Complaint Review: ZOLL LifeVest Pittsburgh PA

On 03/28/2017, a ZOLL Representative came into our home to fit my husband for the Lifevest and to train us on the care of and wearing the vest. The following week the nurse with our cardio doctor called to let us know our insurance company had denied the claim ZOLL submitted, and that they were working on coverage. On 04/09/2017, I noticed an error on the base unit of the Lifevest, I immediately got the manual, and my husband so we could get the error resolved. We followed the instructions in the manual but nothing worked, at one point my husband pulled a wire from the Lifevest and when the alarm didn't we realized the service was disabled.

We called our doctors office to update them, and the nurse agreed it appeared the service had been terminated, we made arrangments to see the doctor and to get another heart monitor. * ZOLL put money before my husband; I still get that sinking feeling in my stomach thinking about it* On 04/13/2017, USPS delivered mail from ZOLL postmarked 04/11/2017, enclosed was a "Member's Grievance Form" (hereafter MGF) which noted the "dates of service" as 03/28/2017 - 05/28/2017, the claim amount was $3670.00. There was a post-it note asking us to sign and return the MGF.

I emailed Ms. Moorefield asking her to send an MGF with the correct dates of service; I would sign and return. I didn't hear back from Ms. Moorfield, so I assumed the matter had been resolved, I was wrong. In early October 2017, ZOLL sent us another MGF again with the wrong dates of service, this time I wrote Ms. Moorefield a letter and mailed it USPS October 5, 2017, and yet again, I heard nothing back from Ms. Moorefield. On January 12, 2018, I was surprised when I received an "Explanation of Benefits" from our insurance company showing a $3670.00 payment made to ZOLL on January 8, 2018. I emailed Ms. Moorefield; asking her to justify the $3670.00 payment for 12 days of service. I was curious as to how the cost of the device started as $60.16 a day, then jumped to $305.83 a day.

 I also reminded her that ZOLL terminated the service. Ms. Moorefield replied " I am the appeals coordinator that worked on your appeal to the insurance company. They originally denied approval of the device. I worked with the physician’s office and provided additional documentation to get the denial overturned and paid. The reasoning by ZOLL charging $3670.00, for just 12 days, is that it is a monthly rental. Because the device is a life-saving device it is set up to be used in monthly time spans. The insurances are aware of this practice, since it is medical equipment, that we only charge by the month. The price is set and negotiated with the insurances based on these facts. Due to the technology behind making these garments and monitoring them, this is also what the pricing is based on.

As you are probably already aware, the denial from your insurance company was overturned and approved. They did made payment on your claim to ZOLL, which was posted to your account on 01/09/2018. Your responsibility after their claim payment is $0. I hope this information was helpful and supports reasoning as to the pricing." I responded back immediately, "worked on your appeal to the insurance company," how is that possible, I never intended to file an appeal. "Please forward the document permitting you to file the appeal along with the appeal documents you submitted to my insurance company."

Ms. Moorefield emailed me three attachments, the two were the ZOLL logo, and the third was the document my husband signed on 03/28/2017 agreeing to send the Lifevest back to ZOLL in the box they provided, the attachments had nothing to do with the appeal. I emailed Ms. Moorefield to let her know she mistakingly sent me the wrong documents and asked her to try again, to date I haven't heard back from her. I have emailed her several times since then, and Ms. Moorefield has not acknowledged nor responded to any of my emails. I also faxed her a formal written request for the documents, and haven't heard back from her, it as if she disappeared, or flat out ignoring my request, makes me think...hmm.

I'd also like to mention; First; I sent ZOLL multiple emails asking when it would ever be appropriate to disconnect/terminate/discontinue service without first notifying the customers. The answer I received, "ZOLL did not disconnect/terminate/discontinue the service, "your account has been "INACTIVATED." Second; I thought the Lifevest was fully functional from 03/28/2017 to 04/09/2017, I was wrong. After I requested and received my husband complete medical record from his cardiologist, I found that ZOLL transmitted the heart monitor reports from 03/28/2017 to 04/04/2017. So the Lifevest was fully functional for seven days, meaning the cost for the Lifevest started as $60.16 a day and ended up being $524.28 a day, that is an increase of 775%. Bottom line is ZOLL values the mighty dollar over human life. I really should proofread this before posting, but I have a sinking feeling in my stomach, I feel exhausted, and the tears are starting to flow! Thanks for your time,