Wheelchair

Jonathan,

You’re apparently saying that GASMH needs to make two visits, one to diagnose, and another to actually perform the maintenance. Will I be charged $170 for each visit? Or is it the case that the $170 is for the diagnostic visit? If the latter, then Mike’s calling it a “diagnostic” charge seems much less farcical. A diagnostic visit is probably prudent with most power wheelchair users as few are thoroughly aware of how their machine functions.

If the $170 is for the diagnostic visit, I have only one firm requirement. I understand that it isn’t your job to go on diagnostic visits, but I must insist that you come on this one because I think it’s essential that you and I meet. I believe Troy would agree on that also. I am not your typical “patient,” and I think it necessary that you develop your own sense of my abilities and limitations. Please plan on spending an hour with me as I unfortunately communicate slowly, and it’s important we not be rushed. Of course I know you’re going to balk at this whole idea, but please remember this is a requirement I have of any DME supplier.

I would also ask that, as part of your preparation for our meeting, you please review the history of part orders for this chair. In particular, notice the long string of casters, and how it suddenly stopped last year. Yes, there’s a story there about who is the best diagnostician when it comes to my equipment, and it will serve nicely as an example. I wonder if Troy still has copies of the relevant email.

Scott Royall

From: Jonathan Crisman [mailto:jonathanc@txmobility.com]
Sent: Monday, December 5, 2016 9:48
To: ‘Scott Royall’ <royall@conchbbs.com>
Cc: troyl@txmobility.com; davidw@txmobility.com; mikem@txmobility.com
Subject: RE: Wheelchair

Mr. Royal-

We will be more than happy to submit for authorization once we come out and diagnose the chair for repairs.

Please let me know if this is agreeable and we can schedule.

Thanks

Jonathan Crisman

Operations Manager

2111 FM 1960 Rd E

Humble, TX 77338

281.705.6254 Mobile

832.445.0956 Office

832.445.0958 Fax

jonathancI www.txmobility.com

From: Scott Royall [mailto:royall]
Sent: Saturday, December 3, 2016 7:04 PM
To: ‘Jonathan Crisman’ <jonathanc>
Cc: troyl; davidw; mikem
Subject: RE: Wheelchair

Jonathan,

Well, thank you for the information. I note that it appears to have come from a PDF that’s not publicly available. As to my supposed rights as a MSP subscriber, I have your word, and I have Healthspring’s. In any case, the issue is academic because of the number of suppliers on the list. I simply don’t have the weeks required to contact each of them to determine if they have out-of-pocket trip charges; my batteries likely won’t wait patiently so a little more help would be appreciated.

Of course, I could point out that, if the suppliers are being squeezed as you say, then it was a miracle that GASMH could afford to hire you, right? Teasing aside, I am aware that GASMH has had difficulty getting paid by Healthspring. I also know Medicare pays less than what the industry considers to be the going rate. My personal viewpoint is the whole medical industry has been high on seemingly unlimited government and insurance money for so long that it has become a very dysfunctional market. I honestly don’t know what it will take to reset the mess, but my instincts tell me it can’t be done without pain, suffering, and a boatload of natural selection. Not what liberals want to hear. Thing is, though, the standard American business practice of passing cost increases on to the consumer might come back to bite those businesses that do too much of it, because the demand for durable medical equipment may be more elastic than currently thought. Poor people may start trying to do without more than they already do if they can’t find affordable solutions. Just keep that cautionary thought in mind.

Oh, one other thing: Although I understand why you would think my “rehab” chair is customized, it isn’t. In fact, avoiding customization of the basic wheelchair itself has been a core rule in building everything added. About the only modifications that have been done to the wheelchair are three sets of drilled and tapped bolt holes in specific places on the main longitudinal spars of the base frame. That’s right, the good stuff just bolts and clamps in place. In any event, none of that is the responsibility of any DME supplier. My supplier is only responsible for the “motive” aspects of the wheelchair, although that might change in the future. Presently though, your field techs only have to deal with the non-motive equipment on the chair when changing batteries. The end of one troublesome bolt simply makes the removal and putting the front battery box back in properly more difficult. It’s harder but doable. That’s not bad considering this is the third wheelchair the equipment has been mounted on.

Sorry Jonathan, but GASMH is stuck with me for the time being. Mike needs to submit an approval request for the items I require. Healthspring will then mail notification of the request to me. As I recall, those notices contain an email address for contacting them regarding DME suppliers. That’s the contact I’ll use to find out Healthspring’s take on my rights in reference to future service visits. However, this one is yours, and I’ll pay the $170 when I can. Of course you know what your options are if that guarantee is inadequate.

Scott Royall

[tags: disability]

From: Jonathan Crisman [mailto:jonathanc]
Sent: Friday, December 2, 2016 15:45
To: ‘Scott Royall’ <royall>
Cc: troyl; davidw; mikem
Subject: RE: Wheelchair

Mr. Royal-

Attached is the current provider listing for the Harris county market, I highlighted some of the providers that work with custom power rehab.

As a patient, you always have the right to choose your provider. As a Medicare Advantage customer, you have the right to choose from the contracted providers that Cigna Healthspring credentials. You are in no way ever locked into one provider for life.

We try our best to work with every patient to meet their needs but our repair policy was put into place so we, as a business, could continue to care for people.

Thank you Mr. Royal and have a good weekend.

Jonathan Crisman

Operations Manager

2111 FM 1960 Rd E

Humble, TX 77338

281.705.6254 Mobile

832.445.0956 Office

832.445.0958 Fax

jonathancI www.txmobility.com

From: Scott Royall [mailto:royall]
Sent: Friday, December 2, 2016 2:47 PM
To: ‘Jonathan Crisman’ <jonathanc>
Cc: troyl; davidw; mikem
Subject: RE: Wheelchair

Jonathan,

Sorry to tell you that this information is incorrect. As it happens, the subject of changing DME suppliers came up about two years ago, and a Healthspring representative told in no uncertain terms that switching wasn’t an option. Now, it is always possible that things have changed, but I haven’t been sitting around for a week. I’ve been plumbing the depths of the Internet, and not limiting myself to just Healthspring either. The only insurer to come close to listing the DME suppliers was Medicare itself, and only 26 were shown nationwide. So if you have a URL for Healthspring’s list, and instructions on how a subscriber can change suppliers, please share. It would be a pleasant surprise if the latter exists.

In any case, it is unlikely that Healthspring even knows or cares which of its DME suppliers have instituted similar charges directly against the customer. With that in mind, I have a simple question for you. What is being done for those who genuinely can’t afford those charges? As I just explained to Mike, those out-of-pocket expenses can become a major burden over time.

Scott Royall

[tags: disability]

From: Jonathan Crisman [mailto:jonathanc]
Sent: Friday, December 2, 2016 11:55
To: royall
Cc: troyl; davidw; mikem
Subject: FW: Wheelchair

Mr. Royal-

I have been asked to reach out to you in regard to your most recent email chain with Mr. Matkin.

My name is Jonathan and I am the new Operations Manager for Great American.

I wanted to reach out to you to review our new Service Policy. This is a policy that many in the industry have already adopted. Our policy for diagnosing issues with any mobility equipment is $170 for in home and then $85 for in office. Unfortunately these are not covered by the insurance and are therefore the responsibility of the recipient. This is a policy that is effective throughout the company for any payor or patient.

Healthspring does contract with other providers and this information is made available through their website.

Thank you for your understanding and please let me know if we can be of any further assistance.

Jonathan Crisman

Operations Manager

2111 FM 1960 Rd E

Humble, TX 77338

281.705.6254 Mobile

832.445.0956 Office

832.445.0958 Fax

jonathancI www.txmobility.com

Advertisements

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s