Apria Healthcare Fraud

lawdognellie · Post by **lawdognellie** » Tue Apr 24, 2007 9:30 pm

I also go to Apria b/c my insurance has a contract with them. I paid at the time I received the equipment and then two month later I got a letter that they referred my unpaid bill to a collection agency. Well, being a nasty law student, I sent them a strongly worded demand letter (with threat of suit of course). It got it fixed.

As for this suit, did you send a demand letter asking for them to refund the charges to the credit card? Did you report the unauthorized charges to the credit card agency? If so, did they run an investigation? Double check any paperwork you signed to make sure you didn't unknowingly sign something allowing them to charge your credit card. You're gonna need a paper trail, even in small claims court.

Sarah

P.S. someone made a comment about Apria having lawyers on retainer so it won't cost them anything to defend against suits...this isn't correct. They probably do have a firm on retainer, but almost all firms are on billable hours (required for a lawyers code of ethics). Depending on the attorney they can charge anywhere from $300 to $700 per hour.

georgev747 · Post by **georgev747** » Tue Apr 24, 2007 11:05 pm

lawdognellie,

thank you for you comments, you know how hard is to deal with this people,
they are nasty and if you have an accent like I do, they treat you even worst. That is why i had to go to court against them.

best regards,

Jorge

Snoredog · Post by **Snoredog** » Wed Apr 25, 2007 12:05 am

georgev747 wrote:lawdognellie,

thank you for you comments, you know how hard is to deal with this people,
they are nasty and if you have an accent like I do, they treat you even worst. That is why i had to go to court against them.

best regards,

Jorge

I say take them to court, just make sure you send that "demand" letter or you won't have much of a case. Demand letter is nothing more than a letter explaining why you were wronged and you WANT your money back. If they refuse, you sue them. Just put at the top of the letter "Demand for Refund", send it to them Registered mail, be sure to keep the Registered mail receipt and copies of all the paperwork.

Then I would go to a few websites, find the exact same machine, print out what they are selling that machine for without insurance and show the judge what they are charging you.

It is a ripoff and someone needs to sue them. Insurance makes us charge that much what a bunch of BS.

If you don't have insurance, they should have given you a "competitive" discounted cash price, not the same they would charge Medicare or insurance. If they bill them for that it will take them 90-120 days before they will ever see their money. They say Insurance sets the price (more BS), they do that so you have to pay MORE in deductible.

If you lose you are only out the $35 bucks for filing fees. They most likely won't even show up to court, if they don't you automatically win the case, just be sure to ask the judge for punitive damages for bad-faith refund of credit, insurance companies hate bad-faith claims, just ask State Farm.

CollegeGirl · Post by **CollegeGirl** » Wed Apr 25, 2007 12:20 am

Snoredog,
He posted that he does have insurance. Even if he didn't, DMEs that accept Medicare have to, by law, charge cash customers the same amount they charge Medicare (this does not apply to private insurance, however, like the OP has).

Jorge,
I would really, really rethink this suit. If you lose, the judge might just see your lawsuit as ludicrous enough that he would grant them a countersuit for their legal fees - which would mean you would be held responsible for paying them. And if they have expensive lawyers with billable hours - you could be looking at QUITE a lot of money here.

I, too, have had horrible experiences with Apria, and I detest them. But at the same time, I would hate to see you out even more money than you are to start with.

fidget · Post by **fidget** » Wed Apr 25, 2007 8:14 am

His set up was actually cheaper than Medicare allowables, which would have come to about $598, for first months rent, humidifier sale, and mask, tubing, etc. He had to sign for credit card payments for the rest of the rental months, or it wouldn't be happening. He has a 50% copay, his choice of insurance, not the DME's fault.

I just don't fathom how anyone can say he was ripped off.

If I sign a contract with a roofer, and find out after the job is done, that another roofer would have done the job for a couple of thousand less, do you think bringing that the info that someone else would have done it cheaper to small claims court would get me that price? That's what you're encouraging him to do by telling him to sue, and it's going to wind up costing him big bucks to the court systems, and nothing else.

If he could purchase online for less than his copay, than that's what he should have done. He didn't.

oceanpearl · Post by **oceanpearl** » Wed Apr 25, 2007 8:21 am

[quote="georgev747"]fidget,
why would an insurance company agree to pay 2-3 times retail for a Cpap machine or anything? upbilling, doublebilling, corporate kickbacks? common, you seem live a very sharp individual, i know you could blame the insurance company, so do i, the problem is not the price, the problem is the fraud.

oceanpearl · Post by **oceanpearl** » Wed Apr 25, 2007 8:22 am

lawdognellie wrote:I also go to Apria b/c my insurance has a contract with them. I paid at the time I received the equipment and then two month later I got a letter that they referred my unpaid bill to a collection agency. Well, being a nasty law student, I sent them a strongly worded demand letter (with threat of suit of course). It got it fixed.

As for this suit, did you send a demand letter asking for them to refund the charges to the credit card? Did you report the unauthorized charges to the credit card agency? If so, did they run an investigation? Double check any paperwork you signed to make sure you didn't unknowingly sign something allowing them to charge your credit card. You're gonna need a paper trail, even in small claims court.

Sarah

P.S. someone made a comment about Apria having lawyers on retainer so it won't cost them anything to defend against suits...this isn't correct. They probably do have a firm on retainer, but almost all firms are on billable hours (required for a lawyers code of ethics). Depending on the attorney they can charge anywhere from $300 to $700 per hour.

It would be HARD for me to believe that a company as big as Apria does not have it's own legal dept.

sleepyinsunnyvale · Post by **sleepyinsunnyvale** » Wed Apr 25, 2007 9:02 am

I suspect that Apria has some in house legal folks who deal with contract law (Insurance companies, Medicare, etc). Unless they are continually involved in law suits most likely they contract out litigation cases onan hourly basis.

DP · Post by DP » Wed Apr 25, 2007 9:09 am

Anybody that is involved in healthcare fears Medicare. The last thing in the world you want is a Medicare audit so you do everything possible to avoid it. Apria has been in business for many many years and has several exclusive contracts with private insurance carriers besides Medicare. While what they do may be morally wrong it is not illegal. The microscope is always on companies like Apria, Lincare, American Home Patient, etc. You would be better off filing a complaint with the insurance carrier.

georgev747 · Post by **georgev747** » Wed Apr 25, 2007 10:20 am

if you think about it there are issues not raised as why the co-payment of a machine is almost twice as the regular price of the equipment. when you rent a car from an insurance company they contract for lower prices, not for higher prices, don't you believe that Maybe our insurance carries secretly profiting by raising the prices, inst that that ann issue, however, they now it is difficult to get tehm on that, in the other hand I can get Apria oin fraud, maybe in the process i can expose their secret agreement with insurance companies. i paid almost $400 dollar a month on insurance are we supposed to have insurance to get a discount or to be made to pay more than cash patients? The big issue is that Corporations do whatever they want with you when they have a priviledged position, your insurance sends you to Apria and you just believe that they will act honorably, and according to what makes sense. when you go and rent a car, do you read the whole contract front and back and fine print. have you ever bought a house, do you read every single page of the 20 page document, would you understand it. do you read every page of a 200 page loan document, do you read the whole insurance booklet or memnership agreement. you rely on good faith, when you give your credit card to someone for final payment and they make it look loke final payment and they change it to charge every month to a monthly payment, that is fraud. when they tell you something different because they are in apriviledge position it is fraud. There is a lot of attorneys that know this, but mostly they want to litigate the easy cases, the broken bones to make their fast cash. Corporations know this and make trick contracts to get people who will not find an attorney, it is to you Alone most of the time to stand up to them. Fear, counter lawsuit, billying are their weapons, but in front of a Jury with people like you and me is where they are likely too loose because we decide what is obscene, not them.

TXKajun · Post by **TXKajun** » Wed Apr 25, 2007 10:23 am

"Caveat Emptor!"

Nuff said?

Kajun

georgev747 · Post by **georgev747** » Wed Apr 25, 2007 10:41 am

Caveat Emptor, if this was the reality, there would be not on single misrepresentation Law or Fraud Statutes. The commerce will came to a halt. For example, Recently in California a new la is on the books regarding used cars, A dealership has oe give the buyer a buyback contract. giving him a time to bring the car back is he is dissatisfied. More than 10 years ago there was a recurring problem where people went to buy cars and left the car lot with a lease although they thought they were buying. the problem was fixed by a law, why you think it was fixed, Caveat Emptor? i don't think so.

CollegeGirl · Post by **CollegeGirl** » Wed Apr 25, 2007 10:49 am

Jorge,
Your bone to pick is with the insurance industry - not with Apria. You cannot "get them on fraud," because despite what you think about their prices, they have not committed any.

You said

georgev747 wrote:are we supposed to have insurance to get a discount or to be made to pay more than cash patients?

The fact is, you did NOT pay more than cash patients pay at YOUR DME. You paid about half of what cash patients pay there. You paid more than someone would ordering online, but it's already been explained to you that, by law, DMEs that accept Medicare (such as Apria) have to charge cash patients the same rate as medicare patients, while online DMEs (who do NOT accept medicare) can charge whatever they want. This is why cpap.com can do things so much less expensively.

Again - I do not like Apria, either - but, UNLESS they charged your card without your permission (and I'd be willing to bet you probably signed something saying they could), they have done nothing wrong. Yes, it SUCKS that the healthcare industry is this way. But all this lawsuit against Apria is going to be is you banging your own head against the wall. I'm telling you this because I genuinely do NOT want to see a fellow apnea sufferer get taken for a ride - and that's very well what might happen to you financially after this suit if they choose to countersue for legal fees (and they very well could).

fidget · Post by **fidget** » Wed Apr 25, 2007 10:52 am

OK George, it's your money. Good luck to you in your pursuit for vengeance for not taking the time to read your own contract.

oceanpearl · Post by **oceanpearl** » Wed Apr 25, 2007 11:08 am

Just a friendly word of advice George, I hope for your sake that you can prove fraud, if not Apria has an excellent defamation suit for what you have posted on this board.
I am sure that Apria monitors this board because I posted a problem here and the local Apria general manager contacted me two days later

Apria Healthcare Fraud

thank you

Re: thank you

Re: counterintuitive

what you see and whe you did not see

caveat Emptor