CPAP setting change legality

That's true so the real question is how much a DME charges people paying cash. Medicare and large insurance companies have bargaining power where the cash-paying individual does not. If someone does not have the total amount up-front to buy something online, could they rent at Medicare rates and get to own the machine in 13 months? I doubt it.

LSAT wrote:QUOTE....DMEs charging over $2000 for a piece of equipment that you can purchase online for $500 should be illegal

Believe me I am not sticking up for DME's,I know many of them are bad, but what some people don't realize is that insurance companies do not pay them what they charge. For example...back when I was on a rent to own program, my DME was charging over $200 month rental...Medicare paid them $60. They charged over $225 for a mask for which they were paid $110. When someone says that a DME charges $2000 for a piece of equipment that can be purchased for $500 on line...this is an exaggeration...the DME is problibly paid under $1000 and they 'should' provide service for that price. Another example is.... A DME should allow you to return a mask or machine within 30 days for a replacement if you are not comfortable with it. You can't do that with an on line provider without paying for return insurance.

aroche wrote:... I am in the process of getting a new CPAP, and the DME told me ahead of time that I can get it online for a lot less. However they also talked about the fact that working with the DME means that I have them working with me to fix issues instead of handling it myself. I have the services of the RT available for that extra $700 -$800.

As a computer systems consultant I understand the value of my time to someone else, so I understand paying for it. I also understand that I am the one paying for it so I will be watching my bottom line and paying for the services I choose instead of taking everything I am offered. ...

Exactly! When I first started xPAP therapy, I used a DME in my area. With a little bit of research, I quickly outstripped that DME and RT in my understanding of using xPAP devices. At that point, when I needed a BiPAP device, I purchased it online. Two years ago, I switched back to a local DME / RT along with a new sleep doctor due to significant problems with central sleep apnea. (My insurance due to a Preferred Provider Network did not want to cover any equipment purchased online). However, I once again dropped that DME / RT due to lack of follow up on their part. Recently, I switched to an ASV unit. As I did that, I did move back to an RT, who has been very responsive to my questions. When they can not answer, they've gotten me in touch with their local ResMed resources!

So, if the resource adds value, I have no problem paying more for that resource. But they have to add value. If I still have to do the research the cost benefit ratio does not make it a worthwhile investment of my time or funds. TANSTAAFL (There Ain't No Such Thing As A Free Lunch) definitely also applies to xPAP therapy.

I can tell you what I paid my DME after I had a house fire.

ResMed S8 Autoset 11 $1415.00
ResMed Humid Aire 4I Humidifier $330.00
Swift LT for Her $247.50

Granted my home owners insurance paid this bill, but this is what was charged to me. What I found interesting was that the price was much lower when my DME provider thought they were billing this to my health insurance. Once I told them this was not the case the price increased, right before my eyes, with an explanation that they make deals to health insurance companies and the charge is always lower.

rosie

rosiefrosie wrote:I can tell you what I paid my DME after I had a house fire.

ResMed S8 Autoset 11 $1415.00
ResMed Humid Aire 4I Humidifier $330.00
Swift LT for Her $247.50

Granted my home owners insurance paid this bill, but this is what was charged to me. What I found interesting was that the price was much lower when my DME provider thought they were billing this to my health insurance. Once I told them this was not the case the price increased, right before my eyes, with an explanation that they make deals to health insurance companies and the charge is always lower.

rosie

Interesting how this works with medical devices. In a situation back in the early '90's, I inquired at a local auto glass shop about getting a windshield replaced. They stated that if I paid cash, it would be cheaper than running it through my insurance provider.....LOTS cheaper.


Den