Wheelchair Wars

My wheelchair and its maintenance is extremely important to my daily life. When my wheelchair is working, I can go out to work, do errands, attend social engagements, and don’t feel restricted or unable to be a full participant in my life.

However, when my wheelchair is not working it is like not having legs or worse.

I cannot do much of anything and am restricted to the short distances I can travel on my painful and weak legs due to my rheumatoid arthritis. Bed to chair and not much further.

So you can understand that a competent and reliable wheelchair repair vendor is a crucial relationship. They keep the wheelchair motor humming and my life moving.

But in recent years my vendor has felt more like an enemy. I have to watch them like a hawk because they overcharge or double bill. It takes weeks for new parts to arrive. Batteries, that should last for years, fail within less than a year. While the repair work is fine, the parts may be bad and the billing is suspicious.

One example is my experience of getting a new wheelchair two and a half years ago. At first, I had difficulty getting an appointment scheduled because they said I needed some insurance paperwork, however, when we called my insurance they explained I was fully covered for a new wheelchair and just needed to get the order completed.

My husband figured out that the wheelchair vendor was making so much money from repairing my old chair that they were dragging their feet on getting me a new one. In one year the repairs they made (replacing wheels, a motor, and more) cost more than it would to purchase a new chair. Thankfully, it was all covered by my health insurance, but the vendor must have been happy to be making such a profit on my old wheelchair.

I loved my new chair!

Eventually, I got the appointment and we ordered my new wheelchair. About a month later they delivered it and did the fitting to make sure it was properly adjusted. I loved my new chair! It got me around and wasn’t constantly breaking down.

But then the billing war began. The wheelchair vendor submitted a bill to the insurance company that was basically double-billing. It had a charge for the wheelchair, then for all the wheelchair parts! They billed for wheels, the seat, the back, footrests, armrests, and more. Can you imagine what a wheelchair would be like without all these pieces? Is it even a wheelchair anymore? Does that count?

The insurance company concluded this was a scam by the vendor and so they paid for the wheelchair, but not all the parts. The vendor then appealed and they fought for two years about what constitutes a wheelchair and how the vendor should be compensated. While my insurer explained that I was covered, the vendor disagreed—saying they were failing to pay. Yet, the real argument was about the billing process and how ‘wheelchair’ should be defined.

I watched in awe and anger as I saw the back and forth.

As a wheelchair user for more than two decades, I couldn’t believe there was a disagreement about what constitutes a wheelchair and how to bill for it. In my heart, I blamed the vendor as it seemed they just wanted more money for a standard motorized wheelchair.

The wheelchair vendor was not satisfied with the appeals process ruling and so then filed a complaint with the government health insurance ombudsman as the final authority on the dispute. (This process is open to consumers in every state and they actually filed in my name without my permission or participation.) Naturally, this process took about another year and they lost the decision.

The vendor then started calling and telling us we had to pay the difference that they wanted for the wheelchair. It made me so angry—that they messed up the billing, that my insurance covered the chair for a fair amount, and that they came after me for more. But instead of acquiescing, I called the ombudsman office and learned that they legally could not bill me anymore, that they should have requested my permission to appeal, and that they were in the wrong all along. When I told the woman at the ombudsman office that I was worried the vendor would take away my wheelchair for not paying their bill, she said it was not allowable and that they “better sit back down” and call her if I had any problems. Once I conveyed this to the vendor and said they could call the ombudsman if they didn’t like it, all was quiet.

But now I have no more trust in them.

Every bill has become suspect, and they have lost all trust and credibility. I am lucky that my husband and I are knowledgeable and resourceful. My fear is that many people pay their inaccurate bills and don’t fight because they either don’t know they have options or don’t have the energy due to their illness.

So if I were to advise others, I would say never take a health bill at face value. Always ask what the charges mean and check with your insurance company. Don’t let the vendors or others get away with scamming you or your insurance!

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