I just received a bill from the DME my doctor recommended, a year after I them giving me my CPAP. I got a ResMed S8 Elite with Humidifier.
At the time of fitting and instruction, a year ago I saw an invoice started with the dollar amount of $2xxx (I couldn't read it all) but told the the person I was dealing with if this thing costs that much we might as well stop because I wasn't going to spend any where near that. She said not to worry as that is what they bill the insurance and it would all work out.
Well, today I got shock! Insurance paid them $1427 leaving me $1523 of the $2950 total bill. This didn't include the mask. Last summer at the time I got my machine I could have purchased the same unit at cpap.com for around $800, if I remember correctly, before the big ResMed internet fiasco.
The DME sent me a memory card twice to send back to them to monitor my progress. They never offered me any adjustments as far as treatment. I think they were only verifying compliance records for my insurance company. I had to come here to the forum for advice to get my numbers to a respectable level which they were not until you fine people helped me out!
Even if the unit was worth $1000 how can they justify almost $2000 for fitting and sending a memory card out 2 time??? Unbelievable!!!!
Does anyone have any suggestions for me? Right now the only thing I can think of is to take the unit back, throw it on the counter and tell them to stick it where the sun doesn't shine. The only problem is I will be untreated until I can save enough money to buy the Resprironics M Series Auto with A-Flex, unless there is another unit I should look at. Let me see pay them $1500 for the old or buy the new unit above for $700? I guess I've got choices to make! Absolute Highway Robbery!
Sorry for the rant, just looking for help.
Is there anything I can do? I think I got screwed!
Is there anything I can do? I think I got screwed!
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| Mask | Humidifier | |
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* Some mistakes are too much fun to only make once!
Have they been billing you nothing for the past year?
Do you now own the thing? Or is it still a rental.
I don't know what I would do. I guess I would have read more carefully to start with (but that is skeptical me, and from the posts on this board, I am atypical).
If you have paid nothing I might be tempted to take the thing back and let them try to collect the $1500, but that might make a big mess and you dealing with a collection agency.
I guess at this point I might go in (with the machine) and firmly tell them that you asked these questions on price and you were given a non-answer ("oh, the insurance company will pay...it will work out") and they were wrong. It didn't "work out" and offer them something like $300 to settle it up. (a reasonable 20% copay on a lot of insurance policies ($1500 billed for the setup) and see what they do.
I say take the machine so they can see you are serious and mean to leave it with them. (Keep the humidifier and mask as you most likely own these for sure).
May not work, but frankly I can't think of anything else.
You asked for cost numbers and really weren't given the info you asked for, however, you were not dilligent in finding this stuff out yourself much earlier, so I can see it going either way. Maybe they will settle to get rid of you.
Good luck and by all means let us know what you do and how it turns out.
Do you now own the thing? Or is it still a rental.
I don't know what I would do. I guess I would have read more carefully to start with (but that is skeptical me, and from the posts on this board, I am atypical).
If you have paid nothing I might be tempted to take the thing back and let them try to collect the $1500, but that might make a big mess and you dealing with a collection agency.
I guess at this point I might go in (with the machine) and firmly tell them that you asked these questions on price and you were given a non-answer ("oh, the insurance company will pay...it will work out") and they were wrong. It didn't "work out" and offer them something like $300 to settle it up. (a reasonable 20% copay on a lot of insurance policies ($1500 billed for the setup) and see what they do.
I say take the machine so they can see you are serious and mean to leave it with them. (Keep the humidifier and mask as you most likely own these for sure).
May not work, but frankly I can't think of anything else.
You asked for cost numbers and really weren't given the info you asked for, however, you were not dilligent in finding this stuff out yourself much earlier, so I can see it going either way. Maybe they will settle to get rid of you.
Good luck and by all means let us know what you do and how it turns out.
It sounds like they were right, it would work out OK, for them. Get your DUCKS lined up in a ROW, and contact your INS provider, and keep climbing the company tree, until they kick you out. The higher you climb, the more likely you are to be happy, but stay civil......... Jim
Use data to optimize your xPAP treatment!
"The art of medicine consists in amusing the patient while nature cures the disease." Voltaire
"The art of medicine consists in amusing the patient while nature cures the disease." Voltaire
Thanks for the quick response. I will let you all know what happens. I am so spittin' mad right know I don't think I should go today until I settle down and get it all clear in my head how to handle it.
I did, back in January I believe it was, call them and ask what it was going to cost me. There answer was they weren't sure because they didn't know how much the insurance would cover. So I call my Insurance provider and ask them and they couldn't really tell me because they didn't know how much the DME was going to bill them for sure. I got mad that day and said to hell with it.
I need angry management now because of sleep apnea!
I did, back in January I believe it was, call them and ask what it was going to cost me. There answer was they weren't sure because they didn't know how much the insurance would cover. So I call my Insurance provider and ask them and they couldn't really tell me because they didn't know how much the DME was going to bill them for sure. I got mad that day and said to hell with it.
I need angry management now because of sleep apnea!
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| Mask | Humidifier | |
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* Some mistakes are too much fun to only make once!
Re: Is there anything I can do? I think I got screwed!
[quote="match8"]........ Right now the only thing I can think of is to take the unit back, throw it on the counter and tell them to stick it where the sun doesn't shine. .................
My experience was a little bit different yet similar. I got my sleep study done in November and got my machine in Dec. Come January.. my school went off state insurance with BC/BS. We went with BC/BS again but not on the state plan. I called to check if the machine would transfer over.. they didn't see any problem. Well, wrong.... Since they rent the machine for one month before purchasing, when my insurance changed.. I ended up owing $1100 for my machine. Like you, I told them in the beginning that I couldn't afford to buy the machine and was told insurance would take care of everything. I don't know what to do either. I can't afford this kind of equipment but now that I'm using it, I don't want to give it up either.
Match, PRINT out the actual page at cpap.com w/the machine and price on it. Do the same for the mask, the humidifier, the machine and humidifier combo.
When you do talk to them you will have actual figures to work with. And to bargain with. And PROOF of the prices you are quoting.
Good luck!
When you do talk to them you will have actual figures to work with. And to bargain with. And PROOF of the prices you are quoting.
Good luck!
_________________
| Mask: Quattro™ FX Full Face CPAP Mask with Headgear |
| Additional Comments: PR SystemOne BPAP Auto w/Bi-Flex & Humidifier - EncorePro 2.2 Software - Contec CMS-50D+ Oximeter - Respironics EverFlo Q Concentrator |
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Sleepdeprived
- Posts: 325
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- Location: Florida
Re: Is there anything I can do? I think I got screwed!
[quote="match8"]I just received a bill from the DME my doctor recommended, a year after I them giving me my CPAP. I got a ResMed S8 Elite with Humidifier.
At the time of fitting and instruction, a year ago I saw an invoice started with the dollar amount of $2xxx (I couldn't read it all) but told the the person I was dealing with if this thing costs that much we might as well stop because I wasn't going to spend any where near that. She said not to worry as that is what they bill the insurance and it would all work out.
Well, today I got shock! Insurance paid them $1427 leaving me $1523 of the $2950 total bill. This didn't include the mask. Last summer at the time I got my machine I could have purchased the same unit at cpap.com for around $800, if I remember correctly, before the big ResMed internet fiasco.
The DME sent me a memory card twice to send back to them to monitor my progress. They never offered me any adjustments as far as treatment. I think they were only verifying compliance records for my insurance company. I had to come here to the forum for advice to get my numbers to a respectable level which they were not until you fine people helped me out!
Even if the unit was worth $1000 how can they justify almost $2000 for fitting and sending a memory card out 2 time??? Unbelievable!!!!
Does anyone have any suggestions for me? Right now the only thing I can think of is to take the unit back, throw it on the counter and tell them to stick it where the sun doesn't shine. The only problem is I will be untreated until I can save enough money to buy the Resprironics M Series Auto with A-Flex, unless there is another unit I should look at. Let me see pay them $1500 for the old or buy the new unit above for $700? I guess I've got choices to make! Absolute Highway Robbery!
Sorry for the rant, just looking for help.
At the time of fitting and instruction, a year ago I saw an invoice started with the dollar amount of $2xxx (I couldn't read it all) but told the the person I was dealing with if this thing costs that much we might as well stop because I wasn't going to spend any where near that. She said not to worry as that is what they bill the insurance and it would all work out.
Well, today I got shock! Insurance paid them $1427 leaving me $1523 of the $2950 total bill. This didn't include the mask. Last summer at the time I got my machine I could have purchased the same unit at cpap.com for around $800, if I remember correctly, before the big ResMed internet fiasco.
The DME sent me a memory card twice to send back to them to monitor my progress. They never offered me any adjustments as far as treatment. I think they were only verifying compliance records for my insurance company. I had to come here to the forum for advice to get my numbers to a respectable level which they were not until you fine people helped me out!
Even if the unit was worth $1000 how can they justify almost $2000 for fitting and sending a memory card out 2 time??? Unbelievable!!!!
Does anyone have any suggestions for me? Right now the only thing I can think of is to take the unit back, throw it on the counter and tell them to stick it where the sun doesn't shine. The only problem is I will be untreated until I can save enough money to buy the Resprironics M Series Auto with A-Flex, unless there is another unit I should look at. Let me see pay them $1500 for the old or buy the new unit above for $700? I guess I've got choices to make! Absolute Highway Robbery!
Sorry for the rant, just looking for help.
You know sleepdeprived may have something here.
You may only owe 20% or 30% of $1427 or something a tiny bit higher since $1427 may be 80% of something (assuming 20% copay...). Good advice to call the insurance company and check you copay etc before you go see them. Normally you owe a percentage of the amount the insurance company owes.
You may only owe 20% or 30% of $1427 or something a tiny bit higher since $1427 may be 80% of something (assuming 20% copay...). Good advice to call the insurance company and check you copay etc before you go see them. Normally you owe a percentage of the amount the insurance company owes.
Hate to say it but a Brick and mortar DME could NOT care less how much you can get it over the internet. They just do not care. They charge at specific medical codes and that allows legal rape of the customers. Even AFTER the allowed contract amount quite often YOUR balance will still be over what you could out of pocket buy the machine for online. Now tie the DME to your doctor and you have yet another problem trying to get the script for the equipment over the internet.. It is a mess in my opinion and exact as already stated.. the leftover balance it high very high .. after my sleep study and titration and M series auto and payment from me of about 400 bucks and the insurance payments I still owe the DME a little over 700 bucks..
It is a racket I think . but I do know they do not care what you "could " got it for since you already have their unit. that is what they will go after one way of another..
It is a racket I think . but I do know they do not care what you "could " got it for since you already have their unit. that is what they will go after one way of another..
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| Additional Comments: Encore Pro 1.8 | ||||
Not that it will make any difference at all to your DME, but I received an S8 AutoSet Vantage with heated humidifier and mask (mirage swift) from a local DME last November/December. Insurance was billed (and paid) 1274.47 as the total amount due on the machine.
It seems to me that your insurance has already paid amply for the machine and humidifier, given that you received a less expensive unit than did I. I'm sure that my DME still made a reasonable profit on the transaction.
Where your DME might start caring is if your insurance company begins to make diligent inquiry into the matter. Hope you get this resolved favorably, and soon!
It seems to me that your insurance has already paid amply for the machine and humidifier, given that you received a less expensive unit than did I. I'm sure that my DME still made a reasonable profit on the transaction.
Where your DME might start caring is if your insurance company begins to make diligent inquiry into the matter. Hope you get this resolved favorably, and soon!
Resmed S8 Vantage - integrated humidifier
Mirage Swift nasal pillow system
Autoscan 5.7 software
Mirage Swift nasal pillow system
Autoscan 5.7 software
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Guest
I think what happened is my insurance company paid what they feel is 80% of reasonable and customary and I am stuck with the remaining 20% (my co-pay) and all that is over reasonable and customary.
Come on...$2950.00 for a regular cpap and humidifier.
For grins and giggles, using the price here at cpap.com as my DME's cost and putting a 50% markup on it (which most retailers would love to get) the unit should have been around $1425. Chances are their cost was less than the retail price here at cpap.com. Using that $950 as cost again, my DME appears to markup their equipment over 310%
What's kind of funny is the Illinois Attorney Generals Office actively went after gas stations that doubled the price of gasoline on 9/11 for ripping people off a couple dollars at a time, but they let these medical supply stores bilk thousands everyday off customers, including the elderly, the majority of their customer base!
I want to thank everyone who let me vent and those who weighed in on my post. This forum has always lead me in the right direction as far as my cpap use and I thank you all for your advice on dealing with my rapist DME.
Mark Matchett
Come on...$2950.00 for a regular cpap and humidifier.
For grins and giggles, using the price here at cpap.com as my DME's cost and putting a 50% markup on it (which most retailers would love to get) the unit should have been around $1425. Chances are their cost was less than the retail price here at cpap.com. Using that $950 as cost again, my DME appears to markup their equipment over 310%
What's kind of funny is the Illinois Attorney Generals Office actively went after gas stations that doubled the price of gasoline on 9/11 for ripping people off a couple dollars at a time, but they let these medical supply stores bilk thousands everyday off customers, including the elderly, the majority of their customer base!
I want to thank everyone who let me vent and those who weighed in on my post. This forum has always lead me in the right direction as far as my cpap use and I thank you all for your advice on dealing with my rapist DME.
Mark Matchett