Complaints

The complaint text that is displayed might not represent all complaints filed with BBB. Some consumers may elect to not publish the details of their complaints, some complaints may not meet BBB's standards for publication, or BBB may display a portion of complaints when a high volume is received for a particular business.

• Initial Complaint

  Date:09/22/2023

  Type:Order Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  I purchased a breast pump on 7/21/2023 for $349.99 from breastpumps.com with the understanding that they would submit a claim to my insurance on my behalf, and then reimburse me after receiving payment from insurance. I received my explanation of benefits from my insurance provider that stated there was an in-network provider negotiated discount of ******. The total left was ****** and my insurance paid 100% of that price. My EOB clearly states that I shouldn't owe anything for this breast pump, but breastpumps.com insists they will only reimburse me for the $120 that my insurance paid them. So my insurance is negotiating a lower price on my behalf but this company is demanding that I pay the difference even though they agreed to that price with my issurance.

  

  Business Response

  Date: 09/26/2023

  Explanation of Benefits are complicated and we field many calls regarding the breakdown of billed amount, discount, payment and amount saved.

  As the President ***** CEO explained to the submitter of this complaint, the discount listed on the *** is not a payment received by the provider of the service. The discount is an arbitrary amount which the insurance company negotiates to help provide additional savings to their members. The full MSRP of the product purchases was billed to the insurance provider and a payment in the amount listed that the plan paid is due to the customer but not a full refund as full $349.99 was paid to the provider. If a full refund in the amount of $349.99 were to be issued to the customer with only $120 reimbursement received then the medical equipment company would be covering the cost of the equipment instead of the insurance provider who is offering the benefit.

  The insurance plan that issued the *** has a maximum allowable rate of $120 and that is the most that will be covered under the product code that was submitted for reimbursement on behalf of the member. If the member had submitted their own insurance claim the payment amount offered by the insurance provider would be the same amount offered to the durable medical equipment provider.