Charged for CPAP purchased with insurance

Hello. I have been using a CPAP for about 15 years now. My old machine still worked, but since I was eligible to get a new one through my insurance company, I took advantage of my benefit and got a new Resmed Airsense 10 CPAP. As my old CPAP still worked, I did not use it immediately. About a week after I got the CPAP, I got a call from my insurance company wanting to know why I was not using it. I asked them how they knew, and they told me that there was a cell phone chip in the CPAP and they were monitoring my usage. Although this creeped my out, I started using the new machine so as to not have any problems. About six months later, I switched jobs and insurance companies, too. About a year after that, I got a call from the CPAP vendor telling me that the insurance company had refused to pay the balance due for the CPAP since I had left my job and no longer had a policy with them and that I was responsible for the remaining $1,000 due on the machine. The vendor charged my credit card for the amount due. I have no idea how they got my credit card information. Has this ever happened to anyone here? Is this legitimate? What recourse do I have?

That was one expensive CPAP when you can buy your own for less.

The mistake you made was not paying attention to your insurance. Most insurance contracts use a sort of "rent to own" policy, called a "capped rental". That means that they pay a certain amount a month rental, and after a certain number of months (typically 13, so they get you for two deductibles) the machine is yours (and some have perpetual rental where you NEVER own the machine). Often there is a co-pay you are responsible for.

You failed to notify the DME that you had a new insurer, which would have required you to turn in that machine when your first insurance ended, and then work with your new insurer to obtain a machine under that insurance contract. You didn't check your coverage, so you may be SOL. Although the DME might have some responsibility for not notifying you for an entire year that they were getting payment denials from your old insurer, especially if they have been collecting a co-pay all this time (good luck with that argument--it's not going to be very fruitful).

If you still have the paperwork from the DME you signed when you obtained the machine (you can demand they send you a copy), read it carefully to see what your obligations were and what recourse you have. Probably not much. You have learned a valuable lesson that when a medical insurance company provides DME, you have to understand the circumstances and your obligations.

As for the "spyware"--yes. Insurance companies want to ensure compliance in order to pay for a machine. If you aren't using it to meet their compliance requirements, they aren't paying. Typically you must use it at least 4 hours a day for 30 consecutive days in the first 90 day period. Sounds like you met the compliance requirements for them to pay--as long as you were still insured by them. But I'll make a guess that the call you received was NOT from your insurance company but from the DME who must provide the compliance data to the insurer. That's to make sure they get paid. And they can still "spy" on your usage and data, unless you put your machine in "airplane mode".

I did read the insurance policy. I paid the co-pay and left my insurance company after the required time had expired.

What really angers me is that they charged my credit card without my consent. Thankfully, I was able to get the charge reversed after I protested the charge with the credit card company.

The credit card company can reverse their reversal if they determine it to be a legitimate charge. B/G/A.

heavysleeper wrote: ↑

Tue Jun 11, 2024 2:00 pm

What really angers me is that they charged my credit card without my consent. Thankfully, I was able to get the charge reversed after I protested the charge with the credit card company.

It sounds like it was resolved then. Glad it worked out for you.

DME's play all sorts of billing games. You have to scrutinize billing carefully and it sounds like you had a good outcome in the end.
Was your DME Crapria (Apria)? They often push people to leave a credit card on file for co-pays, and this is why we recommend that people do not let them have the credit card on file.

And if a DME demands your cc or they "cannot do business with you",
get the he// out of there--FAST!
We even had to CANCEL one credit card in order to get rid of repeated unauthorized charges.

heavysleeper wrote: ↑

Tue Jun 11, 2024 12:25 pm

got a new Resmed Airsense 10 CPAP

I hope you got an AutoSet, not a straight CPAP.