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Insurance: Edgepark Billing

Discussion in 'General Discussion' started by swellman, Feb 24, 2014.

  1. swellman

    swellman Approved members

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    I'm just curious if anyone has looked at their billing through insurance RE Edgepark and saw oddities. There have been a few weird things of late and when I looked at my insurance there seems to be a few, shall we say, irregularities in billing. I would be first to admit that I don't keep records of their deliveries since they are a "no deductible" service. So, I could easily be misremembering deliveries. I haven't done the hard math but my "spidy senses" are tingling.
     
    Last edited: Feb 25, 2014
  2. Mish

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    Oh yeah. I've had a few odd things happen lately with billing, however, I think most of the inconsistancies are due to lack of attention to detail and due to their completely archaic computer system where one department has no idea what another is doing. I am not sure if there is anything more going on, but maybe I'm missing something:

    Purchased sensors. Requested a payment up front which they claimed was my co-pay. I talked them down to a much lower amount because I knew we had met our deductible already. They charged me $81.78. It turns out it was $17 more than the actual amount. I received a check for that amount directly from the insurance company though, but I had paid Edgepark. Not sure how insurance recoups their money. The odd part is that online, on edgepark's system, it shows I paid a completely different amount.

    Received a $3.24 check from Edgepark for something from January 2013. I had to dig, but I found it was a box of skin tac. It doesn't appear that I ever even paid for this item.

    I've also noticed a whole slew of entries in the edgepark system for items that were ordered but cancelled. I think it's items that were originally in their " continuing care" system, but I can't be sure. None of these have hit insurance.

    So, nothing I can put my finger on as being illegal, but certainly plenty of things that are odd.
     
  3. swellman

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    It's probably legit but I just saw some things that looked odd with out UHC account as if they were getting paid once a month Dexcom supplies which we get once every 3 or 4 months. They all use the same "Visit" date which could just be, as you said, archaic billing. UHC is going to call them and figure it out.
     
  4. ksartain

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    I logged in last week and saw a balance of $320. I know for durn sure that was wrong, so I called. Turns out I was supposed to be CREDITED $32.00.

    A statement I just received yesterday from BCBS did not match up with what Edgepark charged me. I need to look more closely to see what's going on. Thanks for this reminder.
     
  5. Marcia

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    I just hung up on a billing rep from edgepark. We have only used them once-last November. I was billed the copay and paid promptly. Got a bill last week for an add'l $100 for the same order.. I placed an order last week (before I got the extra statement) and at first was told I would be billed a 50% DME copay. I questioned this and after transferring to 2 different people was told the previous contacts were incorrect. She gave me what sounded like the correct amount. Tonight, I got a call from a snippy person from their billing dept and informed me I would not get supplies unless I paid the copay over the phone by credit card now. She had a threatening tone, I asked why I couldn't be billed like the previous time and she said they would not ship my order. ???
     
  6. swellman

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    UHC called Edgepark and confirmed that Edgepark had billed, multiple times, for the same services including OmniPods and Dexcom sensors to a tune of between $6000-$10,000. Hopefully, they will get it all straightened out.
     
  7. Mish

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    ooooh! That would be considered insurance fraud, no?

    Even though (in your case) you haven't paid anything OOP, it's a good reminder for all of us to check our explanation of benefits from insurance if we have them. It's one tiny way we can all help the system work more efficiently, by pointing out these things when we find them.
     
  8. ksartain

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    Edgepark confirmed that I was erroneously billed for something BCBS was supposed to be billed for. If I hadn't questioned it, they would have kept sending me statements.
     
  9. rgcainmd

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    DANQ (Dumb Ass Newbie Question):

    What is "Edgepark"?
     
  10. Mish

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    https://www.edgepark.com/
    Just a durable medical supply company. :) Many of us must obtain our supplies through 3rd party companies that are authorized to do business with our insurance. Edgepark is a common one.
     
  11. MEVsmom

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    I don't use Edgepark, but Diabetes Supply and Management which is local to me (New Orleans). they called me to fill my January order. They said they verified insurance and I would owe $432 dollars or somethign like that. I really didn't question and paid them. Then a few weeks later, I got the EOB from BCBS where the claim was denied because we can only now get supplies from Caremark. I had no idea my policy had changed. My bad. The charge was to the tune of $2600 so I clearly freaked out. I looked back at my last EOB and it appears as if DMS just collected from me what they would have gotten from insurance anyway. It's about equal to what my copay would have been, BUT now that amount won't count toward my out of pocket maximum for the year. After I meet that, everything will be covered 100%. It's all very shady, but I will not make that mistake again.

    I just had to order a Dexcom transmitter and now I wonder if I can trust them at all.

    Does anyone else use this company?
     

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