Apria excessive charges for supplemental oxygen generator

My primary care doctor prescribed supplimental oxygen to be used with my CPAP. He did this after the results of over night oxygen testing showed that my blood oxygen would go as low as 82%. The company that supplied the oxygen concentrator was Apria. I was told by Apria that Medicare would cover the cost of the equipment. I used this equipment for several months and got relief for some of my symptoms. I stopped using the Apria equipment and returned it because Colorado Sleep institute recommend that I try a new CPAP equipment without oxygen to see how I would do with the new equipment. This change in equipment came about after a new sleep study diagnosis of central sleep apnea was diagnosed. However, the over night sleep study confirmed that my nocturnal blood oxygen was still below 89%. In the meantime I heard nothing from Apria or Medicare informing that my insurance did no cover the Apria oxygen concentrator equipment. May of 2015 I received a bill from Apria for $706. I called Apria to try and understand this bill. I was informed at this time that Medicare was missing supporting sleep study data and declined the claim. I spoke with several Apria documentation representatives over several weeks and was told I needed to supply them with the sleep study data. I finally got Apria the supporting data showing that I met the Medicare guidelines for coverage of the oxygen concentrator. I was told to egnor the May bill until an Apria supervisor ruled on my claim. This confused me because I felt Medicare should rule on my claim once the supporting sleep study data was reviewed. Again, I waited several weeks to hear from Apria. When I finally heard from Apria, I was shocked to hear my claim was denied because the 180 day Medicare appeals deadline had passed. I contacted Medicare and was told I still must pay the bill and file an appeal. I payed the bill in July 3, 2015. A representative told me that I would receive a 20% discount if I payed the full bill, which I did. Also during this time, Apria had turned my bill over to collection even though I was diligently working with Apria to resolve this claim. When I payed my bill in July I was told by Apria's billing representative that I had a zero bill including any and all collection fees. About July 15th I got a call form West Assent Mamagement saying I still owed collection fees on my account. I informed this West Assent company that I had payed my bill in full including all collection fees in July 3, 2015. I also gave her my conformation number from Apria. Then on the 27th of July I got another call from the West Assent group saying I still owed money on my Apria account. Sure enough, when I called Apria they told me I still owed another $350. I kind of went nuts after hearing this. It did not matter that I was told that I had paid my bill in full including collection fees earlier. I asked to speak to a supervisor and was told by that supervisor ( by the way he sounded exactly like the Apria billing representative I spoke with in early July ) that I still owed another $350 for collection charges. I was again told that If I payed this amount that would satisfy all collection fees and I would no longer be harassed by West Assent. He gave me his word that this time I would be free of all claims from Apria and West Assent. I demanded that he send me a receipt for this $350 with a conformation number stating that I have satisfied all demands and my bill is payed in full. I have yet to get e-mail receipt and I am still getting collection calls from West Assent. I am being extorted by Apria and West Assent and do not know how to proceed. It is my belief that Apria deliberately did not supply the supporting sleep study data to Medicare from the get go, because they would rather allow a ignorant uninformed gulable patient like myself, let a bill exceed the 180 day Medicare appeal deadline and collect hundreds from the patient, not the $80 from Medicare. Can any one help advise me on how I need to proceed?
With gratitude,
William Jackson

bump

I would start by filing your complaint with Medicare's Fraud Unit as well as with your State's Attorney General's office. Don't pay out any more money. Verbal agreements aren't worth the paper they are written on. The next time West calls you, tell them that you are recording this conversation and that it will be turned over to the police for harassment.

https://www.medicare.gov/forms-help-and ... abuse.html

for what it's worth, it's not an oxygen GENERATOR (those do exist, they're used on airplanes when the masks drop down)

it's an oxygen CONCENTRATOR.

though what it really does is filter out nitrogen, leaving the oxygen and other gases.

This behavior is typical of Apria. It is why I fired them.
Please check the link in my signature line for other Medicare providers in/near your zip code.
Look for the green "M", contracted suppliers accept medicare prices as full payment.
Again, file a complaint with the Medicare fraud unit. Please.

palerider wrote:for what it's worth, it's not an oxygen GENERATOR (those do exist, they're used on airplanes when the masks drop down)

it's an oxygen CONCENTRATOR.

though what it really does is filter out nitrogen, leaving the oxygen and other gases.

I confuse the word (often). My late Dad had a concentrator for about 5 years. Thanks for explaining how it works (well, very general, but more than I knew before). Also, is there a board that deals with oxygen concentrators similar to these cpap boards? I have a friend who will likely be diagnosed with COPD and getting a concentrator and I know nothing about brands or what you should look for in a concentrator. This would be a home unit rather than portable (I'm sure that's another kettle of fish).

BP Jacks, Unfortunately I have Apria also. I only use the 02 with my machine and it's always been a concentrator. In the beginning was being charged over 130 dollars per mo. I filled out their papers for a "hardship" discount and got zero payments. This year they told me due to the new regulations, they would no longer have hardship cases and I would have to pay. Right now, I'm only paying $26.00 for the concentrator. I have no idea when they are going to start payment on the rented Respironics. Their customer service is horrible. I can never get to the cpap department and have to wait for a therapist to call me. They just had to switch my ResMed to a Respironics because Apria has a contract with them. The heck with the patient!!

For future reference never assume that any health care provider or collection agency will do what they said. Never accept any answer from someone you don't know has the authority to give that answer. Keep calling and being transferred until you get the right answer from the right person, write down their name and direct phone number. Always be proactive and never reactive. This may have already made it to your credit score, I would suggest that you check that.

Have you checked on the possibility of purchasing a concentrator? Maybe a used one?
Or using tanks?
When we had a power outage, I discovered that one of my neighbors had to go without her concentrator.
{{{to think, I had been grousing over having to sleep a couple nights without my cpap}}}.

SewTired wrote:

palerider wrote:for what it's worth, it's not an oxygen GENERATOR (those do exist, they're used on airplanes when the masks drop down)

it's an oxygen CONCENTRATOR.

though what it really does is filter out nitrogen, leaving the oxygen and other gases.

I confuse the word (often). My late Dad had a concentrator for about 5 years. Thanks for explaining how it works (well, very general, but more than I knew before). Also, is there a board that deals with oxygen concentrators similar to these cpap boards? I have a friend who will likely be diagnosed with COPD and getting a concentrator and I know nothing about brands or what you should look for in a concentrator. This would be a home unit rather than portable (I'm sure that's another kettle of fish).

I'm sure there are boards on the subject, unfortunately, I have to suggest googling for it, (which is where using the right words is important ). the way they work is really fascinating to me, and a marvel for people that need oxygen, so much nicer, and *safer* than oxygen tanks.

the two best models (that I know of) are the invacare perfecto and the respironics everflow q. we've got the invacare perfecto here for a friend that was staying with us who needed it. it's maybe the size of a carryon suitcase, and just hums quietly to itself, with a little thumping noise every few seconds as it switches between the two filter tanks inside.

here's a nice video comparing them: https://www.youtube.com/watch?v=KEGyUHXtUuo

palerider wrote:

SewTired wrote:

palerider wrote:for what it's worth, it's not an oxygen GENERATOR (those do exist, they're used on airplanes when the masks drop down)

it's an oxygen CONCENTRATOR.

though what it really does is filter out nitrogen, leaving the oxygen and other gases.

I confuse the word (often). My late Dad had a concentrator for about 5 years. Thanks for explaining how it works (well, very general, but more than I knew before). Also, is there a board that deals with oxygen concentrators similar to these cpap boards? I have a friend who will likely be diagnosed with COPD and getting a concentrator and I know nothing about brands or what you should look for in a concentrator. This would be a home unit rather than portable (I'm sure that's another kettle of fish).

I'm sure there are boards on the subject, unfortunately, I have to suggest googling for it, (which is where using the right words is important ). the way they work is really fascinating to me, and a marvel for people that need oxygen, so much nicer, and *safer* than oxygen tanks.

the two best models (that I know of) are the invacare perfecto and the respironics everflow q. we've got the invacare perfecto here for a friend that was staying with us who needed it. it's maybe the size of a carryon suitcase, and just hums quietly to itself, with a little thumping noise every few seconds as it switches between the two filter tanks inside.

here's a nice video comparing them: https://www.youtube.com/watch?v=KEGyUHXtUuo

This is a COPD forum, it doesn't seem overly active but when you ask a question someone does answer and there is a lot of good information there.
http://copdforum.portalone.us/index.html
Also for your friend this site has a wealth of info on COPD, when I was diagnosed the doctors didn't seem to give much info but I found a lot here.
http://www.copdbfrg.org/?page_id=207 in easy to understand terms.

PoolQ wrote:For future reference never assume that any health care provider or collection agency will do what they said. Never accept any answer from someone you don't know has the authority to give that answer. Keep calling and being transferred until you get the right answer from the right person, write down their name and direct phone number. Always be proactive and never reactive. This may have already made it to your credit score, I would suggest that you check that.

I would suggest going a step further. Once you have someone who gave you the "right answer" write them a confirming letter--e.g. "Dear So and So, This letter is to confirm our telephone conversation of such and such date. You and I spoke on the phone about the patient co-payment for an oxygen concentrator. You stated that my monthly co-payment would be $26.20 per month for a period of 13 months and at that point I could keep the concentrator with no further payments. If I misunderstood our conversation, please correct this information in writing within 10 business days of the date of this letter. Otherwise I will assume this information is correct and act accordingly. Yours truly, Bilbo Baggins." Send it CERTIFIED with a return receipt and ALWAYS keep a copy for your records.

A telephone call ain't worth the paper it's written on, even if Crapria and others record all their calls now.

Thanks Palerider and Cancun. That information was VERY helpful. The oxygen concentrator is surprisingly affordable as well. The portable ones...gag.. are really expensive! At least knowing this, maybe he can get insurance to pay for the portable and he'll buy the at-home one. With COPD it's not an if, but a when. My Dad had liquid oxygen for his portable option, but I have seen some folks at the clinic who have just these tiny portable concentrators.

edited to add: They had another video that explains about the portables. They only go up to 3 liters in a pulse dose. That is why Dad got liquid oxygen for a portable.