Healthcare providers and insurance -Lack of understanding???

[JHZR2]

A while back I wrote about wanting to buy my CPAP. Aerna told me I could buy it, no problem, do it this year and I'd be working under my deductible, as I have an HDHP.

The money I spend is mine, I self direct my care. I'm not on Medicare or a standard insurance plan.

So why when I call my DME, do they say I need a letter from my doctor saying that I'm compliant? I'm self directed and don't need to prove anything to anyone under my HDHP. Aetna doesn't say I need to have it.

Call my doctor's office, cant help me between vacation and lack of understanding. I'm sure there is a desire for billable hours too...

Very annoying. I'm sure govt healthcare isn't the answer, as it would create more beaurecratic mess, but the excess of the medical industry, especially when coupled with the lack of real knowledge, is disgusting.

[Mary Z]

Did Aetna say you didn't need to prove compliance?

[Janknitz]

You are a rare bird, and your DME is just plain dumb. It's not your insurance that lacks understanding, it's the DME.

Most people are not self insured--most are on Medicare or another provider that does require some documentation of compliance, so your DME just can't wrap it's puny little head around the difference.

Are they refusing to complete the sale without the documentation?

If so, and your deductible turns over at midnight on Dec. 31st, you are going to need to start working your way up the management ladder with the DME. You might need to get some supervisor in Aetna to get on the phone with them too--conference call if you must, but writing (fax or email ) is always better. Time is running out, work fast.

Good luck!

[NightMonkey]

So why when I call my DME, do they say I need a letter from my doctor saying that I'm compliant?

Are you paying out of your own pocket and using a brick-and-mortar DME?

It is usually cheaper (and better customer service) to buy from an internet supplier. Unless there is an insurance angle that dictates otherwise.

I don't buy anything from the local DMEs.

[archangle]

He has a high deductible. He's met the deductible for the year. Whatever he buys for the rest of the year is cheaper than what it will be next year.

Tell the damn DME to bill you now and straighten it out later with the insurance. Tell him you're just going to keep the CPAP machine and stop paying him if he doesn't.

[JHZR2]

Yeah but the medical folks need to keep their boat payments paid, so they dont care who they gouge.

[Paul56]

Yeah but the medical folks need to keep their boat payments paid, so they dont care who they gouge.

I quickly learned that unless insurance is paying the lion's share I am best to cut out the red-tape
and purchase my own equipment online at non-DME pricing.

So, take a look at online pricing and decide if it is worth going through the trouble of dealing with
your DME given the high deductible.

I fired my DME in 2008.