Respiratory Technologies Inc

Initial Business Response /* (1000, 5, 2016/01/27) */
RE: Complaint Filed on 1/15/2016 - Case #[redacted]
To Whom It May Concern:
Thank you for the notification of the customer complaint filed on January 15, 2016. We are sorry to hear that this customer experienced dissatisfaction related to...

our product and/or services, as we pride ourselves on exceptional customer satisfaction.
Based on the complaint received, this customer is concerned about paying his co-payments, as assigned by his health insurance plan, for the months he rented our vest therapy device. Below outlines some of the regulations related to this matter, specific information regarding this customer's account and a resolution to this concern.
Regulations on Co-Payment Collections
Respiratory Technologies (dba RespirTech), is a durable medical equipment (DME) company that is contracted with insurance companies across the country to provide our therapy to their members. As a DME company, there are specific standards and regulations that we must adhere to in order to continue to participate as a provider with these insurance companies including, Medicare, State Medicaid plans and BlueCross BlueShield plans.
One of these regulations relates to the collection of co-insurance payments from our customers who are members of the insurance plans. This regulation requires that RespirTech, as a medical device provider, make reasonable efforts to collect co-insurance payments from its customers. There are conditions on which these co-payments may be waived or lowered, through a financial hardship policy. However, DME providers, like RespirTech, are unable to routinely waive co-payments and must have a financial hardship policy in place that is administered consistently to every customer in order to waive or lower customer's co-payments. Below is an excerpt from the BlueCross BlueShield of Vermont provider manual, related to the waiver of customer's co-payments, as can be found on their website www.bcbsvt.com.
"A provider should limit waiver of copayments or deductible to situations where (1) the provider has a patient financial hardship policy (sometimes called a sliding scale) and (2) the member in question meets the criteria for reduced or waived payment."
RespirTech does have a financial hardship program in place, called The Customer Assistance Program, which will allow for waivers or lowering of customer's co-payments based on financial need. This patient was offered this program, as will be overviewed below.
Account Specifics
Based on a review of this customer's file, we have outlined the following timeline of events.
On July 9, 2015, RespirTech received a prescription from the customer's physician to dispense a vest therapy device for this customer. On July 14th 2015, a call was placed to the customer, at which time he was referred to his health insurance plan for information regarding his benefit and coverage information. During that call, he indicated that he would like to proceed with shipment and deal with the insurance later as documented in the call log in the patient file here at RespirTech.
The device was delivered to the customer and training was provided on July 22nd, 2015. Our five day post training follow-up call was completed on July 29, 2015, with the customer, to ensure that things were going well with the therapy and to answer any questions. During that call, the customer indicated that the training went very well and that the trainer had answered all of the questions he had, as documented in the call log in our patient file.
On November 25, 2015, the customer contacted RespirTech and indicated that he would like to return the device because he could not afford the co-payments assigned to him by his insurance company. At that time, the customer was considered for our Customer Assistance Program for a possible reduction or waiver of his co-payments due to financial hardship, but after review it was determined that he did not qualify for the program due to having a high annual household income. The customer was also offered a monthly payment plan or discount for a lump sum payment in full, which he refused. The amount outstanding represents the co-payment amounts, as assigned by his insurance company, from the invoices issued for dates of service in July, August, September, and October of 2015. The device was returned on December 11, 2015.
Resolution
In terms of resolution, our offer to work out a payment plan or to extend a discount for a lump sum payment in full is still available and we would very much like to work with the customer to bring this to closure. Unfortunately, as the provider of the device, by law and through contractual obligation with the insurance company, we are unable to waive customer's co-payments unless the customer qualifies for financial hardship, which this customer regrettably does not.
Thank you for taking the time to review our response and please contact me directly with any further questions.
Initial Consumer Rebuttal /* (3000, 8, 2016/01/27) */
(The consumer indicated he/she DID NOT accept the response from the business.)
At most I am willing to pay one months rental. Had you notified me in a prompt manner of the costs involved I would have returned your equipment much earlier. Its unethical to wait three months to start billing me and then expect me to pay a very large surprise bill. You have the equipment back, now forgive the debt. You have already been heavily compensated by my insurance company, how greedy can you be. This is whats wrong with the medical industry. No where else in the world can you charge tens of thousands of dollars for an air compressor.