Nurturing Expressions LLC

RESPONSE TO Revdex.com COMPLAINT, MARCH 1ST Nurturing Expressions maintains its position in the case of Ms [redacted] account: the client was informed of her rights and responsibilities for the rental and remains financially accountable for the charges accrued whilst the rental equipment was in her possession Please see the responses to the points listed by Mr [redacted] below: Nurturing Expressions LLC’s response of “she was required to sign a Rental Agreement, Financial Policy Form, and Acknowledgement of Privacy Policies” They failed to provide a signed copy of the Financial Policy Form, they failed to provide a signed copy of Acknowledgement of Privacy Policy as previously requestI had to go to their web site and copy these forms off of it to see what we were missingWhy did we not get copies of these, because my wife never signed these forms Nurturing Expressions and the collections agency, Physician and Dentists, maintain digital copies of Ms [redacted] original, signed contractsClients are given a copy of the Rental Agreement Contract at the time of delivery and have the option to request a copy of the Financial Policy AgreementClients also retain the right to request any of their records at any point of the rental periodAs Mr [redacted] stated, the Financial Policy Agreement is also available for download on the company websiteThus, the contract is accessible and available for clients, as is the administrative office should clients have questions regarding any portion of said contract They only provided a copy of the signed “Rental Agreement Form” which had the following blackened out daytime telephone number, evening telephone number blackened out, I would ask why these are blackened out? Because both numbers were good and were never disconnectedThis also is not Hippa information The third party agency – Physicians and Dentists – redacts any personal information that may compromise a client’s personal health information (PHI) or identityThe phone numbers were redacted to protect the privacy of the clientAccording to the HIPAA Privacy Rule, providers must protect most “‘individually identifiable health information’ held or transmitted by a covered entity or its business associate, in any form or medium, whether electronic, on paper, or oral.” (Guidance on De-identification of Protected Health Information, www.hhs.gov/sites/default/files/ocr/privacy/hipaa/understanding/coveredentities/...⇄ consists of any demographic information, including many common identifiers – such as addresses and phone numbers – when they can be associated with the health informationIn order to protect Ms [redacted] privacy, her PHI was not released Type of equipment is also blackened out, why? This is not Hippa information According to HIPAA (C.F.R§ 160.103), personal health information includes any information relating to “the individual’s past, present or future physical or mental health or condition.” Thus, the type of equipment rented must be redacted in order to protect information pertinent to Ms [redacted] condition They forgot to mention in their response that next to the $a day rental they have “INS” meaning insurance is covering it The denotation of “INS BILL” next to the daily rental rate of $per day plus tax signifies that Nurturing Expressions agrees to bill the client’s insurance company the rate of $per day, as a courtesy to the clientNurturing Expressions cannot guarantee payment for the rental as coverage is dependent on the client’s individual plan, benefits, and eligibility at the time of service They also have 1st Choice\DSHS next to type of paymentTheir web page list “First Choice” as one of several Insurance companies they except Nurturing Expressions is an in-network provider with First Choice and bills claims to First Choice on behalf of the clientsHowever, participation in the network does not guarantee payment for clientsBenefits are subject to the client’s individual plan and eligibility at the time of the service They state my wife did not provide them with copies of her insurance cards, yet they state she signed the “Financial Policy Form” that has Primary Insurance“ Insurance Name/Policy Holder/Policy ID/Policy Holder Date of Birth/Insurance Phone/Relation to Client/Group Number/Employer” and Secondary Insurance “Insurance Name/Policy Holder/Policy ID/Policy Holder Date of Birth/Insurance Phone/Relation to Client/Group Number/Employer”So which is it she did not provide this information or she did on this formAlso this information could have been obtained from the hospital with my wife’s permission or by her asking the staff for a copy and then providing it to the person that brought the breast pump Ms [redacted] did not provide Nurturing Expressions physical copies of her personal identification or insurance identificationTherefore, the insurance, billing, and contact information listed on the Financial Policy Agreement was verified and given to Nurturing Expressions by Ms [redacted] herself when she signed and acknowledged the agreement Once again they state they called and no response, not disconnected, no response to a automatic call on November They also state they sent the daily rental agreement to the primary insurance, so which is it they have the information or they don’t? Per the contract and procedure, Nurturing Expressions billed the insurance company Ms [redacted] verified as primary on her Financial Policy AgreementBilling the client’s insurance is a standard procedure for Nurturing Expressions when a client is renting a piece of equipment and requests it be billed to the primary insurance carrier Also, Mr [redacted] is correct: according to the phone log kept by Nurturing Expressions, no response was received from Mror Ms [redacted] after the automatic telephone call was made on Nov8, Nurturing Expressions did not hear from the client after this phone call was made They state on November that the biller checked and found both plans listed had terminatedThat is not correctI worked from 5/to 03/and had First Choice Insurance thru my employerDSHS was never terminatedPer checking with First Choice Insurance they would not authorize that Model of Brest Pump, but others they wouldPer checking with DSHS they only pay for the first two weeks of rentalSo if they notified us that insurance would not pay for that model of breast pump, they would lose money and we would have returned it like I said priorPerhaps that is why that information is Blackened out As stated in the previous report, additional insurance companies were listed on the client’s DSHS online eligibility statementThese companies were not the same as what Ms [redacted] provided on her rental agreementThe additional insurance plans listed online were inactiveIn order to bill the client’s secondary insurance for payment, the client needed to contact the secondary insurance company and inform them that the two additional insurance companies were no longer active and then provide the most recent insurance company informationThis action is commonly referred to as coordinating benefits Nurturing Expressions’ Biller called Ms [redacted] to inform her that she needed to coordinate her benefits with her secondary insurance and current primary insurance in order to receive payment from them towards her rental claimsFurthermore, it is the responsibility of the client to coordinate and understand her own benefits and coverage limitationsInsurance companies do not permit providers to coordinate benefits on behalf of the client Why is it that the primary number is good some times and others it is disconnected, because it was never disconnected? That is why the number is blackened outWe would be able to prove thru the phone service it was never disconnectedPhones are not temporarily out of service unless there is a problem with the service, which we had never had any To reiterate the point above, Physicians and Dentists redacted the client’s phone number to comply with HIPAA rules and regulations as it is considered personal health information On December 10, 2012, “They state we were notified by our insuranceThis is not true, we never received any notification2ndWhich is it? Insurance is terminated? Or Insurance is in effectSomeone cannot keep their story straightWhich is it the 1st number is out of service/or now it’s working and which is it the second number works and messages are left or now it’s not working???? Members receive paper Explanation of Benefits from insurance companies for claims submitted by providersNurturing Expressions received an Explanation of Payment for the claim in question, resulting in a denial of paymentSimultaneously, the member would have received an Explanation of Benefits showing the claim had denied Regarding communication done by telephone, Nurturing Expressions’ policy is to document all outgoing attempts and incoming conversationsTo comply with this policy, staff members made note of which phone line was functional at the time of the call, as well as on which phone line was a voicemail left Also by their own phone records, that when they contacted and actually spoke to my wife, don’t you think that they would have also in their notes stated that informed her that they have been trying to call, left all these messages because of problems with the insurance or that we now would have to pay for the rental, yet there is none of this in their dates of the live phone calls As previously stated, Ms [redacted] received a copy of her original rental agreement which included the phone number she supplied to us and verified as a working, valid phone numberMr [redacted] is further correct in saying that the phone number on which we spoke with Ms [redacted] was indeed in service; thus, Ms [redacted] has received the many voicemails and attempts at communication left by the Nurturing Expressions staff, informing her of the changes in her insuranceIn addition, the communication attempts by Nurturing Expressions do not begin to include any other contacts undoubtedly made by Ms [redacted] insurance companies, or the many channels of communication available to Ms [redacted] – such as the insurance provider’s website, member benefit booklets, customer service representatives, etcetera – had she wanted to pursue any investigation into her own benefit plan, coverage, and claims determinationNurturing Expressions has provided the pertinent rental information to Ms [redacted] ; any further information was accessible and available So when I called and asked for copies of all paper work I was referred P&D who gets the paper work from them and I am expected to believe that they do not keep any copies of their recordsSo if they were to go to court that would me they do not have copies of the said missing paper work to provide as evidence they were provided and signed In compliance with Washington State Department of Health policies, Nurturing Expressions maintains copies of client medical recordsNurturing Expressions holds a copy of Ms [redacted] original, signed Financial Policy Agreement on which she agrees to the following: I hereby assign all benefits to which I am entitled to Nurturing Expressions LLC, in the event Nurturing Expressions files an insurance claim on my behalf I understand that filing an insurance claim on my behalf is a courtesy only and that I am financially responsible for all charges whether or not paid by said insurance company In the event my account becomes delinquent and is default of payment, I accept responsibility for the principle amount owing as well as all reasonable costs associated with the collection of this debt This includes, but is not limited to, collection services, attorney’s fees and all court costs and additional legal fees associated with the recovery of this debt Interest may be charged at a rate of 1.5% per month (18% annually) for unpaid balances over days old I hereby authorize said assignee to release all information necessary to secure the payment of said benefits Their comment of they contacted us sufficiently is incorrect, by their own admission the main number worked and then it was out of service, yet they still fail to provide what that main number was because we are able to prove it was never disconnect or out of serviceNo business only attempts to contact a client by phone when they have not received payment of any rental equipment for months and months, no they would send out a bill/notice that we were behind in our rental paymentsPer their own admission they had a signed copy by my wife of their “Financial Policy Form” which they never provide to her and it also list for your e-mail on the form, which she never received any attempted contact on this matterAlso the date on the invoice is 9/13/after the breast pump was turned in? Yet they made no other notifications by mailWhich we did not receive until I made a request in To clarify, Ms [redacted] did not supply her email address on the Financial Policy Form; thus, could not be contacted using this method When Ms [redacted] had returned the equipment to Nurturing Expressions, her insurance benefits were still not coordinated between her primary and secondary payersTherefore, Nurturing Expressions could bill neither insurance company for payment and Ms [redacted] is obligated to pay for the dates of service she had the pump in her possessionNurturing Expressions mailed a hardcopy of an invoice to Ms [redacted] and received no responseHad she responded in a timely manner, the Nurturing Expressions staff could have once again instructed her to coordinate her benefits so her claims could have been billed for reimbursement, or a payment plan could have been establishedNeither Mrnor Ms [redacted] contacted Nurturing Expressions regarding the paper invoice that had been mailed to them or the many voicemails that had been left on their working phone number Desired Outcome: To be removed from credit report As stated previously, the client is responsible for knowing his or her benefit coverage and maintaining communication with Nurturing Expressions’ officeThe client is also responsible for contacting our office if her contact information changesThe client is also financially responsible for any services and fees not covered by her insuranceNurturing Expressions followed all policies and procedures by contacting the client sufficiently and documenting the case As far as the credit report is concerned the debt is reported by a third party agency that is collecting the debt on behalf of Nurturing Expressions Since it has been reported by the third party agency and not by Nurturing Expressions directly Nurturing Expressions is unable to remove the debt from the credit report

This is in referanjce to complaint # [redacted] that was closedsome how the previous e-mail went to my junk mail box and I just found itIt has now closedI am wrriting the following as a new complaint or if it may be added to the old numberNurturing Expressions LLC’s response of “she was required to sign a Rental Agreement, Financial Policy Form, and Acknowledgement of Privacy Policies” They failed to provide a signed copy of the Financial Policy Form, they failed to provide a signed copy of Acknowledgement of Privacy Policy as previously requestI had to go to their web site and copy these forms off of it to see what we were missingWhy did we not get copies of these, because my wife never signed these formsThey only provided a copy of the signed “Rental Agreement Form” which had the following blackened out daytime telephone number, evening telephone number blackened out, I would ask why these are blackened out? Because both numbers were good and were never disconnectedThis also is not Hippa informationType of equipment is also blackened out, why? This is not Hippa informationThey forgot to mention in their response that next to the $a day rental they have “INS” meaning insurance is covering itThey also have 1st Choice\DSHS next to type of paymentTheir web page list “First Choice” as one of several Insurance companies they exceptThey state my wife did not provide them with copies of her insurance cards, yet they state she signed the “Financial Policy Form” that has Primary Insurance“ Insurance Name/Policy Holder/Policy ID/Policy Holder Date of Birth/Insurance Phone/Relation to Client/Group Number/Employer” and Secondary Insurance “Insurance Name/Policy Holder/Policy ID/Policy Holder Date of Birth/Insurance Phone/Relation to Client/Group Number/Employer”So which is it she did not provide this information or she did on this formAlso this information could have been obtained from the hospital with my wife’s permission or by her asking the staff for a copy and then providing it to the person that brought the breast pumpOnce again they state they called and no response, not disconnected, no response to a automatic call on November They also state they sent the daily rental agreement to the primary insurance, so which is it they have the information or they don’t? They state on November that the biller checked and found both plans listed had terminatedThat is not correctI worked from 5/to 03/and had First Choice Insurance thru my employerDSHS was never terminatedPer checking with First Choice Insurance they would not authorize that Model of Brest Pump, but others they wouldPer checking with DSHS they only pay for the first two weeks of rentalSo if they notified us that insurance would not pay for that model of breast pump, they would lose money and we would have returned it like I said priorPerhaps that is why that information is Blackened outWhy is it that the primary number is good some times and others it is disconnected, because it was never disconnected? That is why the number is blackened outWe would be able to prove thru the phone service it was never disconnectedPhones are not temporarily out of service unless there is a problem with the service, which we had never had anyOn December 10, 2012, “They state we were notified by our insuranceThis is not true, we never received any notification2ndWhich is it? Insurance is terminated? Or Insurance is in effectSomeone cannot keep their story straightWhich is it the 1st number is out of service/or now it’s working and which is it the second number works and messages are left or now it’s not working???? Also by their own phone records, that when they contacted and actually spoke to my wife, don’t you think that they would have also in their notes stated that informed her that they have been trying to call, left all these messages because of problems with the insurance or that we now would have to pay for the rental, yet there is none of this in their dates of the live phone callsSo when I called and asked for copies of all paper work I was referred P&D who gets the paper work from them and I am expected to believe that they do not keep any copies of their recordsSo if they were to go to court that would me they do not have copies of the said missing paper work to provide as evidence they were provided and signed Their comment of they contacted us sufficiently is incorrect, by their own admission the main number worked and then it was out of service, yet they still fail to provide what that main number was because we are able to prove it was never disconnect or out of serviceNo business only attempts to contact a client by phone when they have not received payment of any rental equipment for months and months, no they would send out a bill/notice that we were behind in our rental paymentsPer their own admission they had a signed copy by my wife of their “Financial Policy Form” which they never provide to her and it also list for your e-mail on the form, which she never received any attempted contact on this matterAlso the date on the invoice is 9/13/after the breast pump was turned in? Yet they made no other notifications by mailWhich we did not receive until I made a request in Desired Outcome: To be removed from credit report

After reviewing the concerns addressed in the official complaint by Mr. and Ms. [redacted], as well as the client file, history, and documented communication log between the client and company, we stand by the financial charges issued to Ms. [redacted].
After delivering her infant, Ms. [redacted]’s...

doctor issued her a prescription for the medical equipment rental mentioned in the complaint. The prescription was faxed to Nurturing Expressions’ office and one of our staff members visited Ms. [redacted] in the hospital to personally deliver the equipment and explain the terms and conditions of the rental. As Ms. [redacted] was renting the piece of equipment from our company, she was required to sign a Rental Agreement, Financial Policy Form, and Acknowledgement of Privacy Policies. Ms. [redacted] did not supply our office with copies of her insurance cards or personal identification, so we were to accept the information she had supplied to us on the rental agreements as true and factual.
Ms. [redacted] signed the Rental Agreement on October 12, 2012. As Mr. [redacted] noted, the Rental Agreement included the daily rate for the equipment rental as $4.00 per day plus tax. Thus, Ms. [redacted] had advance knowledge of the daily rental price for the piece of equipment she was renting from the company. The Terms of Agreement on the Rental Agreement include the following: “Lessee agrees to pay the rental fees in accordance with the fee structure established shown under the rental payment plans below” and “The Lessee shall be responsible for all reasonable legal fees and other costs involved in collection of overdue amounts and/or recovery of equipment.” Ms. [redacted] received her own copy of her Rental Agreement upon receipt of the rental equipment.
Ms. [redacted] also signed the Nurturing Expressions Financial Policy Form, which included two contact telephone numbers, a contact address, and two insurance companies to bill for the rental equipment, all of which Ms. [redacted] verified with our staff member. Furthermore, Ms. [redacted] signed underneath the following two sections, therefore acknowledging that she had read and understood the terms of the rental:
Authorization of Penalty for Failure to Return Rented Property and Acknowledgement of functional equipment, equipment safety, and instruction on proper use:
I understand that my credit/debit card will be charged a full month’s rental for each month or partial month that I fail to return the rented property according to the Rental Agreement. I acknowledge that I have received the equipment in good working condition and have been instructed on safety, warranties, and proper use of the equipment. I acknowledge that I have signed the Rental Agreement and have received a copy of the signed Rental Agreement.
Assignment of Benefits/Authorization to Release Medical Information Financial Policy:
I hereby assign all benefits to which I am entitled to Nurturing Expressions LLC, in the event Nurturing Expressions files an insurance claim on my behalf.  I understand that filing an insurance claim on my behalf is a courtesy only and that I am financially responsible for all charges whether or not paid by said insurance company. In the event my account becomes delinquent and is default of payment, I accept responsibility for the principle amount owing as well as all reasonable costs associated with the collection of this debt.  This includes, but is not limited to, collection services, attorney’s fees and all court costs and additional legal fees associated with the recovery of this debt.  Interest may be charged at a rate of 1.5% per month (18% annually) for unpaid balances over 30 days old.  I hereby
authorize said assignee to release all information necessary to secure the payment of said benefits.  A copy of this assignment shall be considered as effective and valid as the original.
As a courtesy to our clients, Nurturing Expressions contacts individuals who are actively renting equipment to follow-up with their experience and verify whether they would like to continue renting. On November 8, 2012, we conducted our first automatic courtesy call to the [redacted] residence and received no response from either Mr. or Ms. [redacted]. Additionally, we billed Ms. [redacted]’s primary insurance plan the daily rental rate for the equipment.
On November 27, 2012, a Medical Biller reviewed Ms. [redacted]’s insurance eligibility information which is available to contracted providers through the insurance’s website. The information listed on Ms. [redacted]’s online eligibility form contradicted the insurance information she had supplied the company in the hospital. Upon further investigation, the Biller found that both insurance plans listed had terminated and were no longer active. In order to bill the client’s secondary insurance for payment, the client would need to contact them with updated information. The Biller called Ms. [redacted] to inform her that she needed to coordinate her benefits with her secondary insurance and her current primary insurance in order to receive payment from them towards her claims. The first telephone number Ms. [redacted] supplied us with was temporarily out of service, so a voicemail was left with the second telephone number.
On December 7, 2012, the company conducted another automatic courtesy call to attempt to get a hold of the client and received no response.
On December 10, 2012, the company received a claim denial from her primary insurance for the equipment rental. The rental of the equipment provided her was not a covered benefit on this client’s plan at the time of service. As a courtesy, the Biller contacted the primary insurance to receive more information regarding the claim decision and was told the client would need to submit an appeal. In the company’s experience, a client’s secondary insurance can be billed when the primary does not have a benefit for the rental. However, under her secondary insurance guidelines for rental equipment coverage, Ms. [redacted]’s rental would only be covered for 14 days once her infant discharged from the hospital. The Biller called Ms. [redacted] to inform her of the status of her claims, but once again, the first telephone number on file was out of service, and a voicemail was left with the second telephone number we had on file. It is also of note that Ms. [redacted] would have received a mailed Explanation of Benefits from her primary insurance at this time, stating that her claim was denied and she was financially responsible for the rental. Thus, the client had already received four voicemails from Nurturing Expressions as well as a notice from her insurance company regarding her lack of coverage and requesting she contact the company.
On December 17, 2012, the company called the client: the first telephone number was still out of service and we left a voicemail on the second telephone number.
On December 22, 2012, the company called the client and left another voicemail on the second phone number.
On February 5, 2013, the company called Ms. [redacted]. During this call, the first telephone number was able to receive calls. A voicemail was left on the first contact phone number, informing the client to contact us immediately about her rental equipment.  The company also called the second phone number provided, which was out of service at the time.
On May 13, 2013, a staff member spoke with Ms. [redacted] on the second phone number provided. Thus, it can be concluded that the second phone number provided was in working condition and Ms. [redacted] had access to the voicemails the company had left on the phone. Ms. [redacted] informed the staff member that she was going to return the rental equipment that day and was given the location and operating hours of the return site.
On June 11, 2013, the company’s records did not show that Ms. [redacted] had returned her rental equipment. A staff member spoke with the client again, and Ms. [redacted] stated that she would return the rental equipment that day.
On July 7, 2013 it was confirmed that Ms. [redacted] had returned the pump to the designated return site on June 11, 2013. An invoice was mailed to Ms. [redacted] with the balance due for the period she had the rental equipment. 
The company had not received payment or any communication from the client as of 10/24/2013, so the client’s account and balance was referred to the third-party collections’ agency.
To summarize, the client had received the following communication from Nurturing Expressions:
-          An in-person explanation of the contract and policy terms while the client was in the hospital
-          A hard copy of her Rental Agreement for her records
-          Seven courtesy voicemail's asking her to coordinate her insurance information and contact our office with updated information
-          Explanation of Benefits from her insurance companies detailing the claim denials
-          Two live phone conversations informing the where and how to return the rental equipment
-          A mailed invoice from the company requesting payment for the dates she was in possession of the rental equipment
-          A letter from the collections agency requesting payment for the dates she was in possession of the rental equipment
Mr. [redacted] emailed Nurturing Expressions on May 6, 2015 after Ms. [redacted] had discovered the overdue fee on her credit report. The Billing Department offered Mr. [redacted] account balance information.
 
When Mr. [redacted] asked which phone numbers were used to contact them regarding the matter, he was referred to P&D as they now were in possession of the account information and balance.
The documents he received from the third party collection agency are copies of his wife’s contract, but the personal health information may have redacted by the company in order to protect the privacy of the client and comply with HIPAA regulations.
His next concern – “I believe they violated their own Policy by not notifying us properly by Phone, US Mail service or by e-mail that for some reason they found out that our insurance would not cover that type of rental equipment which would have allowed us to follow their policy to the “Right to Refuse Service or Care” and return the pump since it would make us responsible for payment and we could have gone to WIC and barrowed one from their office.” – is also invalid as we have a documented call log of the many attempts to contact Ms. [redacted] but did not receive calls back on the messages left. While the client does have the right to return and refuse the service of the rental equipment, clients are financially responsible for the days that they are in possession of the rental equipment.
The client is responsible for knowing his or her benefit coverage and maintaining communication with our office. The client is also responsible for contacting our office if her contact information changes. The client is also financially responsible for any services and fees not covered by her insurance. Nurturing Expressions followed all policies and procedures by contacting the client sufficiently and documenting the case.

This is in referanjce to complaint #[redacted] that was closed. some how the previous e-mail went to my junk mail box and I just found it. It has now closed. I am wrriting the following as a new complaint or if it may be added to the old number. 1. Nurturing Expressions LLC’s response of “she was required to sign a Rental Agreement, Financial Policy Form, and Acknowledgement of Privacy Policies” They failed to provide a signed copy of the Financial Policy Form, they failed to provide a signed copy of Acknowledgement of Privacy Policy as previously request. I had to go to their web site and copy these forms off of it to see what we were missing. Why did we not get copies of these, because my wife never signed these forms. 2. They only provided a copy of the signed “Rental Agreement Form” which had the following blackened out daytime telephone number, evening telephone number blackened out, I would ask why these are blackened out? Because both numbers were good and were never disconnected. This also is not Hippa information. 3. Type of equipment is also blackened out, why? This is not Hippa information. 4. They forgot to mention in their response that next to the $4.00 a day rental they have “INS” meaning insurance is covering it. 5. They also have 1st Choice\DSHS next to type of payment. Their web page list “First Choice” as one of several Insurance companies they except. 6. They state my wife did not provide them with copies of her insurance cards, yet they state she signed the “Financial Policy Form” that has Primary Insurance“ Insurance Name/Policy Holder/Policy ID/Policy Holder Date of Birth/Insurance Phone/Relation to Client/Group Number/Employer” and Secondary Insurance “Insurance Name/Policy Holder/Policy ID/Policy Holder Date of Birth/Insurance Phone/Relation to Client/Group Number/Employer”. So which is it she did not provide this information or she did on this form. Also this information could have been obtained from the hospital with my wife’s permission or by her asking the staff for a copy and then providing it to the person that brought the breast pump. 7. Once again they state they called and no response, not disconnected, no response to a automatic call on 8 November 2012. They also state they sent the daily rental agreement to the primary insurance, so which is it they have the information or they don’t? 8. They state on 27 November 2012 that the biller checked and found both plans listed had terminated. That is not correct. I worked from 5/2012 to 03/2013 and had First Choice Insurance thru my employer. DSHS was never terminated. Per checking with First Choice Insurance they would not authorize that Model of Brest Pump, but others they would. Per checking with DSHS they only pay for the first two weeks of rental. So if they notified us that insurance would not pay for that model of breast pump, they would lose money and we would have returned it like I said prior. Perhaps that is why that information is Blackened out. 9. Why is it that the primary number is good some times and others it is disconnected, because it was never disconnected? That is why the number is blackened out. We would be able to prove thru the phone service it was never disconnected. Phones are not temporarily out of service unless there is a problem with the service, which we had never had any. 10. On December 10, 2012, “They state we were notified by our insurance. 1. This is not true, we never received any notification. 2nd. Which is it? Insurance is terminated? Or Insurance is in effect. Someone cannot keep their story straight. Which is it the 1st number is out of service/or now it’s working and which is it the second number works and messages are left or now it’s not working???? 11. Also by their own phone records, that when they contacted and actually spoke to my wife, don’t you think that they would have also in their notes stated that informed her that they have been trying to call, left all these messages because of problems with the insurance or that we now would have to pay for the rental, yet there is none of this in their dates of the live phone calls. 12. So when I called and asked for copies of all paper work I was referred P&D who gets the paper work from them and I am expected to believe that they do not keep any copies of their records. So if they were to go to court that would me they do not have copies of the said missing paper work to provide as evidence they were provided and signed . 13. Their comment of they contacted us sufficiently is incorrect, by their own admission the main number worked and then it was out of service, yet they still fail to provide what that main number was because we are able to prove it was never disconnect or out of service. No business only attempts to contact a client by phone when they have not received payment of any rental equipment for months and months, no they would send out a bill/notice that we were behind in our rental payments. Per their own admission they had a signed copy by my wife of their “Financial Policy Form” which they never provide to her and it also list for your e-mail on the form, which she never received any attempted contact on this matter. Also the date on the invoice is 9/13/2013 after the breast pump was turned in? Yet they made no other notifications by mail. Which we did not receive until I made a request in 2015.
Desired Outcome: To be removed from credit report.

RESPONSE TO Revdex.com COMPLAINT, MARCH 1ST
Nurturing Expressions maintains its position in the case of Ms. [redacted] account: the client was informed of her rights and responsibilities for the rental and remains financially accountable for the charges accrued whilst the rental equipment was in her possession.
Please see the responses to the points listed by Mr. [redacted] below:
1. Nurturing Expressions LLC’s response of “she was required to sign a Rental Agreement, Financial Policy Form, and Acknowledgement of Privacy Policies” They failed to provide a signed copy of the Financial Policy Form, they failed to provide a signed copy of Acknowledgement of Privacy Policy as previously request. I had to go to their web site and copy these forms off of it to see what we were missing. Why did we not get copies of these, because my wife never signed these forms.
Nurturing Expressions and the collections agency, Physician and Dentists, maintain digital copies of Ms. [redacted] original, signed contracts. Clients are given a copy of the Rental Agreement Contract at the time of delivery and have the option to request a copy of the Financial Policy Agreement. Clients also retain the right to request any of their records at any point of the rental period. As Mr. [redacted] stated, the Financial Policy Agreement is also available for download on the company website. Thus, the contract is accessible and available for clients, as is the administrative office should clients have questions regarding any portion of said contract.
2. They only provided a copy of the signed “Rental Agreement Form” which had the following blackened out daytime telephone number, evening telephone number blackened out, I would ask why these are blackened out? Because both numbers were good and were never disconnected. This also is not Hippa information.
The third party agency – Physicians and Dentists – redacts any personal information that may compromise a client’s personal health information (PHI) or identity. The phone numbers were redacted to protect the privacy of the client. According to the HIPAA Privacy Rule, providers must protect most “‘individually identifiable health information’ held or transmitted by a covered entity or its business associate, in any form or medium, whether electronic, on paper, or oral.” (Guidance on De-identification of Protected Health Information, www.hhs.gov/sites/default/files/ocr/privacy/hipaa/understanding/coveredentities/...⇄ PHI consists of any demographic information, including many common identifiers – such as addresses and phone numbers – when they can be associated with the health information. In order to protect Ms. [redacted] privacy, her PHI was not released.
3. Type of equipment is also blackened out, why? This is not Hippa information.
According to HIPAA (45 C.F.R. § 160.103), personal health information includes any information relating to “the individual’s past, present or future physical or mental health or condition.” Thus, the type of equipment rented must be redacted in order to protect information pertinent to Ms. [redacted] condition.
4. They forgot to mention in their response that next to the $4.00 a day rental they have “INS” meaning insurance is covering it.
The denotation of “INS BILL” next to the daily rental rate of $4.00 per day plus tax signifies that Nurturing Expressions agrees to bill the client’s insurance company the rate of $4.00 per day, as a courtesy to the client. Nurturing Expressions cannot guarantee payment for the rental as coverage is dependent on the client’s individual plan, benefits, and eligibility at the time of service.
5. They also have 1st Choice\DSHS next to type of payment. Their web page list “First Choice” as one of several Insurance companies they except.
Nurturing Expressions is an in-network provider with First Choice and bills claims to First Choice on behalf of the clients. However, participation in the network does not guarantee payment for clients. Benefits are subject to the client’s individual plan and eligibility at the time of the service.
6. They state my wife did not provide them with copies of her insurance cards, yet they state she signed the “Financial Policy Form” that has Primary Insurance“ Insurance Name/Policy Holder/Policy ID/Policy Holder Date of Birth/Insurance Phone/Relation to Client/Group Number/Employer” and Secondary Insurance “Insurance Name/Policy Holder/Policy ID/Policy Holder Date of Birth/Insurance Phone/Relation to Client/Group Number/Employer”. So which is it she did not provide this information or she did on this form. Also this information could have been obtained from the hospital with my wife’s permission or by her asking the staff for a copy and then providing it to the person that brought the breast pump.
Ms. [redacted] did not provide Nurturing Expressions physical copies of her personal identification or insurance identification. Therefore, the insurance, billing, and contact information listed on the Financial Policy Agreement was verified and given to Nurturing Expressions by Ms. [redacted] herself when she signed and acknowledged the agreement.
7. Once again they state they called and no response, not disconnected, no response to a automatic call on 8 November 2012. They also state they sent the daily rental agreement to the primary insurance, so which is it they have the information or they don’t?
Per the contract and procedure, Nurturing Expressions billed the insurance company Ms. [redacted] verified as primary on her Financial Policy Agreement. Billing the client’s insurance is a standard procedure for Nurturing Expressions when a client is renting a piece of equipment and requests it be billed to the primary insurance carrier.
Also, Mr. [redacted] is correct: according to the phone log kept by Nurturing Expressions, no response was received from Mr. or Ms. [redacted] after the automatic telephone call was made on Nov. 8, 2012. Nurturing Expressions did not hear from the client after this phone call was made.
8. They state on 27 November 2012 that the biller checked and found both plans listed had terminated. That is not correct. I worked from 5/2012 to 03/2013 and had First Choice Insurance thru my employer. DSHS was never terminated. Per checking with First Choice Insurance they would not authorize that Model of Brest Pump, but others they would. Per checking with DSHS they only pay for the first two weeks of rental. So if they notified us that insurance would not pay for that model of breast pump, they would lose money and we would have returned it like I said prior. Perhaps that is why that information is Blackened out.
As stated in the previous report, additional insurance companies were listed on the client’s DSHS online eligibility statement. These companies were not the same as what Ms. [redacted] provided on her rental agreement. The additional insurance plans listed online were inactive. In order to bill the client’s secondary insurance for payment, the client needed to contact the secondary insurance company and inform them that the two additional insurance companies were no longer active and then provide the most recent insurance company information. This action is commonly referred to as coordinating benefits.  Nurturing Expressions’ Biller called Ms. [redacted] to inform her that she needed to coordinate her benefits with her secondary insurance and current primary insurance in order to receive payment from them towards her rental claims. Furthermore, it is the responsibility of the client to coordinate and understand her own benefits and coverage limitations. Insurance companies do not permit providers to coordinate benefits on behalf of the client.
9. Why is it that the primary number is good some times and others it is disconnected, because it was never disconnected? That is why the number is blackened out. We would be able to prove thru the phone service it was never disconnected. Phones are not temporarily out of service unless there is a problem with the service, which we had never had any.
To reiterate the point above, Physicians and Dentists redacted the client’s phone number to comply with HIPAA rules and regulations as it is considered personal health information.
10. On December 10, 2012, “They state we were notified by our insurance. 1. This is not true, we never received any notification. 2nd. Which is it? Insurance is terminated? Or Insurance is in effect. Someone cannot keep their story straight. Which is it the 1st number is out of service/or now it’s working and which is it the second number works and messages are left or now it’s not working????
Members receive paper Explanation of Benefits from insurance companies for claims submitted by providers. Nurturing Expressions received an Explanation of Payment for the claim in question, resulting in a denial of payment. Simultaneously, the member would have received an Explanation of Benefits showing the claim had denied.
Regarding communication done by telephone, Nurturing Expressions’ policy is to document all outgoing attempts and incoming conversations. To comply with this policy, staff members made note of which phone line was functional at the time of the call, as well as on which phone line was a voicemail left.
11. Also by their own phone records, that when they contacted and actually spoke to my wife, don’t you think that they would have also in their notes stated that informed her that they have been trying to call, left all these messages because of problems with the insurance or that we now would have to pay for the rental, yet there is none of this in their dates of the live phone calls.
As previously stated, Ms. [redacted] received a copy of her original rental agreement which included the phone number she supplied to us and verified as a working, valid phone number. Mr. [redacted] is further correct in saying that the phone number on which we spoke with Ms. [redacted] was indeed in service; thus, Ms. [redacted] has received the many voicemails and attempts at communication left by the Nurturing Expressions staff, informing her of the changes in her insurance. In addition, the communication attempts by Nurturing Expressions do not begin to include any other contacts undoubtedly made by Ms. [redacted] insurance companies, or the many channels of communication available to Ms. [redacted] – such as the insurance provider’s website, member benefit booklets, customer service representatives, etcetera – had she wanted to pursue any investigation into her own benefit plan, coverage, and claims determination. Nurturing Expressions has provided the pertinent rental information to Ms. [redacted]; any further information was accessible and available.
12. So when I called and asked for copies of all paper work I was referred P&D who gets the paper work from them and I am expected to believe that they do not keep any copies of their records. So if they were to go to court that would me they do not have copies of the said missing paper work to provide as evidence they were provided and signed.
In compliance with Washington State Department of Health policies, Nurturing Expressions maintains copies of client medical records. Nurturing Expressions holds a copy of Ms. [redacted] original, signed Financial Policy Agreement on which she agrees to the following: I hereby assign all benefits to which I am entitled to Nurturing Expressions LLC, in the event Nurturing Expressions files an insurance claim on my behalf.  I understand that filing an insurance claim on my behalf is a courtesy only and that I am financially responsible for all charges whether or not paid by said insurance company.  In the event my account becomes delinquent and is default of payment, I accept responsibility for the principle amount owing as well as all reasonable costs associated with the collection of this debt.  This includes, but is not limited to, collection services, attorney’s fees and all court costs and additional legal fees associated with the recovery of this debt.  Interest may be charged at a rate of 1.5% per month (18% annually) for unpaid balances over 30 days old.  I hereby authorize said assignee to release all information necessary to secure the payment of said benefits.
13. Their comment of they contacted us sufficiently is incorrect, by their own admission the main number worked and then it was out of service, yet they still fail to provide what that main number was because we are able to prove it was never disconnect or out of service. No business only attempts to contact a client by phone when they have not received payment of any rental equipment for months and months, no they would send out a bill/notice that we were behind in our rental payments. Per their own admission they had a signed copy by my wife of their “Financial Policy Form” which they never provide to her and it also list for your e-mail on the form, which she never received any attempted contact on this matter. Also the date on the invoice is 9/13/2013 after the breast pump was turned in? Yet they made no other notifications by mail. Which we did not receive until I made a request in 2015.
To clarify, Ms. [redacted] did not supply her email address on the Financial Policy Form; thus, could not be contacted using this method.
When Ms. [redacted] had returned the equipment to Nurturing Expressions, her insurance benefits were still not coordinated between her primary and secondary payers. Therefore, Nurturing Expressions could bill neither insurance company for payment and Ms. [redacted] is obligated to pay for the dates of service she had the pump in her possession. Nurturing Expressions mailed a hardcopy of an invoice to Ms. [redacted] and received no response. Had she responded in a timely manner, the Nurturing Expressions staff could have once again instructed her to coordinate her benefits so her claims could have been billed for reimbursement, or a payment plan could have been established. Neither Mr. nor Ms. [redacted] contacted Nurturing Expressions regarding the paper invoice that had been mailed to them or the many voicemails that had been left on their working phone number.
Desired Outcome: To be removed from credit report.
As stated previously, the client is responsible for knowing his or her benefit coverage and maintaining communication with Nurturing Expressions’ office. The client is also responsible for contacting our office if her contact information changes. The client is also financially responsible for any services and fees not covered by her insurance. Nurturing Expressions followed all policies and procedures by contacting the client sufficiently and documenting the case.  As far as the credit report is concerned the debt is reported by a third party agency that is collecting the debt on behalf of Nurturing Expressions.  Since it has been reported by the third party agency and not by Nurturing Expressions directly Nurturing Expressions is unable to remove the debt from the credit report.