Omega Medical Systems

February 11, Dear [redacted] ***,We have received your letter regarding the complaint from our customer [redacted] ***We have been working with both her and husband regarding this matterOmega Medical feels that we have done everything consistent with our policiesUnfortunately, when you are dealing with insurance companies, and their entry level employees, mistakes can and will be madeWith this situation, we contacted the customer's insurance company and were told that she was covered for this particular itemOmega Medical was apparently given misinformation, and we were not told this until days after the claim was filedIt was at that time, we were told that the customer had a deductible and the claim was used toward thatWhen we initially contacted the patient after this, we informed the customer that they would only be responsible for my cost on the pump of $150.00, not the insurance amount of $295.00.Her husband and were both trying to get this claim paid, and had made several phone calls to the insurance companyAfter a few months, Omega finally spoke to someone that told us that the customer was paid directly for the claim, not usAt this point, we contacted the customer and asked them to pay us for the pump, since the insurance company sent them a check for $This is when the customer realized that the insurance company took the money from their FSA accountHer husband was working on this with the insurance company, as he felt this was not rightAt last email correspondence with him, we were told that the insurance company told him they made an exception, and was going to pay the claimAs of today, we still have yet to be paid by the insurance companyWhen a claim is not paid, our in house policy is to send it to our collections department after a certain period of timeThis customer's file was not sent to collections, as the customers have been cooperativeThe customer called to pay $when I was out of the office, so someone else took the paymentI have credited the customer's credit card the difference of $145.00, until this is paid by insuranceAs the customer stated, we have agreed to credit the monies paid back to the customer, once the claim is paid by insurance.The customer has a device from Omega Medical, and is worth the $which is currently what the customer has paidOmega does not feel that they should have to refund the patient in full for this.Sincerely,Debbie B

February 11, 2016
Dear [redacted],
We have received your letter regarding the complaint from our customer [redacted]. We have been working with both her and husband regarding this matter. Omega Medical feels that we have done everything consistent with our policies....

Unfortunately, when you are dealing with insurance companies, and their entry level employees, mistakes can and will be made. With this situation, we contacted the customer's insurance company and were told that she was covered for this particular item. Omega Medical was apparently given misinformation, and we were not told this until 60 days after the claim was filed. It was at that time, we were told that the customer had a deductible and the claim was used toward that. When we initially contacted the patient after this, we informed the customer that they would only be responsible for my cost on the pump of $150.00, not the insurance amount of $295.00.Her husband and were both trying to get this claim paid, and had made several phone calls to the insurance company. After a few months, Omega finally spoke to someone that told us that the customer was paid directly for the claim, not us. At this point, we contacted the customer and asked them to pay us for the pump, since the insurance company sent them a check for $295.00. This is when the customer realized that the insurance company took the money from their FSA account. Her husband was working on this with the insurance company, as he felt this was not right. At last email correspondence with him, we were told that the insurance company told him they made an exception, and was going to pay the claim. As of today, we still have yet to be paid by the insurance company. When a claim is not paid, our in house policy is to send it to our collections department after a certain period of time. This customer's file was not sent to collections, as the customers have been cooperative. The customer called to pay $295.00 when I was out of the office, so someone else took the payment. I have credited the customer's credit card the difference of $145.00, until this is paid by insurance. As the customer stated, we have agreed to credit the monies paid back to the customer, once the claim is paid by insurance.
The customer has a device from Omega Medical, and is worth the $150.00 which is currently what the customer has paid. Omega does not feel that they should have to refund the patient in full for this.
Sincerely,
Debbie B

February 11, 2016 Dear [redacted],We have received your letter regarding the complaint from our customer [redacted]. We have been working with both her and husband regarding this matter. Omega Medical feels that we have done everything consistent with our policies. Unfortunately, when you are...

dealing with insurance companies, and their entry level employees, mistakes can and will be made. With this situation, we contacted the customer's insurance company and were told that she was covered for this particular item. Omega Medical was apparently given misinformation, and we were not told this until 60 days after the claim was filed. It was at that time, we were told that the customer had a deductible and the claim was used toward that. When we initially contacted the patient after this, we informed the customer that they would only be responsible for my cost on the pump of $150.00, not the insurance amount of $295.00.Her husband and were both trying to get this claim paid, and had made several phone calls to the insurance company. After a few months, Omega finally spoke to someone that told us that the customer was paid directly for the claim, not us. At this point, we contacted the customer and asked them to pay us for the pump, since the insurance company sent them a check for $295.00. This is when the customer realized that the insurance company took the money from their FSA account. Her husband was working on this with the insurance company, as he felt this was not right. At last email correspondence with him, we were told that the insurance company told him they made an exception, and was going to pay the claim. As of today, we still have yet to be paid by the insurance company. When a claim is not paid, our in house policy is to send it to our collections department after a certain period of time. This customer's file was not sent to collections, as the customers have been cooperative. The customer called to pay $295.00 when I was out of the office, so someone else took the payment. I have credited the customer's credit card the difference of $145.00, until this is paid by insurance. As the customer stated, we have agreed to credit the monies paid back to the customer, once the claim is paid by insurance.The customer has a device from Omega Medical, and is worth the $150.00 which is currently what the customer has paid. Omega does not feel that they should have to refund the patient in full for this.Sincerely,Debbie B