tucker1970
Junior Member
What is the name of your state? Alabama. Our company supplied durable medical equipment to patients all over the country but the insurance company was based in Birningham Alabama. One of the main items we distributed was TENS or muscle stimulators. It was a good business and we made good money doing it. The insurance company would purchase the items when they were prescribed for a period of 11 months or more. It was comon for doctors to prescribe them for a 12 month duration. When items were purchased based on the 12 month prescription we agreed that 10 months of support supplies would be included in that purchase price. This allowed us to bill for the remaining 2 months. When asked about how or when to bill the remaining 2 months we were told to bill once at the begining and once at the end of the script. So for years this was the standard, our company and many others billed and operated that way. Then one day we get a fedex letter saying that they fee schedule would change and that they would no longer purchase such equipment. The new policy allowed only for a 4 month rental of such equipment. The new policy also stated that all support supplies would be included for the rental price. And the kicker was that they made this change retroactive for the pat 8 months. They asked for all the monies generated (500,000.00) by the supplies were paid prematurely. That those benefits were to be billed and paid in months 11 & 12. They said it didn't matter that there was nothing in our contract or manual as to when to bill these supplies. They say that it dosen't matter that these types of claims have been treated the same way for over 20 years. But they do say we must pay the money back because now that the rental period is only for 4 months, that the month 11 & 12 charges are not valid. Can they do that? Change the rules mid stream and make it retroactive?