ComplaintsforAtos Medical

• Initial Complaint

  10/07/2022

  Complaint Type:

  Delivery Issues

  Status:

  Resolved

  More info

  My husband is a laryngectomy, meaning he does not have a voice box and breathes out of his neck. His supplies require a prescription so we cannot easily switch vendors.My husband started on ******** September 1, 2022 and his monthly supplies should have gone out at the end of September, but ATOS refuses to ship because on their end they are seeing our previous insurance as primary. I have spent over 18 hours on the phone and numerous chats and emails with ******** and ATOS. ******** updated their file on September 22 and confirmed that since the 24th thry are showing as primary. All other vendors: ****, UMS, and ****** care have had no issues and I see the claims in my husband's ******** portal.I was on the phone when ********s DME department called ATOS. We left a voice mail and then called back again. I received a confirmation email from ****** in insurance at ATOS that ******** confirmed they are primary and she put a note in our account.I received a call from our rep ***** stating the order would go out second day air, but later that day received an email stating the higher *** would not let the order ship until the issue is corrected in their system. ***** informed me they exhausted all options on their end. I have also exhausted all options on my end.I have reached out to our speech therapist and ENT to get new orders for different suppliers and a new vendor. This is a highly specialized product and there are only two manufacturers worldwide so it is not something I can easily acquire. We are down to my husband's last few filters, known as HMEs, and are desperate. I am hoping we can switch to the other supplier since **** has denied life sustaining supplies to my husband. This should be illegal. They have confirmation through their employee ****** that ******** is primary and they are reducing to ship.

  Business response

  10/17/2022

  Atos Medical **** provides disposable medical supplies to individuals who have had a laryngectomy.  Atos Medical is both the manufacturer and durable medical equipment (DME) provider who bills ******************* and various commercial insurance plans.  Atos Medical **** provides needed laryngectomy supplies to the consumers insurance plan after benefits have been verified, and active.  
  
  ******** Benefits & Eligibility is verified by Atos Medical ****, prior to shipment of supplies.   This is necessary to ensure Atos Medical **** can file a claim to the ******** with expectation of payment from ******** for services rendered.  ******** benefits are obtained electronically via secure portal into the ******** system.  Although the ******** plan is active, the Benefit & Eligibility check returned with ******** as the secondary payer to a commercial plan.   We typically see this type of response when the ******** beneficiary transitions from their employers commercial insurance to ********.    The consumer is encouraged contact their previous employer to assist with updating the information the employer is sharing with ********.
  
  The DME Provider, such as Atos Medical **** is unable to update ******** status, an action only ******** can complete.   A member of Atos Medicals insurance team contacted ******** Coordination of Benefits (COB) who provided verbal confirmation ******** is primary.   Unfortunately, contact with ******** COB does not impact the DME Provider Benefit & Eligibility Portal, or the Interactive Voice Response system.   Again, the action needed to ensure the ******** record is updated appropriately is to reach out to their previous employer to correct policy status. 
  
  Although this consumer indicates other vendors have filed claims to ********, Atos Medical **** only submits claims for DME, a portion of ******** Part B benefits.  We are unable to comment as to the billing practices for other institutions.
  
  Atos Medical **** is committed to partnering with the laryngectomy consumer as they navigate through their insurance requirements. 

  Customer response

  10/17/2022

  [A default letter is provided here which indicates your acceptance of the business's response.  If you wish, you may update it before sending it.]
  
  Better Business Bureau:
  
  I have reviewed the response made by the business in reference to complaint ID ********, and find that this resolution is satisfactory to me.  I spoke to ******* at ATOS who advised me to get in touch with the former employer for COBRA. He verified that COBRA was cancelled and is working to see why Blue Shield is still showing active. I am grateful that ******* told me to contact Collective Health, Blue Shield and former company as the ************ I was given in the past was to contact Mediare, which I did repeatedly without having an impact on the situation. Hoping this will resolve the issue. **** also shipped out the order so that my husband can have his supplies. Again, not sure why other companies have been able to ship out supplies. We have reached our deductible with ********* so others are able to submit. I am not sure what their workaround is. 
  Regards,
  
  ***************************
  

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