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Welgo Reviews (2)

To whom it may concern:This letter is in response to the above complaint # from an individual regarding Infinite DME Services,LLS D/ba Welgo and one of our previous sale reps, *** ***.Infinite DME Services was a sales agent for the company, ***, promoting the usage of an
amniotic tissue EpifixThe complainant is stating that Infinite DME Services, LLC should award their *** account over 14kWe empathize with the patient in this case but respectfully disagreeAs a sales agent for ***, we promote the clinical benefits of Epifix to doctor customers for them to use on patients to help them healWe are not in the business of guaranteeing reimbursement for the product as that is not possible nor is that our roleEveryone has a different insurance make up therefore it is imperative that the individual take some responsibility before hand to contact the insurance provider or work with the doctor in regards to doing a Prior AuthorizationThe role of what is called a Prior Authorization for a procedure and any products that will be used in the procedure should be done by the Doctor that is performing the procedureOnce that authorization has been completed, then the doctor may move forward with the procedure and any items that may be billed during that timeIf I were the patient, I would be asking the doctor if the Prior Authorization was completed and ask for a copyThe product itself was approved for usage at *** *** Hospital but that does not mean insurance will cover the costAs far as the patient mentioning that the product was "experimental" that is on an insurance by insurance case and would have been know had a prior authorization been done by the doctorEpifix is covered by a number of commercial payers around the country and is also covered nationally by Medicare.Once again, we empathize with the patient and their costs, but believe that their actions guided toward the wrong partyWe hope that they will be able to come to a resolution elsewhere to get this squared away.Kind Regards,

Review: On March 31, 2013 , I underwent a medically necessary breast reduction by Dr. [redacted] at [redacted] Hospital. I was planning on the out-patient option, realizing that would be the least expensive option for my insurance and myself. However due to complications, it was necessary for me to stay 2 nights and receive two units of blood. All of those expenses were covered and payment made by [redacted].Subsequently, the surgical wounds did not heal and skin wound dressings were necessary. Dr. [redacted] suggested a Epi-fix by Welgo. I asked if it was covered by insurance. He stated he would verify and get back with me. Dr. [redacted] and I were told by [redacted] of the company Welgo that [redacted] would cover it since it was medically necessary to address the issue of surgery wounds. On April 12, 2013, I was scheduled again at [redacted] Hospital for an outpatient procedure in the operating room to apply the epi-fix by Welgo. Ms. [redacted] of Welgo was in attendance with Dr. [redacted] to apply the epifix to my wounds. She informed Dr. [redacted] and me that it would in fact be covered by my insurance.[redacted] Health Care ([redacted] Hospital) now states that a balance remains of $15,106.63 for the April 12, 2013 visit. [redacted] states that epi-fix by Welgo is considered experimental and will not cover that part of treatment.If **. [redacted] had informed us correctly of the experimental status of her companys product, I would not have consented to that procedure. I would have opted for a less effective but covered procedure.Desired Settlement: In speaking with the Bureau of Insurance in Richmond, VA and with [redacted] Hospital, it was stated the WELGO should provide a credit for the product. [redacted] Hospital has charged $6441.12(Epifix impant per SQCM) and $4740.50(implant amniotic membrane). Additionally, since **. [redacted] informed Dr. [redacted] that the product must be applied in the operating room instead of in his office, I am requesting a credit for that fee. [redacted] has charged my account $2000.00 (OR base charge) and $1650.00 (33 additional minutes). In total, $14,831.62 should be credited to the [redacted] Hospital account.

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Response:

To whom it may concern:This letter is in response to the above complaint # from an individual regarding Infinite DME Services,LLS D/ba Welgo and one of our previous sale reps, [redacted].Infinite DME Services was a sales agent for the company, [redacted], promoting the usage of an amniotic tissue Epifix. The complainant is stating that Infinite DME Services, LLC should award their [redacted] account over 14k. We empathize with the patient in this case but respectfully disagree. As a sales agent for [redacted], we promote the clinical benefits of Epifix to doctor customers for them to use on patients to help them heal. We are not in the business of guaranteeing reimbursement for the product as that is not possible nor is that our role. Everyone has a different insurance make up therefore it is imperative that the individual take some responsibility before hand to contact the insurance provider or work with the doctor in regards to doing a Prior Authorization. The role of what is called a Prior Authorization for a procedure and any products that will be used in the procedure should be done by the Doctor that is performing the procedure. Once that authorization has been completed, then the doctor may move forward with the procedure and any items that may be billed during that time. If I were the patient, I would be asking the doctor if the Prior Authorization was completed and ask for a copy. The product itself was approved for usage at [redacted] Hospital but that does not mean insurance will cover the cost. As far as the patient mentioning that the product was "experimental" that is on an insurance by insurance case and would have been know had a prior authorization been done by the doctor. Epifix is covered by a number of commercial payers around the country and is also covered nationally by Medicare.Once again, we empathize with the patient and their costs, but believe that their actions guided toward the wrong party. We hope that they will be able to come to a resolution elsewhere to get this squared away.Kind Regards,

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Description: Health & Wellness, Health & Medical - General

Address: 1200 G St NW Ste 815, Washington, District of Columbia, United States, 20005-3814

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