My DME came to my house, set up my equipment and showed my how to use it, take it apart and clean it, etc. etc. All of the DME's are respiratory therapists (I used to work with one of them) and also mine has sleep apnea himself so he is familiar with any questions that I have. They also have a satellite office/supplies in our hospital where I work which is convenient for me. Also when I need refills on filters, etc., I just have to call and they will have them to me in a day or so. I can't complain at all, but from reading these posts it seems that all are not so lucky.
I know of one DME in our town that went from a dry cleaning business to selling medical equipment! I would never deal with them as the are clueless.
On-line vs DME - for the first time
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Sleepless on LI
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Jim,
Good for you. So you are going with BMI? What machine are you getting, do you know? And how soon are they going to be able to get it to you? I'll bet it's quicker than the DME said, 7-10 days.
Once in awhile, I have to say, you do find a DME who works great with you. I was one of the blessed ones to have that experience. I faxed the prescription over to them and the next morning, they set up an appt. to see me that night. Everything was fast and smooth. I can only imagine how much they charged my insurance company to buy me the machine a month later, but I had no out of pocket expense at all with my insurance. I, like I said, was blessed with the luck when it came to all of that.
Let us know when you order the machine/mask and when you are going to be receiving it. I'm so glad you decided to use BMI.
Good for you. So you are going with BMI? What machine are you getting, do you know? And how soon are they going to be able to get it to you? I'll bet it's quicker than the DME said, 7-10 days.
Once in awhile, I have to say, you do find a DME who works great with you. I was one of the blessed ones to have that experience. I faxed the prescription over to them and the next morning, they set up an appt. to see me that night. Everything was fast and smooth. I can only imagine how much they charged my insurance company to buy me the machine a month later, but I had no out of pocket expense at all with my insurance. I, like I said, was blessed with the luck when it came to all of that.
Let us know when you order the machine/mask and when you are going to be receiving it. I'm so glad you decided to use BMI.
L o R i
WAFlowers wrote:Roger, I'm thinking that Johnny should post your message on the billmyinsurance.com and cpap.com sites as a detailed, well-written example of why people should buy from them!
Hello Bill,
Thanks for the kind words. I wasn't trying to create a testimonial, but instead create a clear image of how I saw my experience so JimK would have a recent reference. Now with your note I'm now wondering if I should have dumbed it down a bit.
Thanks again!
Roger...
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Sleepless on LI
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JimmyKSenior
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Thanks again to all! Roger, you gave an excellent word picture and pushed me over the edge to go with BMI, thanks. Bill gave you high praise as do I, you should be a poster boy for BMI - great testimonial! The DME (Keene Medical Products) has had my prescript for a week today and still I know nothing. Whereas Bonnie at BMI hopes to ship tomorrow. There may still be a holdup with BMI, as they still have insurance to finalize with but you can tell there is a difference in service standards.
I guess the bottom line for me is that the references are far more against DMEs overall than for them. It appears they do not have a great reputation. I really don't want someone hired to sell walkers telling me how to breathe. There is a chance the DME and the therapist (or non-therapist) would be great but so far they fail to impress and I don't feel I can afford to take a chance with something I will live with for a long time, or at least I hope a long time. A week with only one conversation, still don't know what they offer for service or machines, and based on the fact they told me my machine was $2000, they are grossly intending to over-charge my insurance company. I work for a worker's compensation insurance company and am pretty aware of insurance costs and what drives them up (I'm in IS, not the insurance side, so let's not go there, its a job).
I realize BMI is there to make a profit and can't exist if they don't, but unlike the others they seem to put service first and that is important to me. They are not perfect, none of us are, and some of the posts here have been critical or sound critical at times, and they read these and they take their lumps and move on, sometimes biting the bullet and not responding, but you know Johnny is there listening. Well, as they say the proof is in the pudding and we'll see, but based on the majority of responses they are the ones to work with. I realize you can't make everyone happy all the time and you have to consider the source when reading stuff. Johnny must have thick skin and patience to match sometimes.
Hindsight will be 20/20 but I am comfortable right now that I made the right choice. Lori - we are looking at the REMstar Auto C-flex with heated humidifier, mask TBD. This may be too much machine but I think everything is there that I will need depending on how well I take to the treatment. I know I slept well in the study and woke only once, but that was one night and statistically not a large sampling so I think there is a lot of room for varying good and bad experiences. The auto c-flex increases my chances of staying compliant.
Well that's it for now, I have to get back to writing specs for a new insurance form for claims to use. And they wonder why I fell asleep?! (snore sound here)
Jim
I guess the bottom line for me is that the references are far more against DMEs overall than for them. It appears they do not have a great reputation. I really don't want someone hired to sell walkers telling me how to breathe. There is a chance the DME and the therapist (or non-therapist) would be great but so far they fail to impress and I don't feel I can afford to take a chance with something I will live with for a long time, or at least I hope a long time. A week with only one conversation, still don't know what they offer for service or machines, and based on the fact they told me my machine was $2000, they are grossly intending to over-charge my insurance company. I work for a worker's compensation insurance company and am pretty aware of insurance costs and what drives them up (I'm in IS, not the insurance side, so let's not go there, its a job).
I realize BMI is there to make a profit and can't exist if they don't, but unlike the others they seem to put service first and that is important to me. They are not perfect, none of us are, and some of the posts here have been critical or sound critical at times, and they read these and they take their lumps and move on, sometimes biting the bullet and not responding, but you know Johnny is there listening. Well, as they say the proof is in the pudding and we'll see, but based on the majority of responses they are the ones to work with. I realize you can't make everyone happy all the time and you have to consider the source when reading stuff. Johnny must have thick skin and patience to match sometimes.
Hindsight will be 20/20 but I am comfortable right now that I made the right choice. Lori - we are looking at the REMstar Auto C-flex with heated humidifier, mask TBD. This may be too much machine but I think everything is there that I will need depending on how well I take to the treatment. I know I slept well in the study and woke only once, but that was one night and statistically not a large sampling so I think there is a lot of room for varying good and bad experiences. The auto c-flex increases my chances of staying compliant.
Well that's it for now, I have to get back to writing specs for a new insurance form for claims to use. And they wonder why I fell asleep?! (snore sound here)
Jim
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Sleepless on LI
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As I understand it, cpap.com gets your money up-front (no carrying charges) and has very little paperwork to do. Most of the "leg work" is done by the buyer: getting the prescription from the doctor, getting the Rx to cpap.com, etc.bulldoger wrote:I just don't understand the price difference between cpap.com and billmyinsurance.com.
I bought a remstar apap from billmyinsurance.com and they charged my insurance $1560.00 and the price at cpap.com is $630.00
OTOH, billmyinsurance.com has to do a lot of work, interfacing with both the doctor and insurance. Then they send you the machine and bill your insurance. Then they wait to get their money ... for months. Effectively interest charges are piling up on the cost of the machine. They may have to chase after the insurance company (more time and people effort) to get that payment.
The amazing thing is that BMI still seems to be significantly cheaper than any other DME I've heard of here! How do they do it? I'm not surprised that they cost more than cpap.com; I'm surprised at how much cheaper they are compared to the alternatives!
The CPAPer formerly known as WAFlowers
Hello "bulldoger",
Pricing differences like you mention here are hard to ignore.
From where I perch Medical pricing lives in a world of misleading accounting and a lot of "slight of hand". To get this across better, here are the statement charges for my sleep study:
In the example above, the sleep center shows the cost of the sleep study to be $2,510. This sleep center is listed as a preferred provider for Blue Cross and has agreed to a total study cost of $1,318.17. However, in order to get something near the Blue Cross pricing when a Medicare billing is involved, they need to show their retail pricing at $2,510 because Medicare only pays a fixed percentage of the retail price.
This kind of approach to medical billing leaves the entire process open to abuse both deliberate and unintentional. It also gives people who know about pricing strategies the opportunity to negotiate with a medical provider an opportunity to avoid being charged more than the insurance company would pay. For example, if a user knows the insurance company is only going to pay $1,318 for the study, an uninsured user could ask the medical services provider to only charge them that amount before the services are rendered. In most cases, if the person is talking to a manger level person and an price agreement is made, the services will still be billed at the standard price, but a "Special Incentive Discount", or "Patient Write-Off" line item will adjust the cost down to the insurance companies cost.
As long as Medicare only bases its coverage amount based upon a percentage of full retail, we will never see an end to misleading accounting and abusive retail pricing in the Medical services industry. In addition this approach to medical billing is increasing the rate at which medical cost are rising because of how percentages work in reality.
When I first spoke with BMI about equipment cost, they clearly said their price was higher than Cpap.com because of the agreements they had with the insurance companies. It was because of that discussion and their own internal guidelines they told me I would be better off to buy from Cpap.com instead of them after they discovered my insurance coverage.
Hopefully this example shows the price billed to the insurance company isn't always the price the insurance company pays. Is it no wonder the world of insurance and medicine is becoming a real sore spot in our country. Just think about the expense debt incurred for people who aren't aware they can get the same price as the insurance company if they only knew enough to just ask.
Pricing differences like you mention here are hard to ignore.
I don't have all the answers to why this is happening, but some the following might be of help.bulldoger wrote:I have to agree that cpap.com and billmyinsurance.com are great.
I just don't understand the price difference between cpap.com and billmyinsurance.com.
I bought a remstar apap from billmyinsurance.com and they charged my insurance $1560.00 and the price at cpap.com is $630.00
From where I perch Medical pricing lives in a world of misleading accounting and a lot of "slight of hand". To get this across better, here are the statement charges for my sleep study:
Code: Select all
Date Description Charge Insurance Patient Balance
9/14 950CG: Attended
SLEEP Study 2510.00 1975.00 535.00 2510.00
9/16 $2510 claim filed
WITH Blue Cross
9/29 Ins. Payment
Blue Cross -656.83 1853.17
9/29 Ins. WRITE-OFF:
Blue Shield -1318.17 535.00
9/14 Patient Deductible
Payment -500.00 35.00
10/01 Patient Balance due 35.00
This kind of approach to medical billing leaves the entire process open to abuse both deliberate and unintentional. It also gives people who know about pricing strategies the opportunity to negotiate with a medical provider an opportunity to avoid being charged more than the insurance company would pay. For example, if a user knows the insurance company is only going to pay $1,318 for the study, an uninsured user could ask the medical services provider to only charge them that amount before the services are rendered. In most cases, if the person is talking to a manger level person and an price agreement is made, the services will still be billed at the standard price, but a "Special Incentive Discount", or "Patient Write-Off" line item will adjust the cost down to the insurance companies cost.
As long as Medicare only bases its coverage amount based upon a percentage of full retail, we will never see an end to misleading accounting and abusive retail pricing in the Medical services industry. In addition this approach to medical billing is increasing the rate at which medical cost are rising because of how percentages work in reality.
When I first spoke with BMI about equipment cost, they clearly said their price was higher than Cpap.com because of the agreements they had with the insurance companies. It was because of that discussion and their own internal guidelines they told me I would be better off to buy from Cpap.com instead of them after they discovered my insurance coverage.
Hopefully this example shows the price billed to the insurance company isn't always the price the insurance company pays. Is it no wonder the world of insurance and medicine is becoming a real sore spot in our country. Just think about the expense debt incurred for people who aren't aware they can get the same price as the insurance company if they only knew enough to just ask.
Last edited by Roger... on Fri Oct 21, 2005 11:00 am, edited 1 time in total.
Roger...
Hello Jim,
Thank you for the kind words, and I'm also glad the information was helpful. That was my primary goal. A secondary goal was to recognize the performance of Bonnie and Becky and the organization that employs them. I don’t find a lot of good service these days and when it appears, I surely want to catch people doing it right.
Machines:
We ordered the same APAP machine. In my case I needed a device that would help me zero in on a treatment pressure because my sleep center didn’t want to do a split study. Because I have no information about pressure other than to know that 5 is too low. That pressure is too low because during the sleep study setup they had me hold the mask in place with that pressure setting for about 10 minutes while they fiddled with something in the control room as they had me do some strange exercises. When the mask was in place before the sleep study I could feel the blockage beginning to happen.
To get started I'll use the 7 to 12 range and then begin reading the titration output from the machine. By using this data during the time we have a mask on I’ll be able to retrieve what the machine thinks happened to see at what pressure the events stop, or diminish to negligible frequency. It won’t tell us sleep stage, BPM, position or desaturation information, but knowing we can use the device for real-time prolonged event frequency feedback sure fits how I look at life and problem solving. I may try to gather some of the missing information another way if this turns into a science project.
Hello Lori,
Your response was cute.
As for accepting praise, I sure do like it and don’t mind hearing a lot of it. My earlier comment was a concern that I may have diminished the worth of my message by being overly gushing about how I felt about the experience. That concern is based upon a jaded view I hold of all testimonials. My experience in my industry has shown far too many testimonials are contrived and shallow. Because of that belief, when I saw the word “testimonial”, all my testimonial baggage started parading around my head pulling needless emotional alarms. Oh well, that’s life I guess.
Thank you for the kind words, and I'm also glad the information was helpful. That was my primary goal. A secondary goal was to recognize the performance of Bonnie and Becky and the organization that employs them. I don’t find a lot of good service these days and when it appears, I surely want to catch people doing it right.
Machines:
We ordered the same APAP machine. In my case I needed a device that would help me zero in on a treatment pressure because my sleep center didn’t want to do a split study. Because I have no information about pressure other than to know that 5 is too low. That pressure is too low because during the sleep study setup they had me hold the mask in place with that pressure setting for about 10 minutes while they fiddled with something in the control room as they had me do some strange exercises. When the mask was in place before the sleep study I could feel the blockage beginning to happen.
To get started I'll use the 7 to 12 range and then begin reading the titration output from the machine. By using this data during the time we have a mask on I’ll be able to retrieve what the machine thinks happened to see at what pressure the events stop, or diminish to negligible frequency. It won’t tell us sleep stage, BPM, position or desaturation information, but knowing we can use the device for real-time prolonged event frequency feedback sure fits how I look at life and problem solving. I may try to gather some of the missing information another way if this turns into a science project.
Hello Lori,
Your response was cute.
As for accepting praise, I sure do like it and don’t mind hearing a lot of it. My earlier comment was a concern that I may have diminished the worth of my message by being overly gushing about how I felt about the experience. That concern is based upon a jaded view I hold of all testimonials. My experience in my industry has shown far too many testimonials are contrived and shallow. Because of that belief, when I saw the word “testimonial”, all my testimonial baggage started parading around my head pulling needless emotional alarms. Oh well, that’s life I guess.
Roger...
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Sleepless on LI
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rested gal
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Roger, having followed the saga of your sleep study (such as it was) on the ASAA message board, it's nice to see that you found your way here where you, like so many of us, find practical advice about how to get the kind of equipment you want at reasonable prices. You're already helping others sort out what you faced such a short time ago. Good job.
Roger,
I would like to say "ditto" on EVERYTHING Rested Gal just said. (although I would call it an "ordeal")
Welcome to this forum. I'll be looking forward to hearing more from you.
And, Rested Gal......
I was beginning to think you had fallen off the face of the earth......
Glad to see some posts from you (again), too.
P.S. I just read your post to Jan in Colo. and now I know why..... Hope you had a good trip.
Best wishes,
Den
I would like to say "ditto" on EVERYTHING Rested Gal just said. (although I would call it an "ordeal")
Welcome to this forum. I'll be looking forward to hearing more from you.
And, Rested Gal......
I was beginning to think you had fallen off the face of the earth......
Glad to see some posts from you (again), too.
P.S. I just read your post to Jan in Colo. and now I know why..... Hope you had a good trip.
Best wishes,
Den
(5) REMstar Autos w/C-Flex & (6) REMstar Pro 2 CPAPs w/C-Flex - Pressure Setting = 14 cm.
"Passover" Humidification - ResMed Ultra Mirage FF - Encore Pro w/Card Reader & MyEncore software - Chiroflow pillow
User since 05/14/05
"Passover" Humidification - ResMed Ultra Mirage FF - Encore Pro w/Card Reader & MyEncore software - Chiroflow pillow
User since 05/14/05
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Sleepless on LI
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Den,Wulfman wrote:Roger,
I would like to say "ditto" on EVERYTHING Rested Gal just said. (although I would call it an "ordeal")
Welcome to this forum. I'll be looking forward to hearing more from you.
And, Rested Gal......
I was beginning to think you had fallen off the face of the earth......
Glad to see some posts from you (again), too.
P.S. I just read your post to Jan in Colo. and now I know why..... Hope you had a good trip.
Best wishes,
Den
You must have missed RG's post that she left before she went on vacation letting us know she'd be gone till the 20th. If I hadn't seen it, I would have worried, too, as it's not like her to be so silent when there are so many great threads to answer. I agree, it's nice to see her back. It's like the kids enjoy when mom is out of the house, but only for a little while and then they feel better once she returns. I feel like RG is the Queen Mother of our boards and things aren't truly the same when she's not around.
RG, if you read this, you can never leave this site for good, you know. Too many people would miss you.
L o R i