Posted on Oct 31, 2016
In our industry, our sole goal is to provide our patients with the highest quality care possible and to do it at the lowest cost. We’re not in this business to get rich, or to make money off the backs of out patients, and when things go wrong it drives us just as crazy as it drives you! Our customer service team would much rather be helping a patient with their actual care rather than chasing down an insurance question - and we’re sure you don’t want to be asking us them!
Often times, the issue is caused by outside factors, such as your insurance provider, medical billing companies and the myriad of the companies in the constellation of care. Usually, there’s little we can do about an issue as we’re caught in between restrictive rules set by insurance companies, information sent over by your doctor’s office and ever-changing government regulations. However, that doesn’t mean we can’t help! Check out our new guide on Who to Call When Something Goes Wrong With Your Homecare:
I Was Told I Was Covered But Now I Have to Pay
Who to call: Your Insurance Company
Why: Often times, you are covered but you still have to pay via your deductible or pay a portion out of pocket. This is one of the more confusing parts of health insurance, as providers offer hundreds of different plans and each of those plans has different rules for what it will cover and how you (or they) have to pay for it. If you’re paying out of your deductible, you are still covered, but your insurance company is requiring you to pay a certain potion out of pocket. This varies from provider to provider and plan to plan and it’s very hard to keep up with - even for us! We can help point you in the right direction, but ultimately your insurance company has the answers! (For a list of insurance providers who work with us, please click here)
My Payment Did Not Get Processed
Who to call: Cape Medical Supply
Why: We receive thousands of bills and payments from patients every month, and work with a specialized medical payment processing company to ensure that everything gets taken care of properly. Occasionally, errors happen, and bills might not get processed and trust us when we say, it drives us crazy when this happens to! Sometimes, it’s a technical glitch or a check filled out improperly or an expired credit card, or another innocent mistake by you or the payment company that causes the headache. Don’t hesitate to call us should this happen - we want to get it resolved as quickly as possible!
Coverage Was Denied
Who to call: Your insurance company and your doctor
Why: When it comes to health insurance, it’s impossible to ever pin down exactly who is at fault or what is actually going on with a referral, a prescription, therapy, or anything else. Often times, a misplaced check mark or something being done “out of order” can sideline an entire referral, causing a delay in care that you may critically need! Often, care requires a “prior authorization” sent from your doctor to the insurance company, and, if the prior authorization is not exactly to the insurance company’s liking, they can deny you care, starting what can be a lengthy appeals process to get the care approved. Yes, you and your doctor have to appeal to your insurance company to get medically necessary care approved!
We never benefit from denying you care or coverage. However, due to our contracts with insurance companies, we cannot provide you care until all the proper steps have been followed. Our team never has the authority to make the denial / approval decision and we are completely at the mercy of insurance companies. If you keep striking out with your insurance company and doctor’s office, call our team, as chances are we are in the process of working with your doctor to ensure that we can process the referral anyways.
My Machine is Broken (and other equipment issues)
Who to call: Call Cape Medical Supply
Why: We have a team dedicated to solving your equipment issues. They are equipped with a model of every piece of equipment we carry and can walk you through steps to restart or repair your equipment at home, and are trained to determine if we need to send you out replacement equipment. Don’t let an issue linger! Call us any time - if it is after hours and there is an urgent need, our on-call service will respond. For the more tech-minded among our patients, dedicated email support is coming soon!
The Price of My Care Changed
Who to call: Your insurance company or Cape Medical Supply
Why: We have to abide by the rules the insurance company sets for how much (or how little) we can charge you for care. Often times, the insurance company will only reimburse us for a portion of your care, leaving us in the unfortunate position of having to send you a bill for the remaining portion. Trust us, we don’t like having to do this!
Healthcare plans and reimbursement rates change all the time, and often with little to no notice to us or to you. If your care cost suddenly changes, your first call should be to your insurance company to check that yes, there actually was a rate increase and to fight it if possible! If you can’t get any information from your insurance company, give us a call and we’ll do what we can to help!
You’re Confused About Your Therapy
Who to call: Cape Medical Supply’s Compliance Support Team
Why: Because that’s what they’re there for! If you are confused about anything with your therapy, do not hesitate to give us a call! We have a team dedicated to helping our patients solve issues with their care and it’s what we love doing!