Insurance claim issue with supply order

I called in my supply order to Apria about a week ago. They told me they'd ship the supplies, and I would be on the hook for $38.40 of coinsurance (which was about right). Supplies shipped, received, all good there.

In a related story, I've been getting very close to maxing out my insurance for the year. I wasn't tracking that as closely as I could have been, and as luck would have it this claim puts me over the top. The claim is still pending, but I should only pay about $5 for it.

Apria has already charged my credit card the $38.40. (I know, I shouldn't have given it to them in the first place, and I plan to change the card number and not give them the new one since they've been naughty with it. Lecture if you must, but I've already got that one.)

Since it's only a difference of $33 I'm not in dire straits or anything, but I do want to get this resolved. What's the best place to start? Call my insurance? Call Apria? (*shudder*) Dispute the charge through my card?

We don't call them "Crapria" for nothing!

I would do all three of them !

My DME billed Medicare and my other insurance for a full face mask: Full Face Mask $512.16, Full Mask Interface $189.42, and Headgear $94.17. This is highway robbery!

but that is not what medicare will pay them ... watch for the paper work from medicare to see what they pay.

grayghost4 wrote:but that is not what medicare will pay them ... watch for the paper work from medicare to see what they pay.

I agree.....Medicare will allow about $120- $130 and you will be responsible for 20%.

JeffV wrote:Since it's only a difference of $33 I'm not in dire straits or anything, but I do want to get this resolved. What's the best place to start? Call my insurance? Call Apria? (*shudder*) Dispute the charge through my card?

Until the EOB hits your insurance you really can't do much. If you file a dispute and you end up have miscalulated, you wasted your time. However, when the EOB does show up, it will show what was billed, the contracted price and your responsibility. IF you were close to the max on your co-pays and total out of pocket expenses, it will show your responsibility will be less than you have already been charged. If you were already over, it will say $0.

You normally can view Claim and EOB results online with your insurance company. Until they actually see the claim there really is nothing they can do yet.

EOB is filed... At that time, just call the Insurance company first, inform them that the DME over billed you and they will send notification to the DME of the corrected amounts and call Crapria with a copy of the EOB and give them the same info.

You will normally get a refund check, not a deposit back on the card and it can take 30 days or more to get it.

If you get flack anytime after you have seen the EOB, file a claim with the credit card company. They will return your disputed money normally right away and take up to 90 days to make a finding. If you have the paperwork, should be no problem.

BTW if you used a debit card... you really shouldn't do that. No they have your hard cold cash out of your bank unlike a real credit card where they have someone elses money. The dispute is similar but you might not get the money back right away.

Since my supplement pays all my deductibles and copays, Apria had no need for my card number.
Still, they demanded--so I fired them! It felt so good.