[mbhc10]

We have a situation in which we have been providing a whole gamut of equipment and trach supplies, including 2 ventilators, oxygen concentrator, pulse oximeter, I Fill O2 system, suction and a few other things.

Prior to switching over to us (the family was moving from another state to our area), the family was nice and cordial and desperate since the company that was supposed to provide them with the equipment backed out at the very last minute. We should have caught this as a red flag but didn't. Ever since the switch out (approx 6 mos ago), it has been a nightmare to deal with the family. From billing insurance to co-pay responsibility to supply demand, we just cannot get this family to cooperate. We are at a point where we're being accused of holding up supply deliveries because of non-payments from the family. We are now stuck with very expensive equipment out and not getting paid correctly.

Questions that I would like to pose this group:

1. Can we give them a 30 day written notice and pick up our equipment legally?
2. What legal course of actions can we take if we cannot do a 30 day notice?

I realize that we are not lawyers and do not know all the legalities. However, if your company had run into a similar situation, I would very much appreciate your advise and suggestions. Please feel free to email me privately if needed. Thank you very much for reading.

[Regina]

We have had this problem in the past, and we have sent the patient a certified letter telling them they have thirty days to find a new provider. It works sometimes, but it sounds as if the patient is not cooperative, so this might not work anyway. Often, they won't even sign for the letter. We also had a patient who would not let us into the house to pick up the equipment. I'm not sure of the whole legal part of this. Maybe someone else can chime in.
What is the patient's insurance? I would imagine you will have a harder time picking up equipment from a Medicare or Medicaid patient than you would from someone withe private insurance.
Th only other recourse I can think of is small claims court. Although, even if you win, they will probably never pay. You might be able to get your equipment back though.
These kind of patients are one of the reasons so many of us want to get out of the business. Best of luck to you.

[teresaml]

You should refer to the DMEPOS chapter 5 information under "Oxygen and
Oxygen Equipment" section: It states there are only three ways patient's can
be termed from oxygen after you bill the 1st month. 1) Beneficiary locates
outside service area 2)Beneficiary elects to obtain oxygen equipment from
another supplier 3) Certain cases granted by the DME MACs or CMS, such as in
emergency situations. We had similar situation and petitioned Medicare to
allow us to give patient notice to find another provider & we were denied
stating patient's non compliance is not grounds to terminate the patient. We
were advised by Medicare we could not send a letter to the patient to
request she find another supplier. We will pursue again at 60 months.

Teresa Leibold
Reimbursement Supervisor
CarePro Home Medical
402 10th Street SE, Suite 600
Cedar Rapids, IA 52403
(319) 298-0953
(319) 298-0954 Fax

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[leejgbt]

Is this patient Medicare? If so, contact an attorney as this might be the only recourse. If it is not Medicare then the 30 day notice is sufficient.

[lsologuren]

You need to aware of your State laws. In Florida, we cannot pickup certain life sustaining equipment (a ventilator would seem to be such equipment) without a doctor's discharge order. We cannot pickup those type of equipment because of billing issues.

However, you are not obligated to continue to provide future disposable supplies and can refuse to dispense unless done on a COD basis. Of course, the family is going to scream and yell and threaten you.

Consult your attorney.

[mbhc10]

Thank you everybody for your comments. This patient is a minor with private insurance and it's the parents that are uncooperative. As of right now, we are looking into California laws to see what kind of legal actions we can take. It is unfortunate that we even have to think about doing such things.
Thanks again for all the advises and thank you CPR+ for providing this forum.