St Mary's Pharmacy

Re: [redacted]Dear Sirs/ Madam:We take seriously the pride in which we offer service to our customers. I submit a history of this account andcan assure you that all possible customer service and billing options have been considered here.Unfortunately, I believe there...

may be some miscommunication or understanding between patient andinsurance carrier regarding coverage and payment responsibility. Patient has not responded in last 15 days.As such, we now consider this customer service issue closed until new information or circumstance arise.Account History:8/13/15 Kari R[redacted], Billing ManagerPatient called today to ask about a bill she got for $28.00.1 explained to her that is deductible for herhumidifier rental. She said she didn't understand what that meant. We had a lengthy discussion. We have notgotten paid yet for the machine so I billed that as a rental as well.10/9/15 Teresa H[redacted], RTI got the Revdex.com email last evening and have been trying to back trace everything with insurance. I called ** toverify that I got auth on everything which I did. The auth is for both [redacted] and [redacted] for a rental only they donot purchase. As I told [redacted] at that time she had met her deductable and copay and it was to becovered. I was unaware she was changing her insurance. She changed insurance the next month. She nowneeds an auth for [redacted] and she is going to owe for the cpap and heated humidifier if I bill this. We were noteven aware that she changed until we got a denial. Now she is getting billed for the heated humidifier butnot the cpap yet. What we can do is this. I can offer her a purchase at a 15% discount of cpap and heatedhumidifier and the price will be $842.52 due to how much was paid by insurance at this time. This means itcannot be applied to her deductible however. Lew could try and work this out poss. Price on the internet forthe machine she had to have is $883.00 this is still less than what she would pay on line. If Lew can do thiswith her insurance this may work or may not work with the pt. We can try. I certainly did not misrepresentanything to this pt. I cannot dictate or know what insurance is going to do. They will not purchase themachine from ** period.10/9/15 Lewis M[redacted], RT/ Dir of HMEI called patient and left a message 10/9/15 at 1:15 PM. Asked her to call back to discuss the billing issue. Herold insurance did authorize payment on the PAP and paid one month, however there are the rest of themonths (12) to go. She changed insurance at month 2. She has three options: 1: return machine and we'll nolonger bill any claims. 2: She can keep the machine and we'll continue to bill the new insurance, howeverbecause of her high deductible, she'll have to pay rental until the machine is purchased outright.Approximately $900 3: She can keep the machine and we'll give her a discount for paying cash and not havingto deal with insurance, if she pays upfront for the balance on the machine. $842.52 less 110.13 that has beenalready paid or $732.39. This price is only good if we do not bill insurance and if she pays the total upfront.She needs to understand that if she chooses this third option that none of the balance she pays will gotoward the current insurance deductible.10/22/15 Lewis M[redacted], RT/Dir of HMEMrs. [redacted] has not called back in nearly 2 weeks from my last call. I again left messages on both her cellphone and home phone to call me back. The message I left on her cell phone was a bit more detailed givingher the options.10/23/15 Lewis M[redacted], RT/Dir of HME[redacted] left me a message yesterday. I called her this morning and had a lengthy conversation trying to explainthe bills that she has with us and the bills she is going to have. Explained was the fact that she has the unitunder rental and not purchase and that she has a high deductible. She is going to call her insurance and getback to us next week. I reiterated her choices and said we want to work with her.10/26/15 Teresa H[redacted] RTGot another message from [redacted] stating that she spoke with customer service at ** and was told wecould call or the doctor office could call ** and get this turned to a purchase. I have already spoken with **about this previously and was told no they only do a rental they do not purchase until 13 months. I calledagain today to confirm and was told by auth department that is correct they will not do anything but a rentalof [redacted] and [redacted]. They will not give me a letter stating this so he transferred me to customer service and Iwas on the phone for every waiting for something that I could get I writing from this stating they only do arental. They can not find anything in writing about this. Yet it is a policy. I asked to get a copy of the policyand she can not find that in writing. I requested she call up to auth dept and get a supervisor that can get mesomething in writing. She said would call a supervisor and get back in touch with me. I was on the phone for33mins with this conversation already.If you have any additional questions, please do not hesitate to call me at ###-###-####.Patrick *. S[redacted], COOSt. Marys Pharmacy, Inc.

Re: [redacted]Dear Sirs/ Madam:We take seriously the pride in which we offer service to our customers. I submit a history of this account andcan assure you that all possible customer service and billing options have been considered here.Unfortunately, I believe there may be some...

miscommunication or understanding between patient andinsurance carrier regarding coverage and payment responsibility. Patient has not responded in last 15 days.As such, we now consider this customer service issue closed until new information or circumstance arise.Account History:8/13/15 Kari R[redacted], Billing ManagerPatient called today to ask about a bill she got for $28.00.1 explained to her that is deductible for herhumidifier rental. She said she didn't understand what that meant. We had a lengthy discussion. We have notgotten paid yet for the machine so I billed that as a rental as well.10/9/15 Teresa H[redacted], RTI got the Revdex.com email last evening and have been trying to back trace everything with insurance. I called ** toverify that I got auth on everything which I did. The auth is for both [redacted] and [redacted] for a rental only they donot purchase. As I told [redacted] at that time she had met her deductable and copay and it was to becovered. I was unaware she was changing her insurance. She changed insurance the next month. She nowneeds an auth for [redacted] and she is going to owe for the cpap and heated humidifier if I bill this. We were noteven aware that she changed until we got a denial. Now she is getting billed for the heated humidifier butnot the cpap yet. What we can do is this. I can offer her a purchase at a 15% discount of cpap and heatedhumidifier and the price will be $842.52 due to how much was paid by insurance at this time. This means itcannot be applied to her deductible however. Lew could try and work this out poss. Price on the internet forthe machine she had to have is $883.00 this is still less than what she would pay on line. If Lew can do thiswith her insurance this may work or may not work with the pt. We can try. I certainly did not misrepresentanything to this pt. I cannot dictate or know what insurance is going to do. They will not purchase themachine from ** period.10/9/15 Lewis M[redacted], RT/ Dir of HMEI called patient and left a message 10/9/15 at 1:15 PM. Asked her to call back to discuss the billing issue. Herold insurance did authorize payment on the PAP and paid one month, however there are the rest of themonths (12) to go. She changed insurance at month 2. She has three options: 1: return machine and we'll nolonger bill any claims. 2: She can keep the machine and we'll continue to bill the new insurance, howeverbecause of her high deductible, she'll have to pay rental until the machine is purchased outright.Approximately $900 3: She can keep the machine and we'll give her a discount for paying cash and not havingto deal with insurance, if she pays upfront for the balance on the machine. $842.52 less 110.13 that has beenalready paid or $732.39. This price is only good if we do not bill insurance and if she pays the total upfront.She needs to understand that if she chooses this third option that none of the balance she pays will gotoward the current insurance deductible.10/22/15 Lewis M[redacted], RT/Dir of HMEMrs. [redacted] has not called back in nearly 2 weeks from my last call. I again left messages on both her cellphone and home phone to call me back. The message I left on her cell phone was a bit more detailed givingher the options.10/23/15 Lewis M[redacted], RT/Dir of HME[redacted] left me a message yesterday. I called her this morning and had a lengthy conversation trying to explainthe bills that she has with us and the bills she is going to have. Explained was the fact that she has the unitunder rental and not purchase and that she has a high deductible. She is going to call her insurance and getback to us next week. I reiterated her choices and said we want to work with her.10/26/15 Teresa H[redacted] RTGot another message from [redacted] stating that she spoke with customer service at ** and was told wecould call or the doctor office could call ** and get this turned to a purchase. I have already spoken with **about this previously and was told no they only do a rental they do not purchase until 13 months. I calledagain today to confirm and was told by auth department that is correct they will not do anything but a rentalof [redacted] and [redacted]. They will not give me a letter stating this so he transferred me to customer service and Iwas on the phone for every waiting for something that I could get I writing from this stating they only do arental. They can not find anything in writing about this. Yet it is a policy. I asked to get a copy of the policyand she can not find that in writing. I requested she call up to auth dept and get a supervisor that can get mesomething in writing. She said would call a supervisor and get back in touch with me. I was on the phone for33mins with this conversation already.If you have any additional questions, please do not hesitate to call me at ###-###-####.Patrick *. S[redacted], COOSt. Marys Pharmacy, Inc.

Review: Sir----In May of 2015 I was re-evaluated by a doctor to get a new cpap machine as my last one was over 5 years old. I went to St. Marys Pharmacy in St. Marys, Pa. and saw two different girls---one was named Theresa. I was given a large machine and within a few hours, realized that it was not the machine I wanted to have for the next five years. It was too large for my nightstand and too large for traveling. I took the large machine back without even opening the box and ask for a small white machine that I had seen online. Theresa agreed to order the machine for me and two weeks later I picked it up thinking that my machine was paid for completely as I had fulfilled my deductable and knew that my policy covered medical devices 100%. My receipt from St. Marys Pharmacy had $0 on the amount due lines and at the bottom of the paper. A few months later, I start getting billed for 28.00 for the humidifier----which comes attached to the cpap machine as the cpap machine will NOT work without the humidifier. I call my insurance provider ([redacted]) and they said I didn't owe the 28.00 and they had covered 100% of the small cpap machine. I called St. Marys Pharmacy and told them to call [redacted] and get this straightened out. Well, Saturday I received another bill for a monthly rental of the humidifier on the cpap machine. After 1/2 hour on the phone with [redacted] they again confirmed that they covered 100% of the cpap machine and humidifier and I did not owe the 28.00 monthly charge on the humidifier.Desired Settlement: I again called St. Marys Pharmacy and told them to call [redacted]. Then another person from St. Marys Pharmacy called me back and with forceful words tried to tell me that I owed the money and if I didn't want to pay the charge, I should bring the cpap machine back to the store. I told her that Theresa never told me about any rental and that is was deceptive on their part. I also told her to call [redacted] and talk to their representative. That is when I got on the internet and saw that this type of scam is being told on different blogs and people have gone thru the same thing. I am filing this claim for myself and for anyone that has been cheated by St. Marys Pharmacy. I am also sending a letter to the Revdex.com. Sincerely----Mrs. [redacted]

Business

Response:

Re: [redacted]Dear Sirs/ Madam:We take seriously the pride in which we offer service to our customers. I submit a history of this account andcan assure you that all possible customer service and billing options have been considered here.Unfortunately, I believe there may be some miscommunication or understanding between patient andinsurance carrier regarding coverage and payment responsibility. Patient has not responded in last 15 days.As such, we now consider this customer service issue closed until new information or circumstance arise.Account History:8/13/15 Kari R[redacted], Billing ManagerPatient called today to ask about a bill she got for $28.00.1 explained to her that is deductible for herhumidifier rental. She said she didn't understand what that meant. We had a lengthy discussion. We have notgotten paid yet for the machine so I billed that as a rental as well.10/9/15 Teresa H[redacted], RTI got the Revdex.com email last evening and have been trying to back trace everything with insurance. I called ** toverify that I got auth on everything which I did. The auth is for both [redacted] and [redacted] for a rental only they donot purchase. As I told [redacted] at that time she had met her deductable and copay and it was to becovered. I was unaware she was changing her insurance. She changed insurance the next month. She nowneeds an auth for [redacted] and she is going to owe for the cpap and heated humidifier if I bill this. We were noteven aware that she changed until we got a denial. Now she is getting billed for the heated humidifier butnot the cpap yet. What we can do is this. I can offer her a purchase at a 15% discount of cpap and heatedhumidifier and the price will be $842.52 due to how much was paid by insurance at this time. This means itcannot be applied to her deductible however. Lew could try and work this out poss. Price on the internet forthe machine she had to have is $883.00 this is still less than what she would pay on line. If Lew can do thiswith her insurance this may work or may not work with the pt. We can try. I certainly did not misrepresentanything to this pt. I cannot dictate or know what insurance is going to do. They will not purchase themachine from ** period.10/9/15 Lewis M[redacted], RT/ Dir of HMEI called patient and left a message 10/9/15 at 1:15 PM. Asked her to call back to discuss the billing issue. Herold insurance did authorize payment on the PAP and paid one month, however there are the rest of themonths (12) to go. She changed insurance at month 2. She has three options: 1: return machine and we'll nolonger bill any claims. 2: She can keep the machine and we'll continue to bill the new insurance, howeverbecause of her high deductible, she'll have to pay rental until the machine is purchased outright.Approximately $900 3: She can keep the machine and we'll give her a discount for paying cash and not havingto deal with insurance, if she pays upfront for the balance on the machine. $842.52 less 110.13 that has beenalready paid or $732.39. This price is only good if we do not bill insurance and if she pays the total upfront.She needs to understand that if she chooses this third option that none of the balance she pays will gotoward the current insurance deductible.10/22/15 Lewis M[redacted], RT/Dir of HMEMrs. [redacted] has not called back in nearly 2 weeks from my last call. I again left messages on both her cellphone and home phone to call me back. The message I left on her cell phone was a bit more detailed givingher the options.10/23/15 Lewis M[redacted], RT/Dir of HME[redacted] left me a message yesterday. I called her this morning and had a lengthy conversation trying to explainthe bills that she has with us and the bills she is going to have. Explained was the fact that she has the unitunder rental and not purchase and that she has a high deductible. She is going to call her insurance and getback to us next week. I reiterated her choices and said we want to work with her.10/26/15 Teresa H[redacted] RTGot another message from [redacted] stating that she spoke with customer service at ** and was told wecould call or the doctor office could call ** and get this turned to a purchase. I have already spoken with **about this previously and was told no they only do a rental they do not purchase until 13 months. I calledagain today to confirm and was told by auth department that is correct they will not do anything but a rentalof [redacted] and [redacted]. They will not give me a letter stating this so he transferred me to customer service and Iwas on the phone for every waiting for something that I could get I writing from this stating they only do arental. They can not find anything in writing about this. Yet it is a policy. I asked to get a copy of the policyand she can not find that in writing. I requested she call up to auth dept and get a supervisor that can get mesomething in writing. She said would call a supervisor and get back in touch with me. I was on the phone for33mins with this conversation already.If you have any additional questions, please do not hesitate to call me at ###-###-####.Patrick *. S[redacted], COOSt. Marys Pharmacy, Inc.