I was frustrated when I received a new couple last month about the issues of hearing aids and denture. Before being enrolled with our plan, they had applied for hearing aids via Elmhurst Hospital by Medicare, and then supposed to get their hearing aids on Oct 16, 2015. However, being enrolled with our plan, Medicare does not pay for their hearing aids so that our plan needs to cover their hearing aids. Also, we don’t have contract with Elmhurst Hospital. As a result, they need to follow up with our network providers. They did not …show more content…
listen to my explanation. They requested me to get their hearing aids and dentures for them immediately after being enrolled to my plan. They kept calling to request as well as visited our office. However, they did not understand these kinds of equipment that would took at least three months to be done, which was the same process as they had done with Elmhurst Hospital. Also, they needed to see by our network provider for the test of hearing aids. However, they refused to see our providers.
I discussed their issues with my supervisor.
However, I did not get the clear response back from her. However, I am the person who directly answers the call from this couple. Also, I am the person who directly faces to this couple. I cannot allow myself to be in this situation every day so that I need to find a solution for myself and this couple. As a result, I phoned to the coordinator at Home Health Service Inc, and then explained the benefit of our plan to him due to this couple trusted him so that this home care agency referred them to be enrolled with our plan. After that, I requested him to explain the policy and rule to this couple. A few days later, I got a call from this couple about apologizing to me for the previous conversation due to they did not understand the policy and rules of applying for durable medical equipment. Also, they were happy to ask me to arrange the schedule to see the health care provider for the test of hearing
aids.
I did not know whether this action was right or wrong. However, this couple did not get frustrated and angry about our plan’s benefit. Also, I did not feel frustrated to explain the term of applying durable medical equipment via Medicaid. I believed this was better solution to solve their problem by their trusted providers being involved in this event.