Preferred Homecare

I do see this patient called in concerned that they had been sent to a collection agency He stated he never received the invoices from Preferred Homecare (PHC)I show PHC sent out invoices on 3/17/2015, 4/16,2015, 5/19/2015, 6/16/and 7/16/before the patient was sent to collections
None of the letters PHC sent out were returned to PHC stating the mail was undeliverable Patient should have also received EOB’s from their insurance company letting them know they would have a responsibility for services provided by PHC Balances sent to collection are validPatient has paid off their collections balance with the agency on 8/28/and I do not show any indication the agency ever reported any non-payments to the credit bureaus. Patient did call requesting to speak with a supervisor Patient did receive a phone call back on 8/3/from *** *** and a VM was left but the Patient never called back in to return the phone call. Patient did report that he did received an itemized statement from PHC.Patient did call on 10/05/requesting the status of his invoices that were mailed out on 9/15/ but patient reported he had not received it yet in the mail Patient was advised he may need to speak with the post office as we are sending invoices to the address on file which he confirmed is correct The itemized statements and invoices have the exact same address printed on them Preferred Homecare offers online bill pay and automatic payments if patient is concerned about invoices not being paid Patient most recently walked in today (10/06/2015) and made a payment Patient is currently in good standing and next invoice will be sent out on 10/15/

Ms*** is correct this was a coding issueMs*** has been credited the $
Thank you,

After several attempts to contact mom and no return call was made we have stopped. Here is my response and what was going to be communicated to momFirst of all she was correct, Name removed please share with staff as this is a learning example, when they received the call from mom we needed to adjust the balance as Primary paid no need of transferring to secondary as they paid at a full allowed. Name removed as this could of been prevented as payer paid and the balance needed to be adjusted or transfer back to primary, mom is correct we should not be booking anything to secondary as the primary paid at full. Thank you,*** *** •Credentialing SpecialistPreferred Homecare • LifeCare Solutions

The Manager from the department that handles Ms*** insurance spoke to the patientThe branch in *** is going to give her a call and let her know she can come and pick up her cpap as she had returned it thinking it wasn’t covered. Preferred Homecare will keep an eye on
her account and the patient is very happy

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID ***, and have determined that this proposed action would not resolve my complaint. For your reference, details of the offer I reviewed appear below.“A 3-way call
was made with the patient to *** regarding the repairs and the verbiage of that call was added to the Advanced Beneficiary Notice (ABN)The member was alerted the cost and her responsibility for the repairs if *** deniedThe member signed the ABN prior to delivery of her repaired PWC.”We reject the response given by Preferred Homecare for the following reasons:A 3-way call was made on 3/27/between myself, *** *** from Preferred Homecare and *** *** from *** (employee # ***) at which time she told us that according to the records she was able to access, my wheelchair was purchased by *** on 9/9/At no time was there any discussion of cost because Preferred was not in a position to determine the cost until they had a chance to work on it and see what was needed to be done to it (see attached copy of my receipt from Preferred Homecare).When it was finally time to set up a repair appointment, Preferred hadn’t heard in writing from *** that they paid for the chair*** asked to sign an ABN so that they can begin working on the chairIt should be noted that I made my initial contact with Preferred for the repairs on August 27, 2013, and it wasn’t until 4/16/to get the repairs doneAgain, I was NOT informed of the costWe drove down there on April 16, 2014, and the technicians worked on my chair all day
Regards,
*** ***

[A default letter is provided here which indicates your acceptance of the business's response. If you wish, you may update it before sending it.]
Revdex.com:
I have reviewed the response made by the business in reference to complaint ID *** and find that this resolution would be satisfactory to me. I will wait until for the business to perform this action and, if it does, will consider this complaint resolved
Regards,
*** ***

Preferred Homecare (PHC) would like to respond to the Revdex.com (Revdex.com) regarding Ms***’s positive airway pressure device (PAP) service concerns. 12.06.2013: PHC sMs***’s PAP. Ms*** continues to receive PAP supplies regularly. 08.16.2016: Ms*** came into
a PHC location to have her PAP evaluated. PHC’s Respiratory Therapist (RT) determined the PAP was malfunctioning and needed to be replaced. Ms***’s PAP was out of warrantyPHC’s Area Operations Manager (AOM) decided to replace Ms***’s PAP device even so, as a courtesy no-charge to Ms***. Ms***’s PAP was replaced same day. 08.25.2016: PHC received an order for a replacement PAP, despite having just replaced PAP 08.16.2016. 08.31.2016: Ms***’s son, ***, called to inquire on status of second replacement order. *** was advised that PHC had already replaced Ms***’s PAP on 08.16.2016. *** then stated the replacement PAP was not working, even though the replacement PAP had just been evaluated by a certified RT only weeks prior. PHC advised we would submit for prior authorization (PA) of a second replacement PAP to Ms***’s insurance company. Ms***’s second PAP replacement is currently pending PA from her insurance company

My concerns have not been addressedI also requested that there be weekly scheduled visits. the manager that contacted me did give me his numberBut I never said I was satisfied He stated that the company takes this type of negligence seriousObviously that is not true from the response that I received from this company. The manager wanted to know what location I was dealing withAdditionally I would like this be be made as public record- people see to know that big companies that go out and buy smaller companies need to provide adequate services and respond to customers in a timely manner

A supervisor in the Reimbursement Department has talked to Mrs*** During their conversation today 1/7/ the phone was disconnectedPreferred Homecare is attempting to assist the *** with their billing concerns and will continue to help them to their satisfaction

Preferred Homecare (PHC) would like to respond this Revdex.com complaint regarding our patient, *** *** Nebulizers. Mr*** received the initial portable (battery operated) nebulizer on 7/6/2012. Each time MrWarner has asked for an exchange, PHC has complied,
with the most recent exchanges completed on 10/19/15, 12/09/15, 12/18/and 03/02/16. Mr*** also received a standard nebulizer on 10/19/15. Each time Mr*** has asked for an exchange, PHC has complied, with the exchanges completed on 12/13/and 03/02/2016. Each nebulizer that was returned to PHC was found to be in proper working condition. At no time was our patient without at least one working nebulizer. Preferred Homecare strives to make a difference in the lives of the patients we serve and will continue to support MrWarren’s respiratory needs while on service with our company Sincerely, *** *** Vice President of Managed Care

Preferred Homecare (PHC) would like to respond to this member's Revdex.com (Revdex.com) concern regarding her power wheelchair (PWC). PHC's Rehab Area Manager has worked directly with this member's order. This member's order was processed timely and the member's concerns have been
addressed timely. Please see the order processing details below in response to this member's concerns. 10.20.16: PHC received an order for repair or replacement of the member's PWC. 10.26.16: PHC verified member demographics, processed scheduling for PWC evaluation and left a message for the member to complete the evaluation. 11.2.16: PHC completed PWC evaluation. 11.09.2016: PHC submitted evaluation to product vendors for parts quotes and submitted for prior authorization to the member's health insurance plan. 11.21.2016: PHC received prior authorization from the member's health insurance plan and submitted member's order to Purchasing. 11.23.2016: PHC's Purchasing Department approved order and submitted to vendors to obtain equipment. 11.30.2016: PHC received equipment from the vendors and assembled the member's PWC. 12.03.2016: PHC notified member of scheduled delivery of PWC. 12.06.2016: PHC completed delivery of PWC. 01.13.2017: PHC was notified by member that the PWC "battery won't charge." 01.16.2017: PHC coordinated piof PWC for evaluation 01.17.2017 01.17.2017: PHC pickPWC for evaluation. PHC's Rehab Area Manager continues to be involved in this member's PWC repair and will coordinate with the member for re-delivery timely

Preferred Homecare (PHC) would like to respond to this member's Revdex.com (Revdex.com) complaint regarding the billing of his medical equipment. PHC processed claims to the member's insurance company until 10.16.2016. At that time, his insurance company transitioned to a different
medical supply company and PHC was no longer able to bill the insurance company. Because the member did not transition to the in-network provider and yet retained PHC's equipment & service, the member was responsible for out-of-network charges post 10.16.2016. Though PHC billed this member appropriately and according to his insurance guidelines, we have agreed to waive his collections balance due. For all future needs, the member should understand that he will be required to work with an in-network provider to avoid financial responsibility for services utilized

My son is severely disabled. He is total care special needs. He uses alot of medical supplies from just about every department. On my last order he recieved a head strap for his cpap . It was brand new but was faulty an velcrose did not stick Well. It actually kept coming off an finally it got wrapped around his neck an choked him to the point of causeing a seizure oxygen dropped. Luckily the alarm finally went off or it could have been fatal. The strap had only been opened one week was brand new. I called an explained this all to Preferred an all they said was oh well we cannot replace it. So I guess what there saying is if there faulty stuff causes a fatality they will be willing to except that fault. This company is very poor managed . They have already caused a seizure with this mess. Looking into what can be done about this.

I just want Preferred Homecare and the Revdex.com to know that's not what happened. After continuing to not hear from anyone at Preferred Homecare I contacted Ronda, the manager of the rehab department on 8/3/16 and that's when she informed me that the wheelchair would be delivered on 8/4/16 although Ken the rehab driver informed me that the wheelchair adjustments were completed on 7/30/16 and would have liked to have dropped it off on 8/2/16 but unfortuneatly that wasn't possible.

Preferred Homecare (PHC) has reviewed Ms. [redacted]’s concern regarding the billing of her small volume nebulizer machine (SVN). Upon review of [redacted]’s account, the SVN was billed by PHC according to insurance coverage guidelines. The SVN is a sale item that converts to purchase after a rental...

period defined by her insurance coverage guidelines. All billing rates follow insurance guidelines and Ms. [redacted]’s responsibility includes meeting the deductible of her plan. Ms. [redacted] was informed of these guidelines 08.04.2015 and has been in contact with PHC’s Billing Supervisor to review the claims on her SVN.  PHC’s Supervisor did write-off 3 months as a courtesy at Ms. [redacted]’s request.

Preferred Homecare (PHC) did elevate this member's concern to our Reimbursement Manage for review. The member was charged in-network rates, as he states below.  The member's charges are due to his deductible not being met. The supplies dispensed are billed at his insurances company's...

rates, regardless of brand.  A brand change would not affect the allowed amount charged. It appears this member's account was billed correctly and according to his insurance benefits.

Preferred Homecare in [redacted] researched and found they had attempted to contact this patient on 3 separate occasions to get patient scheduled. After reviewing the documents we received from the physician the number provided on the paperwork we received was different than the...

number we had in the system as this patient already has an existing account with Preferred Homecare. The information provided in this complaint matched the information provided by the physician.  The staff has been counseled on verifying information received from the physician if it doesn't match the information we have if the individual is a current patient of Preferred Homecare.  We have since spoken with the patient and have updated his account to reflect the correct phone number. This patient is scheduled @ 3:30 on July 29th.

PHC has re-reviewed this member's billing concern.  The online eligibility portal used to verify in-network coverage status still shows the member as in-network, and pricing still populates at in-network rates.  We are unable to determine why the member's out-of-network deductible would cause billed charges to populate, despite in-network verification online.  This can only be explained by the health plan, not PHC.  To simply resolve the issue and move forward, we will write-off the charges and forgo reimbursement from either the member or the health plan for services rendered.

Preferred Homecare (PHC) Management has reached out to the member & provided a direct contact for any concerns going forward.  The member did receive the correct green colored O2 tubing instead of the clear O2 tubing.  Management feedback at this time is the member's concern has been...

addressed.

[redacted] was billed monthly for her copay on the Concentrator in the amount of $42.78.  This started in February of 2014. She had [redacted] insurance at that time. The insurance company was paying their portion of the claim till dos 7/2/2014.  On 3/3/2015 [redacted] began to deny our claims stating...

that the items have exceeded their maximum benefits under the plan.  They basically were considering their O2 that began in 2011 to be a purchase as of Sept 2013.  Oxygen is a non purchasable item so we did appeals all denials.  On 4/15/2015 We received a denial to our appeal . The insurance [redacted] stated they will no longer pay on the Oxygen concentrator even though we have no contract to purchase with them nor do we sell O2 equipment. At that time all open claims in the amount of $598.86 were billed directly to the patient as non-covered under their plan. 5/5/2015 – patient discontinued service and bought their own concentrator [redacted] also let us know that she was going to and was in the process of appealing with her insurance for payment. She spoke with the billing department and did inform us that she would not be able to make a payment with us on the 13th as she was appealing with the insurance. She was informed at that time that non payment regardless of insurance appeal would result in late notices and collections. We have no record of the patient calling us again until 9/3/2015 in regards to the collections balance.  I did check today and the pt has made arrangements to pay the agency.