will dme find out if i turn on alarm

[oldgearhead]

I'm afraid we have kept this post going for so long now, that Bank4cat's
DME will know a setting was changed. But I won't tell if you don't...

[Wulfman]

What we need to be lobbying for is a way to have both.
We need traditional DME companies.
We also need internet retailers who can offer the products at a lower cost for those who are able to use them.

Unless I misunderstand the point you're trying to make, I believe it's quite clear we already HAVE BOTH at the present time. (Does CPAP.COM ring a bell?)
I believe the pressure needs to be applied to the insurance companies to accept and reimburse for Internet purchases.....although many presently do. There's also BILLMYINSURANCE.COM and CPAPFORSENIORS.COM.

Gosh no. I've never heard of such a place! Come off it and quit being a jerk.
You mentioned billmyinsurance and cpapforseniors. That's exactly the point I've been trying to make. Using those companies saves NO money. They bill the EXACT SAME RATE that the DME companies bill.
So there is no savings there.
What I and many others have been fighting for is the ability to have more than just the 1 rate. We need BOTH sources available.
The traditional DME company available at a higher cost for those who are unable or unwilling to look after themselves and thier equipment and internet suppliers (or other direct-purchase suppliers) for those who wish to provide thier own care at a reduced charge.

I was TRYING to be nice....but....

WHAT PART OF THIS DON'T YOU UNDERSTAND? Or, what is your POINT?
There ARE both sources available! There are MANY Internet suppliers who sell at less than DME prices.

By the way, you keep giving yourself away by misspelling the word "their".

Den

[Guest]

I never have been able to spell their. Dunno why. Sue me! I'm a freaking walking spellchecker for nearly everything else (Which I'm sure means I'll mispell 97 things in this post now) but never the word thier.

I don't know why this is, but you seem to be totally missing my point. Look again at what I've been saying all along:

The traditional DME company available at a higher cost for those who are unable or unwilling to look after themselves and thier equipment and internet suppliers (or other direct-purchase suppliers) for those who wish to provide thier own care at a reduced charge.
...
Using those [internet] companies saves NO money. They bill the EXACT SAME RATE that the DME companies bill.
...
What I and many others have been fighting for is the ability to have more than just the 1 rate. We need BOTH sources available. [and reimbursed by the insurance companies]

So yes, both avenues are out there currently [internet and tradtional DME] however so matter how you go at it, if your purchase is reimbursed under insurance, the insurance company has set the price at the same level.
Here is what I'm referring to laid out in numbers:
Full Face Mask (A7030)
Cash Price - ~$90.00
Medicare - $188.64
cpapforseniors - $188.64
billmyinsurance - ~$188.00
you submit the claim yourself - ~$188.00

There is NO savings when you use an insurance company. This is what I've been continuing to try and get across. You can buy things on the internet all day long. You still don't save a dime going through an insurance company. The insurance company sets the price - not you, not the doctor, not the DME company. The insurance company.

So once again, what myself and many others have been fighting for is the ability to have more than just the 1 rate. We need BOTH sources available.

I've spelled it out THIER for you and hopefully this is a little clearer.

[Wulfman]

OK, lets try to get the "edge" OFF of this discussion......

This was part of what I was trying to get across in a previous post:

I believe the pressure needs to be applied to the insurance companies to accept and reimburse for Internet purchases.....although many presently do.

Now, in MY case, I DID save money (for my PPO and myself) with my purchases. I purchased my equipment from CPAP.COM and then billed my PPO for the exact cost I was charged. They then reimbursed me at 80%. So, my equipment (less the software and card reader) only cost me about $160 of the (approx) $800 (again, that doesn't count the $200 I paid for software and reader).

I did price that stuff at a local DME and it would have been in the $2000 range.....but I do NOT know (and haven't been able to find out from them what they normally pay) how much they would have negotiated that amount down to. I strongly suspect that it would have been far greater than $800.
(Actually about $640 for their outlay)

If EVERYBODY had that capability to work with their insurance providers, this would be a wonderful situation. And, that's why I said that more pressure needed to be applied to the insurance industry to save money for everybody involved.

Are we on the same page yet?

Den

[Guest]

Huh. You really were able to get paid less? If you still have your reimbursement form from your insurance company I'd be really interested in seeing if they paid under the regular billing codes for the stuff or if they paid under a miscellanous code. Or do you happen to remember?
With all the companies I've spoken to, both online and brick/mortar, other users and even insurance folks they've always said the same thing - The insurance company sets the price paid - no one else.
That's really cool if you were able to do so!
I really hope you still have the paperwork so we can see how it was written up by them.

[Wulfman]

Here's the exact (lower part) of my invoice to my insurance provider in May of 2005. I had to add all the "dots" (periods) to keep the form as much intact as possible because it was skewing all of the columns....but otherwise it's the same thing. (It ain't perfect, but I think I've got the columns pretty close to lining up).
I copied the bill I received from CPAP.COM to make out the invoice from ME to my insurance provider. Again, I made out the invoice with myself as the billing party and my insurance provider as the party being billed. They paid 80% of the total amount, less the software and card reader. I DID include those items just in case I could twist their arms to get them to pay.....unfortunately, they wouldn't.
I had already (by a long ways) met my deductible by this time, so I received a check from them for about $640.


.Qty.: Description:..................................................Billing Code:..Unit Price:..Amount:
------------------------------------------------------------------------------------------------------


..1....Respironics REMstar Pro 2 C-Flex CPAP..............E0601NU......$615.00......$615.00
.......Heated humidifier with bag, hose and manuals.....& E0562NU

..1....ResMed Ultra Mirage Full Face Mask......................A7030........$139.99......$139.99
.......with Headgear - Large Standard.........................& A7035

..2....Disposable White Filters..(6 Pack).........................A7038........$.14.00......$.28.00
.......for Respironics Remstar Lite, Remstar Plus,
.......Remstar Pro, Remstar Auto, Bipap Plus, Bipap Pro 2

..1....10 Foot Extra Long CPAP Hose with Silicone Ends....A7037........$.11.99......$.11.99

..1....Oxygen Supply Connector......................................................$...4.95......$...4.95


..1....Encore Pro Software & Smart Card Reader ( USB )..................$199.00......$199.00

...................................................................................................................---------
....................................................................................................Total:.......$998.93

[bank4cat]

Hey dont worry about DME finding out i messed with the machine i took it in to have card read and there was nothing on it they put in wrong serial numbers.........i should turn pressure up all the way before takin in next month and see if they notice any body wanna make some bets for fun