Sleep Remedies

Initial Business Response /* (1000, 10, 2016/01/12) */
Health Choice, which is the customers insurance provider, will only authorize the use of a PAP device if the patient qualifies via their specific criteriaOnce submitted, Health Choice authorizes the rental of a PAP device and heated
humidifier, per medical necessity, that has already been establishedAuthorization is for the rental of the PAP device for an initial day periodIt is then up to Sleep Remedies to establish that the patient is compliantly using the device hours or more 70% of the time in a consecutive day periodThis criteria was clearly established on 12-30-with patient compliance at 100% usage with therapeutic benefitThis is clearly different than the customers claim in the Revdex.com complaint that the machine "has not worked for him since 2014." Once their criteria is established, Health Choice will approve a rental of the device up to the purchase priceHealth Choice will rent the device for months total and at that time the device is considered purchasedThe customer has an outstanding balance of $This amount is a combination of his co-insurance amount and deductibleHe has made one payment in June and we have sent him statements since thenNo dialog with the patient has taken place about any of his complaintsIn fact, the first notification of non usage reported by the patient was during a follow up phone call that was placed to him by our office on 10-27-By this time, his machine had already reached the end of its rental period and was considered purchasedAny outstanding co-insurance and deductible remaining is due and routinely mailed to the customer by our billing department
Prior to this Revdex.com complaint, we had established an ongoing communication with the customer regarding his therapy and had no knowledge of his issues with therapyHe was non-responsive to all of the statements sent dating back to JuneHe was actively involved with his therapy and was compliantly using his device with therapeutic benefit