Thursday, April 13, 2006

Lincare Can Kiss My Black Ass

Yah u heard me. Lincare is a piece of shit company, and I have proof. Cuz I WAS FIRED!!!!
Yes, that is correct, I was fired. Which to anyone who knows me comes as a complete shock. What? Jessica fired? No way! But I do have a legitimate firing reason. I was fired because Lincare is a piece of shit company. Don't believe me? Check 'er out-
Cpap machines are for people with sleep apnea. Sleep apnea is a condition in which the patient stops breathing at night. Cpap stands for continuous positive airway pressure. What is does to treat sleep apnea is blow a stream of continuous air pressure into the patient's lungs.
Lincare sells cpap machines, and all the parts that go with it. These parts consist of a mask, a headgear, tubing, and filters. All together, before insurance, a cpap system costs roughly 2500 dollars. Most insurance companies, including Medicare pay at about 80 percent. So the patient would pay 500 dollars for the complete machine.
Now a little Lincare background- Lincare is huge, with 800 centers in the US. It has huge profits, sometimes earning record profits while the competition is in bankruptcy. The reason Lincare is so profitable is because almost all their money comes from Medicare. Lincare bills Medicare for oxygen and nebulizer therapy, cpap machines, and nebulizer medication. They're the welfare mothers of the medical world.
Only problem is, after Medicare part D was introduced, the government slashed the reimbursement amount on nebulizer medication by almost 40% to help pay for the new prescription plan. Lincare took a huge hit, and started losing money on these "designer medications."
Forced to keep revenue up to keep the stock value up, Lincare decided to milk money out of cpap supplies and parts, which as I pointed out are pretty pricey. From a CEO's point of view, it's not a bad plan:
Each mask is about 200 dollars. A headgear runs about 70. Tubing is 30, and filters range from 5-30 dollars. If you multiply all those parts by the number of cpap patients Lincare services (easily a million and more) you come up with a pretty hefty number. And since Medicare allows a new mask and other parts every 3 months, you could easily bill for all those items a million times 4 times per year.
That's a shitload of money.
And here's where I come in. It gets a bit dicey from here on, so hang tight. I was introduced to this scheme in December. Lincare implemented a new computer program that listed all the center's cpap patients in a queue that rotated every 3 months. My job was simple- call the patient, tell them it was time for more cpap supplies, order them through the queue, and Lincare would bill the insurance company. And it went pretty okay for the first couple of weeks. I was given a list of Medicare cpap patients, and I spent an hour or two getting my goal of 2 orders a day.
After the Medicare patients, I moved on to private insurance patients. I noticed there were a lot more private insurance patients than Medicare patients, probably because sleep apnea seems to affect the men and the overweight more that older people. And since my instructions were to say that they were eligible for new supplies every three months, and because they were rotated in the queue every three months like the Medicare patients, I had no problem telling them they could get these things at the 80% insurance rate, just like Medicare.
Then I started to get phone calls from people asking what these Lincare bills were. I told them I had no idea, and referred them to the billing office in Casper, Wyoming. I started to get e-mails telling me that I was not to ask patients if they would like new supplies, but to tell them that they WERE going to get new supplies. One gave us permission to send masks that weren't currently prescribed just to make the sale. Another said that if a patient came in to the center to get a part in person, to tell them that we didn't have anything in stock and then ship one to them. And everyday, I had to call more and more people.
Eventually, people were calling and literally screaming at me about these bills. Turns out, the three month rule ONLY applies to Medicare. Blue Cross and Mutual of Omaha and United Healthcare don't follow Medicare guidelines. Some plans had a cap, some allowed parts once a year, and others only paid for one part at set-up, and the patient was responsible for the rest. While most of the plans had a cap, I had no idea whether the patients insurance was capped or not, and for the most part, neither did the patient. So even though everybody in the company knew that most private insurance companies DO NOT follow Medicare guidelines, I was still required to call them every three months and tell them they were eligible for parts.
Not being one to rip people off, I stuck to Medicare patients only. I had enough to scrape my goal every month. And I could be sure that none of them was going to receive a bill for 250 bucks by account of me. And this got me through most of Februrary and March.
Then came a fateful day in the middle of March, when I came back to work after a long weekend, and found a fun little e-mail. From now on, I was to bill 40% of my cpap patients a month. This was about 120 cpap sales a month. I wouldn't be able to stick to Medicare anymore, and worse, more and more people were going to pay out of pocket for stuff that I told them would be covered. The more I though about this, the more it started to bother me. I mean, what if that 40 bucks the Medicare patient has to pay for their 20 percent of the mask is their food or drug money? When I say "eligible" are they always going to be lucid enough to understand that it won't be completely covered? What if they have ahlzimers and don't remember ordering a new mask? What if they're sick and think it's gonna be paid for? They are old, remember, and I was to be as ambiguous as possible.
But what really bothered me was the private insurance people. Even if the first mask I sold them was covered, chances were the second or third one wasn't going to be. And I knew that, which made me nothing short of a liar. And again, what if that 200 or so bucks was rent money, or food money? They would think "great, I could probably afford 30-40 bucks every 3 months to have this new mask", but imagine when they get a bill for 250.
The kicker was that these masks DON'T need to be replaced every 3 months, they can easily last 6 months or more if you take care of them. But for some reason, Medicare allows for them every 3 months, which is now the "standard" at Lincare. I honestly felt that the "customer service" part of my customer service title was slowly being replaced by "lying telemarketer."
Once they suggested that I work late and on weekends to get all my sales in, I had had enough. My responsibility was to the patients, taking care of their needs, not selling them stuff they didn't need because some guy in Florida I've never met said I had to. So I wrote my boss an e-mail. I was very blunt in it, which I figured was no big deal because she was my friend and nobody would read it but her. In it I said this is horrible, we are ripping off patients and Medicare, I wasn't hired as a telemarketer, and I had ethical objections to lying to people to make a sale. Which I guess pissed her off, probably because if I wasn't going to do it, then she would have to. She had already written me an e-mail saying "please do this so I don't have to," and honestly, I don't know what I was trying to accomplish by sending her the e-mail, only to vent a little I guess. Well, the e-mail pissed her off, so she sent it to the manager above her, who decided to fire me, because I was easily replaceable and money is king at Lincare. They don't want "ethical objections," they want lying ass-kissers who won't stand up and say they think something is wrong.
So goes in the corporate world.
I'm sitting here hoping and praying this thing blows up in their face. It's only a matter of time before Medicare changes their guidelines on this, I mean imagine the money Lincare is sucking out of Medicare's pockets. Our pockets, actually, because taxpayers pay for Medicare. Everytime you look at your Medicare deduction on your paycheck, realize that money is going to pay for shit that doesn't really do patients any good. I'm also hoping that enough people complain to their insurance companies about this that maybe they'll investigate fraud against Lincare. Wouldn't be the first time- the Attorney General's office conducted an investigation against Lincare for Medicare. Lincare ended up paying a 3 million dollar settlement, which isn't even a dent in their wallet, believe me.
And I don't want to work for a piece of shit company like that anyway. So one more time: Lincare- Kiss My Black Ass!