Got Dem Ol' DME Blues Again

First of all, I'm having one of those times when it really seems as if the world is conspiring to drive me crazy. Example: Yesterday I tried to set up a wireless router. The instructions said "easy 1-2-3 setup," just plug this into 1, this into 2, this into 3, and go. Did it. No go. Decided to use the installation disk. Worked through it several times. No go. Gave up and called India (i.e., tech support). Turned out that many, many, MANY steps had been left out of the installation instructions and off the installation disk. There is no way the router could be set up by following the instructions. Thankfully, "Sean" in India was able to get it working (if you've ever called for any kind of computer tech support, you know that getting your problem solved is often not the outcome).

Then I opened the mail and got a $300 bill from my DME for the CPAP setup I supposedly paid for in January. In January, they required $200 up front for my insurance deductible and then explained that insurance and I would be billed for rental each month, my share being a $10 co-pay, until the rental of the machine equaled the purchase price, at which time it would convert to a purchase. Big ripoff, but I figured okay, rent-to-own always costs more and it's about time I got something back for all the zillions of dollars I've paid in insurance premiums (yeah, I know that's what's wrong with American healthcare and all that, but not the issue here).

Anyway, it turns out that the DME is billing the humidifier and the machine separately. Now, you may not be familiar with my machine, but it has an integrated humidifier. It's not an option, it's not an add-on, it's just part of the machine. The machine doesn't come without the humidifier. The humidifier doesn't come without the machine. I explain this to the billing office. Nevertheless, they insist it must be paid for separately.

The final upshot is, if I don't want to pay for the humidifier, I can bring it back. I explain that I can't bring back the humidifier without bringing back the machine. She's unimpressed and repeats the offer. I use the example of selling someone tires for $500, then billing them another $300 for the rubber a few months later and telling them they can keep the tires but will have to bring back the rubber if they don't want to pay for it. She remains unimpressed and asks if I want to schedule an appointment to have someone pick up the humidifier. Resisting the urge to bang my head on the wall, I say yes, and she transfers me to a respiratory therapist. I explain the situation to the RT and tell her that when she arrives, she will need to figure out how to take the humidifier only. Having actually seen the machine, she understands immediately what I'm saying.

Waiting at this point to hear from "a manager." Still resisting the urge to bang my head.

And now you know why many of us just pay out of pocket. It's less stressful.

I'm so sorry. Seriously, if you can buy a machine on your credit card, FIRE YOUR DME before the rental period expires.

I fired mine, returned the machine, and called the fraud department of my insurance and raised holy hell with them.

I then bought a machine from cpap.com, and submitted my own claim for reimbursement. I've been doing that ever since. I only get about 70-80% back when I do that, but I can write the rest off through my FSA.

Yes, insurance is supposed to work. Unfortunately, it just doesn't for many of us.

BEST OF LUCK!!!!!!
Barbara

Thanks! Yep, raising hell with my insurance's fraud department is on my to-do list at this point, regardless of how this turns out. It seems to me that no matter how anyone looks at it, the DME has worked out a way to bill twice for the same single piece of equipment by pretending the humidifier is an add-on.

If there's ANY WAY that the humidifier tank can be removed from the CPAP machine (like for cleaning or replacement), it's NOT an "integrated" machine.
Leave it to the DME companies to figure out how to get every dime they can out of you.


Den

I hope things get sorted out soon!

Catnap wrote:Thanks! Yep, raising hell with my insurance's fraud department is on my to-do list at this point, regardless of how this turns out. It seems to me that no matter how anyone looks at it, the DME has worked out a way to bill twice for the same single piece of equipment by pretending the humidifier is an add-on.

Have a similar problem. Last year went on CPAP & O2 concentrator at the same time. Needless to say the billing items were extensive and not really labeled properly, everything broken down into individual pieces. Returned the O2 concentrator and the CPAP is paid. Found a charge in the last billing for filters for an "e regulator". Since this was always included with the O2 concentrator items and these were returned I asked why I was still being billed. They informed me that this was for an emergency O2 tank that I have not returned. I never received one. Been paying for this for 15 months, me & Aetna. Asked for an itemized statement listing all services & equipment that was billed for this time period. They sent me a list that gave numbers instead of descriptions, means nothing to me. Going over my records now. Will request refund for me and insurance. Hopefully I will not have to escalate to the next level.

Bigburd wrote:

Catnap wrote:Thanks! Yep, raising hell with my insurance's fraud department is on my to-do list at this point, regardless of how this turns out. It seems to me that no matter how anyone looks at it, the DME has worked out a way to bill twice for the same single piece of equipment by pretending the humidifier is an add-on.

Have a similar problem. Last year went on CPAP & O2 concentrator at the same time. Needless to say the billing items were extensive and not really labeled properly, everything broken down into individual pieces. Returned the O2 concentrator and the CPAP is paid. Found a charge in the last billing for filters for an "e regulator". Since this was always included with the O2 concentrator items and these were returned I asked why I was still being billed. They informed me that this was for an emergency O2 tank that I have not returned. I never received one. Been paying for this for 15 months, me & Aetna. Asked for an itemized statement listing all services & equipment that was billed for this time period. They sent me a list that gave numbers instead of descriptions, means nothing to me. Going over my records now. Will request refund for me and insurance. Hopefully I will not have to escalate to the next level.

And they wonder why we're ready to go after these companies with torches and pitchforks....

Wulfman wrote:If there's ANY WAY that the humidifier tank can be removed from the CPAP machine (like for cleaning or replacement), it's NOT an "integrated" machine.
Leave it to the DME companies to figure out how to get every dime they can out of you.


Den

What a great visual aid that will make if we end up in court. "Your honor, this is the 'attachment' they are billing me $300 for," and I pull out the flimsy, thin plastic and aluminum tank that costs $16.95 at retail (and is a total ripoff at that), AND demonstrate how the hose attaches to the tank, making the machine unusable altogether withe out the tank.