ComplaintsforMidsouth Medical

• Initial Complaint

  05/12/2023

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  I WAS CALLED ON THE PHONE ON 1-17-2023, AND WAS OFFERED SOME PRODUCTS TO USE AT ABSOLUTLY NO COST, AND I WAS TOLD SEVERAL TIMES ON THE PHONE THAT THE ITEMS WOULD NOT COST ME ANY THING, THEN A FEW MONTHS LATER I RECEIVED A BILL FOR THE ITEMS. I HAVE CONTACTED THE COMPANY SEVERAL TIMES, AND THEY REFUGE TO TAKE THE CHARGES OFF MY ACCOUNT. MY ACCOUNT NUMBER IS (*****) AND THE WRONGFUL CHARGES IS ($262.33) I DO HOPE THEY WILL CORRECT THIS MATTER.

  Business response

  05/26/2023

  According to our records we received a call on 1/11/2023 and he spoke with our billing department regarding a bill, at that time he stated he was unaware his machine he received in October was a rental through his insurance and didn't understand why his insurance did not cover it completely.  The insurance process was explained at the time he received the machine; however, it was explained again by the billing department and after the call he stated he understood.  According to his insurance coverage, the machine is to rent for 13 months and then it is fully owned by the patient.  The supplies that accompany the machine are replaced every 3 months, with some of them replaced every 6 months. 
  

  Every January his primary insurance has a deductible that must be met before the insurance will pay out.  Unfortunately, his secondary policy does not cover the primary policy’s deductible.  On 1/17/2023, when he was due for supplies, he verified what insurance he had, which supply he was using and requested an invoice to be sent.  Therefore, when the supply order was placed on 1/17/2023 that amount went to his deductible.  He was invoiced as requested, this also included the remaining balance from October, November and December that had not been paid for the monthly rental of the machine.
  

  In March (3/17/2023) the patient called very upset with the statement received and asked us to clear his account of charges, stating he would return the machine and unopened items.  The employee he spoke with in the billing department informed him that he didn't have to pay the balance all at one time and could set up a payment plan.  Also at this time, it was explained that per our company policy, we could not accept the return of the supplies due to purchase items (such as supplies) having a 3-business day return period, at this point it had been 2 months.  On 5/10/2023, the patient came into the store very upset with another statement received, the employee he needed to speak with was out and he said he would be back to return the machine and he will expect to have monies removed from his bill.  On 5/16/2023, the patient came into the store again and wanted to speak with the billing supervisor.  She spoke with him via phone and explained that she could remove $36.33 off the bill for date of service 01/17/2023, which would bring his total to $226.00.  However, that was all she could remove from the bill because that amount was processed by his primary insurance and applied to his deductible.  He said, again, that he wants to return the supplies, but she again explained that he is more than welcome to return the machine, but the supplies are a purchase item and those only have a 3-day return period.  He stated that he is willing to pay the money owed for the monthly rental, but that he is VERY upset over this.  The billing supervisor apologized multiple times and explained that he didn't have to pay the whole balance at once and could make payments.  He stated he shouldn't have to pay at all due to what he was told.   At that time, he returned the machine and was given an updated invoice to reflect the adjusted amount owed.

  
  

  Customer response

  06/12/2023

  STILL UPSET,  THE COMPANYS RESPONCE HAS A COUPLE OF LIES IN IT. ON 1-17-23 WHEN I WAS CALLED AND TOLD ABOUT THE SUPPLIES TO BE SENT TO ME, NO INVOICE WAS MENTIONED AND I WAS TOLD THE SUPPLIES WOULD BE FREE AND I WOULD NOT HAVE TO PAY FOR THEM!!!!!

• Initial Complaint

  10/06/2022

  Complaint Type:

  Delivery Issues

  Status:

  Answered

  More info

  I obtained a breathing machine (CPAP machine) through this company and today I had to surrender it. If you know anything about CPAP machines and why people use them it is to prevent someone from dying in their sleep due to the body not inhaling properly. I want my machine back which is being provided by Medicaid in order to continue to breathe adequately while sleeping. I do not want a refurbished machine, I want a new machine at this time because I do not trust that they will not give me someone else's refurbished machine which would be unsanitary. I also want them to arrange this through my primary carrier as I do not have any more leave time to go to the doctor this year. They are causing a great disadvantage to me.

  Business response

  10/31/2022

  Business Response /* (1000, 6, 2022/10/18) */ In response to case #XXXXXXXX: Patient received a BIPAP Machine on 7/18/22. She was instructed on the use of the machine and compliance importance at time of set up. This included the requirement by her insurance company for payment on the machine (Please see paragraph below for insurance guidelines). On 8/17/22 she was called and left a voice mail regarding her compliance and 30-day face to face follow up visit with her Physician. Several unsuccessful attempts were made via phone, email, and mail. On 9/21/22 a voice mail was left regarding 60-day compliance check. At this time our company contacted her physician's office to verify correct contact information. With no compliance being obtained, her insurance company would not give approval for continuation of payment, so attempts were made to pick up or have her to surrender the machine. On 10/4/22 contact was made with her, and an appointment was scheduled for 10/6/22 to bring in her machine and get a compliance report downloaded. The compliance percentage was not acceptable and below insurance standards therefore machine was surrendered. At this time, she was instructed on the restart process to obtain another machine. She agreed and understood the process and left the store. *As with other positive airway pressure (PAP) therapies, long-term compliance is an issue. Adherence to therapy is defined by the Centers for Medicare & Medicaid Services (CMS) as use of PAP greater than or equal to 4 hours per night on 70% of nights during a consecutive 30-day period. Compliance may be as low as 50% at one year and for this reason compliance monitoring is an important component of the management of patients using BPAP. Every effort should be made to achieve compliance. Newer PAP devices record (and may transmit) use times such that compliance monitoring may be performed remotely. Unless compliance is achieved and documented, the continued use of PAP devices (and the ongoing provision of associated supplies) cannot be considered to be medically necessary.

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