DME Billing Insurance Issue Help

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trex6464
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Location: CA

DME Billing Insurance Issue Help

Post by trex6464 » Mon Jul 06, 2015 8:58 am

First time poster and long time lurker!

Grateful for anyone that can provide any advice to my issue. I will try to keep this as short and concise as possible.

My DME company has sent me a bill a year after they sent me to shipment of CPAP supplies. When I received my shipment of CPAP supplies, I still had medical insurance. But few months after the last package my insurance ended and since then I don't have insurance. So finally a year later, the DME company finally sends me a a bill for the supplies as if I didn't have any insurance at all which is about $1100. I had absolutely no knowledge that they would be charging me as uninsured. I would expect the DME company to deal with my insurance company first before sending me any of these supplies. I also told a representative of the company that I no longer had insurance and was not told that I still had any outstanding bills with them.

When I received my CPAP machine and first supplies, it was all covered by my insurance but was dealt by my doctors office. So I thought there wouldn't be any problems with the DME dealing with my insurance company. I haven't had much interaction with this DME company from the beginning after being referred to them from my doctors office. There was only one in-home visit where the representative made it sound like they would deal with my insurance company and it would be seamless. Afterwards, I only received a couple of calls from them checking in. Nothing about billing or my insurance. How can they charge me as uninsured when I didn't even agree to it? Is that something that can do when they become my provider?

So I was wondering has anyone been in this similar situation. Is it possible that the DME company made a mistake. Is there anything that protects me from making charges that I didn't agree to? I also did not use most of the supplies sent to them. So was hoping it would be possible to even return the items and just paid for the ones I used. But I expect they would have a return policy for products that have been received after a year.

This has been a pretty long post. Thank you if you manage to make it down here. My main hope is to bring down the cost of the bill. I haven't spoken to the company yet. But hope to receive some input so I have a better idea if I have any rights to bring down the bill. Thank you!!!

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BlackSpinner
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Re: DME Billing Insurance Issue Help

Post by BlackSpinner » Mon Jul 06, 2015 9:11 am

Ok first of all dealing with DME's is a lot like dealing with the worst used car dealership run by the local mafia. Except that the used car salesman usually knows what he is selling.

Once you have your head around that you need to start calling and talking to supervisors and getting the details of what was billed. If they billed your credit card - dispute it and cancel the card and get another one.
Other people with more experience will help with more details soon.

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trex6464
Posts: 2
Joined: Mon Jul 06, 2015 8:29 am
Location: CA

Re: DME Billing Insurance Issue Help

Post by trex6464 » Mon Jul 06, 2015 9:25 am

Thanks BlackSpinner. That's what I'm starting to see.
They actually don't have my credit card details. Just a bill to my house.

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Pugsy
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Re: DME Billing Insurance Issue Help

Post by Pugsy » Mon Jul 06, 2015 9:34 am

Items received/shipped during the time when you had insurance coverage should first be billed to the insurance company. Payments and/or co pays would be according to whatever your insurance plan contract stated.
Items are/should be billed out per date of service and if the date of service was when you had insurance coverage then insurance should get the bill first.

Just because you don't have coverage now doesn't mean that items you received when you did have coverage, but maybe the DME didn't bill ins for them at the time, aren't a covered expense.

Items (if any) that you received after insurance termination would of course be your responsibility.

If the only supplies you ever received were when you had ins coverage...the billing should reflect that coverage at the time of service.
Check with the insurance company directly to find out if the items were ever submitted in the first place and if so what the explanation of benefits might have been.

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