Founders HealthCare, LLC Preferred Homecare Overcharges Medicare and Insurance for durable medical equipment by almost 250% Mesa, Arizona

Preferred Homecare has been in business in AZ for over 14 years, has been a Medicare-approved supplier of medical equipment for all of that time, and is a member of the Better Business Bureau.  Unfortunately, the Medicare/Insurance Plan billing process was not explained to you so let me explain.



1. We bill Medicare and all insurance plans our retail rate, which for this walker with the billing code of E0143 is $204.39.

2. If we get paid by Medicare, they pay us 80% of $111.31, which is $89.05.

3. We bill the Medicare beneficiary 20% of $111.31, which is $22.26.

4. If we are billing another insurance plan, they have a set reimbursement rate that they pay us, and a set percentage to bill the customer.



As a Medicare provider we are required to:

1. Deliver the product and provide education on the use of the product

2. Accept returns and honor warranties

3. Have appropriate facilities with established hours of operation

4. Have inventory on hand

5. Be accredited

6. Bill Medicare and wait for reimbursement

7. Meet all of Medicare's 30 Supplier Standards.



Internet providers are not required to meet any of these requirements and can therefore sell equipment at a lower cost than Medicare providers. 



Please feel free to contact us at Preferred Homecare should you have any questions.

This is the way the agreements between Medicare and their suppliers.

To hear the other side of this, I sent a link to this report to Preferred Homecare.