Superior Oxygen & Medical Supplies, Inc.

REVIEWING THE COMPLAINT AND AFTER REVIEWING THE PATIENTS FILE I DO AGREE THAT THERE WAS SOME CONFUSION WITH THE PATIENTS ORDER WHEN HE CAME TO PICK IT UPWHAT HAPPENED WAS THAT THE PATIENT WANTED HIS SUPPLIES BUT HE WAS A WEEK SHORT OF BEING ELIGIBLE TO RECEIVE THEMTHE PERSON HELPING
HIM DID NOT KNOW THAT SOMEONE WAS WORKING ON THAT ISSUE ALREADYBASICALLY WE WERE HELPING HIM OUT WITH THE ISSUE AT OUR EXPENSEWE COULD HAVE EASILY DENIED HIM THE ORDER FOR A WEEKON 8-9-HE CAME IN ABOUT A LEAK IN THE HOSE AND WAS TOLD BY A REPRESENTATIVE THAT THE PERSON WHO COULD HELP HIM WOULD BE IN AT 8:30AM AND IT WAS 8:15AM AT THE TIME OF THE INCIDENTTHE PATIENT WAS NOT SATISFIED WITH THE RESPONSE SO THE REPRESENTATIVE CAME TO GET ME THE MANAGERTHE PATIENT TOLD ME ABOUT HIS PROBLEM AND I ALSO TOLD HIM THAT THE PERSON THAT COULD HELP HIM DOES NOT START TILL 8:30AMHE WAS NOT HAPPY WITH MY RESPONSE AND TOLD ME THAT WE SHOULD HAVE A PERSON STARTING AT 8:00AMI TOLD HIM THAT THIS WAS NO DIFFERENT THAN A DOCTORS OFFICE AND PEOPLE HAVE FIXED SCHEDULES HE WAS GIVEN THE OPTION TO COME BACK LATER OR SCHEDULE AN APPOINTMENT ON SEVERAL OCCASIONSHIS RESPONSE WAS THAT HE HAD TO GO TO WORK AND DID NOT HAVE THE TIMEAS FAR AS THE JOKING AND SWEARING HE WAS TALKING ABOUT I CAN'T RESPOND TO BECAUSE I WAS NOT PRESENT AND AT THIS POINT HE IS BEING A DISGRUNTLED PATIENT FILING A COMPLAINTMOST PATIENTS WILL CALL WITH A PROBLEM AND NOT WAIT FIVE DAYS TO SAY THEY HAVE A PROBLEMPATIENTS ARE ALSO AWARE THAT WE HAVE SATURDAY HOURS FOR THEIR CONVENIENCE WHILE OTHER COMPANIES IN OUR AREA ARE CLOSED ON WEEKENDSWE CAN'T ACCOMMODATE EVERYONE ON A MINUTES NOTICE LIKE THIS PATIENTS BELIEVESWE UNDERSTAND THE IMPORTANCE OF HIS SITUATION BUT IT IS NOT OUR RESPONSIBILITY TO ALWAYS ACCOMMODATE SOMEONES PERSONAL SCHEDULE

Our records indicate the patient obtained a CPAP on 4/2/13.  He received a machine, mask, headgear & tubing.  The machine is a reusable item.  The other supplies are not.  The ordering doctor does not allow us to take back a machine they ordered.  We have an...

agreement with that office that if anyone wants to return a PAP it must be taken to the doctors office for return - no exceptions, so our indication we could not take that back is correct.   It would violate our contract with the doctor and jeopardize our relationship with the referral source.  We are in receipt of a letter from Dr. [redacted] office stating the machine was returned on 8/12/13.  All charges that are outstanding are from dates of service 4/2/13, 4/16/13, 5/16/13 & 6/16/13.  All dates are correct and can be billed to insurance since the machine was still in the possession of the claimant.  Anything after the date of service 8/12/13 would be a fraudulent claim.  The mask and disposable supplies cannot be returned as they would not be able to be re-used.  The claimants primary insurance authorized a rental from 4/16/13 to 7/16/13 for the machine.  After those dates, we would have needed the chip from the machine in order to get anymore authorizations.  If any billing did go into the insurance after this date, it would not and did not get paid as there was no authorization in place as the claimant refused to send in the chip.  We did not bill a secondary insurance because we did not have that on file.  As of this day, we still do not have that on file.   Per claimants letter dated 8/18/13 to Superior Oxygen it states the doctor refused to give the information as it may confuse us.  That is laughable as we bill insurance every day and would not have been confused by the addition of a secondary insurance.  No where in the letter does the claimant give us the secondary insurance and the claimant suggests she gave it to us but we have no evidence of receiving the information.  We would have needed a copy of the insurance card in order to properly submit.  If the doctor indicated to claimant the claim would be paid in full, that is the responsibility of the doctor and every insurance plan is different.  There is always a disclaimer that eligibility is never a guarantee of coverage and that depends on the claim and diagnosis per plan provisions.  The patient should have checked with their insurance to find out exactly if there were any outstanding charges that could possibly be paid.  It is not the responsibility of the doctor nor us to know the patients particular benefit package.  As stated above, we billed the patient for the time they had the machine.  It was returned on 8/12/13 to the doctors office.  Since the doctor refused to give us the secondary insurance information and we did not receive a copy of the card from the claimant, we had no choice to send the bill to the claimant.  No response after 6 months of bills, we send the account to collection.  We were within our rights in this situation.  It seems if the claimant should be upset with anyone, it should be the doctors office since they seem to be the ones that misinformed the claimant as to coverage and guidelines for returning.  We followed our guidelines per the authorization and the information we were supplied at time of dispensation.

[To assist us in bringing this matter to a close, you must give us a reason why you are rejecting the response. If no reason is received your complaint will be closed Administratively Resolved]
 Complaint: [redacted]
I am rejecting this response because:  I contacted Superior in the beginning of June to tell them I wanted to return the CPAP machine.  They told me they would have someone call me to schedule a pick up.  At no time during that time did anyone tell me that I had to return the machine to the doctor's office.  During that conversation I did give them my son's secondary insurance.   I waited at least two weeks or more  with no response. I contacted them again. At this time I was told that I needed to give the machine back to the doctor's office. At that time I asked if they had billed my son's secondary insurance and they told me no.  I gave them the secondary insurance number again.  That is a complete fabrication they did not have my son's secondary insurance. I gave it to them twice. At no time did they tell me on the phone that I needed to provide them with a copy of the card.  Never did they attempt to charge my son's insurance.
It is also a complete fabrication that they will not pick up the machine from someone's house as once I did bring the machine back to the doctor's office, I received two calls from their office asking when they can come and pick up the machine.  This was in August AFTER I had already brought the machine to the doctor's office. I explained to them that I already brought the machine to the doctor.  After that, I continued to get calls from them for months asking for my son to provide them with the card from the machine so they can bill the insurance company.   HOw could I give them something I did not have in my possession anymore.  It was clear to me that one section in that office does not talk to the other section in that office.
Though they say they billed me for the time I had the machine, the bills kept getting bigger each month - even after I brought the machine back.  Never once did they provide me with extra material that would need extra billing.  They were clearly aware in the beginning of June that we did not want the machine and were not using it.  It is because of their ineptness that we had the machine past that date.  It seemed to me they kept dragging their feet so they could continue to bill the insurance company for something we were not using.
I do agree with them that I am angry with the doctor's office.  I do not know why they told me that they did not want to provide Superior with my son's secondary insurance. Maybe because they were aware of the other people who were complaining of Superior's problems with billing - you can just look at their reviews online to see I am not the only one being incorrectly billed. I give everyone my son's two insurances, including the doctor's office that suggested we use Superior.  Needless to say, we have never gone back to that Doctor's office.  
My son had a CPAP machine not long before we received one from Superior from another agency with the same insurances we have now.  At no time during the time that he had that machine and all of its equipment from the other agency were we billed a penny-- and he did get more equipment from the other company as the time passed because he had the machine longer from the other agency than he did with Superior. I find it very strange and suspicious that all of a sudden we owe money to Superior, especially after all of the incorrect information provided to me on the phone from staff members and in their response to Revdex.com.
We do not plan on paying and will dispute the claim with the collection agency.  We will also file complaints with other agencies until this is resolved.
Regards,
[redacted]

[To assist us in bringing this matter to a close, you must give us a reason why you are rejecting the response. If no reason is received your complaint will be closed as Answered]If yiu are going to have hours hours of operation beginning at 8am, would not make sense to have the busisness staffed to accommodate any need that should arise from 8am-6pm?  Also, I work many hours.  That was the first chance I had to go in.  I don't know why am appojtment is needed, it's a simple exchange.  Not a set up.  I want to cmexcahnge my non working piece for ones that work, rather easy in my opinion.  When the mangers response was the same as everyone else and really offering no assistance to resolve the matter, that's poor customer service.  Also, I didn't wait 5 days to go in on purpose, it was my first available chance.  All I want is a replacement for what I have and to be done with this.  Why is an appointment needed for that? 
 Complaint: [redacted]
I am rejecting this response because:
Regards,
[redacted]

[To assist us in bringing this matter to a close, you must give us a reason why you are rejecting the response. If no reason is received your complaint will be closed Administratively Resolved]
 Complaint: [redacted]
I am rejecting this response because: they are correct -- we are at an impasse.  I notice you are not asking now for my secondary insurance to have payment made to you.  therefore I will contact the debt collector that I am not paying and will see you in court
Regards,
[redacted]

In response to the rejection.  We have no notes as to the patient ever giving us the secondary insurance.  The claimant lists no names of who specifically this information was given to so we cannot confirm or deny it was given to anyone based on statements such as "They said", "He said", "She said".  If it was given to an employee, that employee would put a note of the conversation in our computer.  Our computer shows no notes, so we have to believe we did not receive it.  As to the claimant stating she always supplies the information, that is contradictory since the doctors office told her they would not supply to us because it would be paid in full by the primary insurance.  She should have insisted the doctor forward all information because the doctor would have no knowledge of the patients primary benefits.  It's is a doctors responsibility to take care of patients and not to understand insurance plans.   Doctors are often misled and thinking insurance pays for everything and they are not schooled on insurance plans policy's etc.  Pulling the patients chart and looking at the information supplied and signed for, there is only an indication of 1 primary insurance and no information as to a secondary.  As stated before, had we had the information, we would have gladly billed to the secondary insurance.  Our goal is to get claims paid and not have to report a client for collection for non-payment when another payer can be responsible.  There really is nothing more, that can be stated.  The doctors office protocol is patients need to return the machine to the doctors office.  The claimant can state that is not true, however, she would not be aware of an agreement between companies.  Other doctors offices do not have such protocol, just this particular doctors office.  Again, I can only state that the problem seems to lie with the doctors office and not Superior Oxygen.  As to the bills getting larger and larger etc.  We billed the patient for a rental of a machine and initial supplies for the time the machine was in claimants possession until 8/12/13.  We have the insurance Explanation of Benefits explaining what the patient owes and only billed the patient for exactly what the insurance agreed they owed.  There was no over-charging the patient.  We have contracted rates with the insurance company and they dictate to us, what fees can and cannot be charged.  If anyone is at fault here, it sounds like the doctors office held the reigns.  We were all at the mercy of the information the doctors office supplied and followed their protocol as to how the machine needed to be returned.