OLD DOMINION HOME HEALTH SERV's complaint:
February 08, 2013

Insurance Company: Coventry Health Care
Coverage Type: Health Insurance

• Claim Handling - Fraud
• Claim Handling - Unjustified Accusations

Old Dominion was given Authorization to care for an infant at least 2 year of age with a g-tube and complex problems including seizure. The agency obtained authorization and Billed Southern Health the contract rate. We received the check for less than what was billed for. "THE PROBLEM IS THAT SOUTHERN HEALTH THREATEN THE AGENCY AND TOLD US TO SEND ALL THE MONEY BACK AND THAT WE SHOULD WORK FOR FREE". There was continuous
continuous dialogue which is now ended. Specifically, The referral came in, the agency accepted the patient. The infant child was cared for per MD orders. Southern Health was billed according to Contract rate. Southern Health latter send a demanding letter stating we had 45 days to return all the money and work for free. Southern Health claimed the agency was paid $100.00 per hour. The claim total was $8400.00 and Southern Health paid 8113.00 for the servic3e. The agencies bill rate was $80.00 per Souther Healkth revenue code of 0551. Southern Health stated that they will pay us $9.00 for RN and $9.00 for LPN because they have a contract with Medicaid to pay this amount for a patient in the EPSDT Waiver program. This is the incorrect rate for this program. Southern Health wants to pay $9.00 for the service and have threaten to terminate contract if we do not accept $9.00 for a Skilled Nursing Level of care for an infant.\
The Company is Old Dominion Home Health Services
8014 Midlothian TNPK, North Chesterfield, va 23235
804-745-5133. If you are not the correct person for this complaint, Please let me know. email: odhhs@msn.com

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