instead of to me. This reimbursement was for rental fees that I already paid out of pocket to Liberty Oxygen. Liberty Oxygen was already paid in full for the scooter rental (by me) and had no money due to them. I requested that they forward this reimbursement of $98.96 to me and they have not responded to my request.  Regarding the response they provided here, it does not address the fact that Liberty Oxygen is a contracted in-network provider for PreferredOne, and as an in-network provider, is contractually obligated to absorb the provider discount. That is what I have been told by numerous PreferredOne customer service representatives. Liberty Oxygen never provided any explanation of "self-pay" other than to say that they would not bill the rental through PreferredOne. I was very clear about my intention to file a claim for reimbursement. Whether a purchase was approved or not has no bearing on this issue.