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MPS Medical Supply, Inc.

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Reviews MPS Medical Supply, Inc.

MPS Medical Supply, Inc. Reviews (4)

RE: Complaint# [redacted]Dear Sir or Madame:After researching our files we cannot find a client by the name of [redacted]. Possibly we can locate the client by their account number if the would provide that. However, universally all of our clients do have access to their files and copies of...

documents that we have within them upon written request. If it is an active file we have 30 days to produce the requested documents and closed files we have 90 days to produce requested documents. there is a copying charge for the documents the client receives and the client is asked to sign a release of PHI upon receiving their requested documentation. Hope this helps. If more specific information is needed an account number will be required so we can locate the specific client. Cordially,[redacted]Administrative Office Manager

[redacted]RE: Complaint# [redacted]Customer: [redacted]Complainant: [redacted]Dear Sir or Madame:I am responding to the above referenced complaint regarding transactions related to aprescribed medical device. I would like to annotate that the...

complainant is apparently thespouse of the client and not the customer that we conducted business with. Thecomplainant was not present during the transaction period.I would first like to thank the patient for their payment that satisfies their financialobligation to the transaction that was conducted on 07-05-201. Now I would like toexplain how the transaction was conducted and the process by which the claim was filedand why the client was sent a bill of financial obligation.>The patient was delivered a prescribed medical device. At the point of delivery theclient was presented a Delivery Ticket that outlines precisely the item being received andhow much the item is along with acimowledgement that of their financial responsibilities.The patient signs the document and receive of copy of it for their records.>The patient also is given a Consent to Treat document that outlines our responsibilityfor delivery’ and billing of their specific device. It also specifically outlines our billingprocess and collections process. The patient signs the document and receives a copy of itfor their records.>The patient is given a Waiver of Liability’ that specifically outlines their potentialobligation if their insurance carrier does not provide payment for the device that they arereceiving. It list the specific item and the cost incurred. The patient signs the documentand receives a copy of it for their records.>The patient is given a Customer Satisfaction Survey at the end of our time with them sothey are given an opportunity to respond to our performance with them while we areproviding services. There are 9 questions relating to the appointment, the quality of theequipment, the instructions that they received in correlation to their equipment, ourtechnicians helpfulness and courteousness, financial responsibilities being explained,after hour call policies explained, would they recommend our company to others and bowthey would rate our overall complete service. There are 5 response options that rangefrom Poor to Excellent. The client answered all 9 questions EXCELLENT. The clientsigns the document and it becomes a part of their ifie at our location.page 2RE: Complaint # [redacted]Customer: [redacted]Complainant: [redacted]This demonstrates the thoroughness that we provide to EVERY client that allows them touse their device properly, understand their financial obligations, and have an opportunityto discuss concerns, or refuse services if they so wish.After we deliver services then paperwork is processed through our office for billing to theinsurance carrier. Whether its TriCare or any and all other insurance carriers, Theprocess is conducted the same, this process is outlined and mandated through theinsurance carrier industry.We then filed the claim to the clients insurance carrier with all the supporting documentsof the Certificate of Medical Necessity and the authorization that we received at the timeof the referral. The claim was processed and denied because the device that the client hasreceived is no longer a covered benefit per the insurance coverage allowance. When aclaim is denied for being a non covered benefit that leaves the claim in a state of notbeing able to be appealed. Since we have a Waiver of Liability signed at the time ofdelivery- that explained the clients possible financial responsibility in the case of a denialof the claim, we sent the client a statement of $75.00.When the client called to inquire about the statement she was relayed the informationwithin her file in a polite and courteous manner. She spoke with our Senior OfficeAssistant. I was present in the room during the call and everything was conducted withthe utmost respect and patience. No THREATS were ever made and we never makeany assumptions to a person ability to pay or not to pay. Comments made regardingthese issues from the complainant are unfounded and not accurate. Complainant statedthat our customer service was horrible, but our Customer Satisfaction Survey reflects allExcellent Service. The complainant also stated that we should figure out what ourcontract states. Well we have be contracted with his specific insurance carrier for 18years. Our contract states that we must bill every client their balance owed and are notallowed to “write off’ anything, because that is considered an inducement which isagainst the law, We also have a letter from the insurance carrier dated 08-01-2017 thatspecifically states the item the client received is not covered, therefore allowing us to billthe client since we have a signed Waiver of Liability on file at the time of delivery.I am regretful that the complainant feels that he should not have had to pay, but hisinsurance carrier determines the outcome of every claim submitted.I would like to specifically address the comments on the desired settlement from thecomplainant:>We do not conduct shady business practices. Everything is very detailed in explanationas well as written so that the client is completely informed at the time of transaction.>We do provide excellent customer service. This is even documented by the clientreceiving the services,page 3RE: CompIaint [redacted]Customer [redacted]Coniplainant: [redacted]> We are completely aware of what our contract requirements with the insurance carrierare and are followed exactly as outlined. We have been a contracted provider for 18years.>We do not have the client to sign one document that covers everything. There areactually 3 required signatures. (Delivery Ticket, Consent to Treat, Waiver of Liability)1 Voluntary signature on the Customer Satisfaction Survey.> We cannot refund the $75.00 that has been paid toward the balance of the account. The$75.00 is for the medical device that was received by the client since the insurance carrierhas stated that the device is a non covered benefit and is not payable under the terms oftheir contract with the client.I hope that this clears up any misunderstanding between the client and our company.Unfortunately when dealing with insurance claims many times things are not paid orcovered as the clients think they will be.Respectfully,[redacted]Administrative Office Manager[redacted]Local([redacted] — Toll Free ([redacted]FAX ([redacted]

Ms. [redacted]
Thank you for taking the time to respond. And yes apparently I am the spouse of [redacted] however, since the insurance is in my name I take care of issues like this. My wife, who you did conduct business with is right next to me as I type this. I also listened in to her subsequent calls to your business after she told me about the poor customer service on the first call.
First, you’re welcome for the payment as we do not want to end up with extra finance charges, or have it sent to a collections agency as we work through this. We also figured you would use the fact that we did not pay in your response in an attempt to make us look bad. The issue is not the $75….I could care less as about that….the issue is your poor customer service and your company not attempting to help customers out. Now to your response:
1) Understood about the delivery ticket, my wife signed it as it was required before she received the device. Would you not have released the device had she refused to sign it? (see picture of form). Where on this ticket does is state it’s a “Waiver of Liability”? The paragraph in the middle of the delivery ticket states “Assignment of Benefits”. Can you please upload the signed “Waiver of Liability” or do you consider the underlined sentence within the “Assignment of Benefits” paragraph it? Also please see paragraph 6 of this response in regards to the Tricare “Hold Harmless Policy” as this makes the waiver issue a non-issue according to Federal Regulations.
Secondly, the lady who delivered the device DID NOT thoroughly explain the form, the other documents, or even how to use the device. The device is still in the original packaging unopened (see pictures). The only thing that the lady did was deliver the device and have my wife sign the form. She had five minutes with my wife as my wife was heading out the door to catch a flight out of Austin on a business trip. (see picture)
2) Please upload the signed waiver of Liability. (picture attached of unsigned patient copy)
3) Please upload the completed customer satisfaction survey. How can you have someone fill out a customer service satisfaction survey at time of delivery and with only 5 minutes of time spent together? Also, how do you have a customer fill out a survey about the quality of the product when it is unopened? How do you have a customer fill out a survey with a question regarding instructions on use when the product is unopened, meaning they were never shown how to use it, or used it in front of the lady to ensure it was done correctly, or even shown how to assemble it? Not sure you can fill out a complete survey until a few months after delivery because of instances like this. I’m sure everyone is 100% satisfied in the first 5 minutes….but most businesses provide a survey a few days or months after service to get true responses. This is a sign of a deceptive business practice. Again if the device was thoroughly explained like you do to EVERY client, why is the package still sealed?
4) After talking to the insurance company, they stated they sent you a denied claim because they needed more information before they could process the claim to make it a covered service. At what point were you going to let us know that they needed this? If they needed something sent for the claim by our doctor, how are we supposed to know? Also, what exactly did you receive and send from our doctor when you filed the claim (I will call and verify as we are working to provide more info)?
You file the claim and get the denied claim letter. We received an explanation of benefits AFTER we get the bill from you saying we owe money and AFTER we filed this complaint. This meant we would have to pay or have finance charges added to the bill before we could call the company or the insurance carrier regarding the claim. Also, the insurance company stated it was denied because they needed more medical information from my doctor, and sent you a second letter after we contacted them stating just that along with we are not responsible for any payment. The insurance representative typed the letter up while we were on the phone with her. I am the process of working with the doctors office to have the information sent in for the claim to be processed. Regarding the claim being not able to be appealable…attached is the paragraph out of the provider handbook (along with the provider handbook, its on page 45) for Humana regarding appeals…It states very clearly that a denied claim “because the service is not covered under TRICARE or exceeds policy limitations/coverage area.” Is an appealable issue. We are working to get it processed with no help from you. Also, once we did receive our explanation of benefits, it states patient responsibility “$0”. If you have been with them 18 years, how do you not know this?
5) My wife made multiple calls to your office after the first call. This was after we contacted the insurance company and wanted to call and explain the above, that they needed more information. It’s funny, because after the first call and how upset she was regarding the manner in which she was spoken to, I listened in on the rest of the calls and back her up. I understand you’re not going to admit wrong doing, but how are you going to remember every call, are you sitting there quietly listening to every call that comes in for every complaint? I called two times, do you remember what it was about and how it went? I also will back up my wife when I told her the insurance company said we were not responsible, she called to tell your representative, and was told it will go to collections if not paid.
6. This is the big one…Tricare has a “Hold Harmless policy” The paragraph is included in an attached document along with the Humana provider handbook (its on page 18). This states:
Pg 18: “A TRICARE beneficiary is held harmless from financial liability for noncovered services. If the beneficiary has agreed in writing (using the TRICARE noncovered Services Waiver form) in advance of the service/care being performed, the provider may bill the beneficiary directly” (This form was never provided or filled out and we were never informed that the item was not covered, also, the “Assignment of Benefits” does not fulfill this form being filled out)
“If there is not a TRICARE waiver on file for the patient and the specified date of service and care, then the network provider has no recourse and must uphold the hold harmless provision according to Title 10 of the Code of Federal Regulations on TRICARE.”
Further Reponses:
7) I am regretful that the complainant feels that he should not have had to pay, but his
insurance carrier determines the outcome of every claim submitted.
- My insurance carrier (Humana military) determined I am not responsible for the claim without a TRICARE noncovered services form on file, regardless of what the “Assignment of Benefits” paragraph says. See paragraph numbered 6. Also see explanation of benfits stating “Patient Responsibility is $0”
> We are completely aware of what our contract requirements with the insurance carrier
are and are followed exactly as outlined. We have been a contracted provider for 18
years.
-Please see attached provider handbook as it does not seem you are aware of federal laws and regulations regarding TRICARE or the required forms to make the patent responsible for noncovered services. TRICARE is different than civilian services provided by Humana.
>We do not have the client to sign one document that covers everything. There are
actually 3 required signatures. (Delivery Ticket, Consent to Treat, Waiver of Liability)
1 Voluntary signature on the Customer Satisfaction Survey
-Please upload all signed documents since you have them in your records. Also, the waiver is not in conformance with Federal regulations nor the HUMANA TRICARE provider handbook to waive the “hold harmless policy”
> We cannot refund the $75.00 that has been paid toward the balance of the account. The
$75.00 is for the medical device that was received by the client since the insurance carrier
has stated that the device is a non covered benefit and is not payable under the terms of
their contract with the client.
- Unless you can provide the required “TRICARE noncovered service form” required by Humana and TRICARE, then you have taken my money against federal regulations. Again it is very specific on what form has to be filled out by a beneficiary before they can be held liable for non-covered services. This is not the civilian healthcare version of Humana.
I hope that this clears up any misunderstanding between the client and our company.
Unfortunately when dealing with insurance claims many times things are not paid or
covered as the clients think they will be.
-Please see above as it should now clear things up for your company in regards to why our insurance company we were not responsible for the charges.
v\r
[redacted]
[redacted]
[redacted]
[redacted]

December 07, 2015 Revdex.com Corporate Office  1005 La Posada Drive  Austin, TX 78752 RE: [redacted]...

[redacted] Complaint of Billing or Collection Issues To Whom It May Concern: In response to Mrs. Prabe- crons concerns regarding her account with our company please review the following: On 05-21-2015 we delivered an elastic lumbar support as prescribed by her physician and authorized by her insurance carrier. The client completed paperwork with our company that thoroughly explains about our companies responsibilities and the clients responsibilities concerning insurance billing, client billing, finance charges on unpaid balances, collection fees, etc. This document is signed by every client we encounter as required by the insurance industry. The following is an expert from this documentation that specifically informs the client of our billing process: PATIENT BILLING All accounts due and payable by the patient will have a monthly account statement mailed to their address on record, A?ny unpaid accounts will incur a 5% finance charge each month until said balance is paid in full. Anyunpaid account past 90 days due will be sent to our collection agency for payment and will also incur an additional 35% for the collection fee. I understand that if necessary I may be contacted via cellular phone, email or wireless device regarding my delinquent account. I also understand that MPS Medical Supply may use a collection agency that may choose to use automated telephone dialing equipment, artificial or pre-recorded voice or text messages and personal calls and emails in their effort to contact me for purposes of collecting any portion of my account which is past due. As per our billing policy as stated above, we billed the claim to her insurance carrier on 06-15­2015 and they paid her claim on 06/19, 2015. We sent the client her first statement reflecting her 20% copay of $12.75 on 07-01-2015. We mailed the statement to the address on file for the client and did not receive any return mail. No payment was received from the client. The 5% finance charge was added to unpaid balance and her second statement was sent on 08-01-2015 with PAST DUE (in red) stamped on the document. No payment was received in August. The 5% finance charge was added to the unpaid balance and her third statement was mailed with URGENT (in red) stamped on the document. On 09-03-2015 the client called stating that she paid her copay to the technician when the lumbar support was delivered. We explained to her that we never collect copay amounts in the field because there is never a set amount for the copay. It is figured by the insurance carrier at a 20% copay of the allowed amount lathe item received. After the insurance carrier determines the allowed amount of the items received they submit payment and an Explanation of Benefits to our company as well as a copy of the 12/07/2015 11:55 5125563878                                   ... PAGE 05/05 Explanation of Benefits is sent to every client from the insurance carrier. Also if any money transaction occurs in a patients home there are areas on the delivery ticket that indicates the amount of money and the method of payment. On the clients delivery ticket that was signed by her the amount paid reflects -0- and the method of payment states INSURANCE. This demonstrates that we are waiting for the insurance company to make their determination of patient financial responsibility. After the clients telephone inquiry about the money she stated she paid I spoke with every technician and office personal to ask if they had any knowledge of a payment, etc. I also checked her file to make sure something wasn't inadvertently place in there. All areas of inquiry did not uncover any payment made by the client Our manager called the client on 09-04-2015 and I was in the same room to hear the conversation. The manager told the client that we could not uncover any payment made by her. If she had a copy of a receipt to show payment or a canceled check I would be glad to credit her account. We told her that her account balance is still due. She told the manager that she would get a copy of the check and would send it to us. We never heard from her. We again sent out statements with the added finance charge on 10-01-2015 with PAST DUE, URGENT and FINAL NOTICE stamped in red on the invoice. This is standard protocol for every client that we send statements to. We have never received any returned mail for this client as of this date. The client never stated to us during our phone conversations with her that she didn't receive any statements. No payment was received in October 2015. November 01, 2015 when we perform our clients account statements any account that is over 90 days past due with no payments made are sent to collections with the additional 35% collection fee as outlined in our policy that every client receives upon delivery of their goods and signs that they have received the information. As policy for billing and collections was made evident to the client and we followed our policy as outlined. The client stated she did not like the quality of the item she received and disputed the cost that was billed to her insurance carrier. The Items that we furnish to our clients are SADMERC approved which is a requirement and governed by the insurance industry. We delivered exactly what her physician ordered and her insurance company approved. The client accepted the item and never made a negative comment about it until her statement to the Revdex.com. The items are priced according to the insurance industry computed on cost of goods and expense to deliver items to clients and the cost of billing, etc. The client received a discount of $61.25 which is reflected in the approved amount by her insurance carrier since she used a preferred provider. The client also completed a Customer Satisfaction Questionnaire with 9 areas dealing with the items received, quality of goods, explanation of policies, right and responsibilities, instructions for use, overall service rating. The client can choose poor, fair, average, good or excellent on the questionnaire, the client checked all EXCELLENT and signed the questionnaire. The client stated the desired settlement was to be cleared of all charges and to receive an apology from our company. We are unable to clear the client from charges that are owed. This is a contractual requirement that is deemed by her insurance carrier. We are required to bill and collect all accounts on a fair and level playing field. No exceptions. We have committed no offense or wrong doing to extend an apology. The policies and procedures that we operate by are requirements from the insurance industry and contractual obligations from the insurance carriers that we are providers for. It is our duty to apply all policies equally and fair to every client. No wrong doing has been done by our company, we have performed at the highest levels of customer service. The client will need to deal with the collections agency that has contacted her since her account is now in their control. Cordially, [redacted] cc: file pg 2 [redacted]

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