Likewise, I need to iterate that I appreciate that you have been professional enough to at least answer your email more consistently than your colleagues. You have also been transparent enough to share information that you believe I should have. Those factors, along with the fact that it took you several hours to compose this last email, suggest to me that you have discussed this matter with upper management at Great American Scooter and Mobility of Humble (henceforth referred to as simply “GASMH”). Rather, I am going to make that presumption in your favor as I do not think you foolhardy enough to make these decisions on your own.

This discussion has become protracted and very contentious, and nobody wants it concluded successfully more than I do. I would love to be able to lay out my final position and be done with the matter, but some of your recent statements make clear there are realities that GASMH is not recognizing. Therefore, I have no choice but to state a couple of things explicitly before I can conclude.

First, I was being quite facetious when I asked if Healthspring intended to allow its subscribers to switch durable medical equipment (DME) suppliers in their new contract. That is something Healthspring has never offered, to my knowledge, and the purpose of my question was to cause you to do a reality check. GASMH, as a contracted DME supplier, should be aware that Healthspring does not offer its subscribers any way of changing DME suppliers. As the Medicare Supplemental Plans are largely standardized, it is unlikely that the other plan providers offer their subscribers that either. What I know from a week of research is that plan providers do NOT make their lists of contracted DME suppliers public. Potential subscribers can receive packets that contain lists of participating doctors and hospitals, even formularies of prescription medication covered by a plan, but no list of DME suppliers. Evidently, a DME supplier is chosen by the plan provider based on geography and type/brand of equipment needed.

Second, the latest information I can find on the management of GASMH (2014) still lists Troy Liles as President, and David Wood as Vice President. Although you and I have not met, both of those gentlemen know me and are aware of my somewhat unusual symbiotic relationship with this wheelchair. This wheelchair is far more than a mobility device. It also serves as the base supporting an array of equipment originally developed while I worked for Shell Oil. Although I can neither walk or talk, the custom-made equipment enables me to function and interact with anyone. Undoubtedly, you have seen people tack all sorts of assistive communication devices on their wheelchairs, but what I have is lightyears beyond that. I wrote my own communication software while I was with Shell, and I run it on a regular high-end laptop that also runs a broad variety of other things. That is connected to all sorts of other equipment like an audio system and various wireless communication and safety devices. All of which is fed by a 24-to-12 voltage converter plugged directly into the battery harness of the wheelchair. I am still a reasonably active person so all of this equipment continues to prevent me from becoming just another vegetable rotting in an institution somewhere.

Now all of the relevant facts from my side have been laid out. There can be no more illusion that I’m free to go elsewhere for service when, for all intents and purposes, I am stuck with GASMH. If your new charges pose a hardship for me, you know I can’t afford someplace else uninsured.

Of course the situation is probably different for GASMH as it’s generally true that businesses reserve the right to refuse specific customers service. No doubt there is a clause in that new contract with Healthspring granting the right to refuse service to plan subscribers for reasons not insurance-related. Making those new so-called “diagnostic” charges not coverable by insurance was clever, because the only recourse offered to subscribers dissatisfied with a DME supplier is an internal dispute process. These new charges will conveniently fall outside the purview of any such process.

So let’s use my current disagreement with GASMH over these dubious new charges to explore the likely outcomes. I could be dishonest and accept the charges knowing that I probably couldn’t pay all of them. Or I could be honest upfront and decline the charges, knowing that paying any one of them would be legally viewed as accepting responsibility for paying them all. Naturally, GASMH may well refuse service in return, leaving me stranded somewhere when these batteries do go flat. The critical issue isn’t so much what the charges are supposedly for as it is the phrase, “per visit.” These batteries are recommended to be changed every eight months, guaranteeing GASMH at least two visits within 12 months. If, Heaven forfend, the wheelchair actually malfunctions, that’s another one or two visits minimum, bringing my annual cost to $680 or more! A unscrupulous supplier might rack up a sizable fee by doing service piecemeal and drawing it out over multiple visits. I make no secret of the fact that I will run out of money sometime in mid-2019, but I’m not going to allow nuisance charges to rush that end any. No, if I’m going to accept “per visit” charges, GASMH has to agree to reasonable 12-month caps on those charges.

I should mention one other aspect of this wheelchair. All of the most essential communication equipment aboard also has at least some internal emergency power. Probably enough to summon transportation home, and definitely sufficient to update certain people on my situation. That can’t be considered a threat because I don’t know what these people will do. Perhaps nothing. Still, none of them are especially bashful, and some of them have media/political contacts so it might be wise to tread lightly on me.

With all due respect, Mike, I rather not hear further from you until Troy and I have worked out a few matters.

Scott Royall

[tags: disability]

From: mikem@txmobility.com [mailto:mikem@txmobility.com
Sent: Friday, November 11, 2016 15:36
To: Scott Royall <royall@conchbbs.com>
Subject: RE: Wheelchair

Mr Royall,

I would first like to say that we value you as a patient and want to help you in any way that we can in the future. Unfortunately, if we continue to provide service for you there will be a charge of $170 dollars if we come out to the house and an $85 dollar charge if you bring the chair in. This is a set amount and cannot be changed. In saying all this we would like you to know that we completely understand if you need to contact other providers to avoid this charge, but if you use us in the future this will be the charge. If I can help you any further please let me know.




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