Medical supply store trying to rob me

[donny last]

My doctor presribed me the Remstar M series auto-pap. He sent me up with the loocal medical supply store,and I about had a cow when I saw what they thought they were going to charge me. They wanted 1500$ for that machine,and that's without a humidifier! I bought that Machine with humidifier,and a nice mask for 803.76 at an online site. I thought Jesse James was shot 100 years ago! this is hi-way robbery,and totally corrupt. Since my doctor sent me to these robbers,I'm not sure I even need a auto-pap. My sleep apnea is so minor,my insurance wont cover it.

[jules]

do you stop at the nearest 7 - 11 and pick up a cup of coffee, or a snack?

ever buy a soda , bag of chips, or a candy bar out of a vending machine?

ever shop your local stores during the holidays over going into a big mall or ordering online?


We make decisions all the time on where to buy and how much we are willing to pay for the service of having a "convenient" store that supports our local economy by providing jobs in the area which will then result in dollars staying in the area to be used for other jobs etc.

We are also expecting "service", credit (takes insurance money then bills remainder - not send out collection notices when they never sent the bill for example), polite staff, nice locations when we work with a local DME.

I walked away from my local DME when I couldn't get the service and couldn't get a correct bill ever (I had an O2 contract and a CPAP deal). I was dealing with the head of their billing office in another part of the state and they still couldn't get it right (the person under him made major insulting comments to me on the phone and got warned about that). I would have been happy to put a few more dollars into the local economy if I could have felt it was well spent; I know the economy in the town the DME is located is pretty bad.

cpap.com gets all my business now

[hobbs]

Yeah I know what you mean. Just got a S8 II AutoSet + humidifier and Swift LT mask for $1020.00 and don't even want to know what Apria would have gouged me for it.

[Georgio]

What is a minor lack of oxygen and only considered minor suffocation? From my experience, Apnea is a progressive condition that if not treated gets worse until your blood pressure is permanently high, or your just have a stroke. I"m only 3 weeks into APAP but I'm glad I am because I didn't start as soon as I was diagnosed, and I started to go down hill fast!

Yes, there are people out there that want to get rich on us. If you can get an auto machine, that is probably a good thing. Do yourself a favor and do some research here. There are lot's of kind folks that want to help. Good luck...Georgio

[Slinky]

Do you want to rely on your insurance company to Dx your health problems and determine which need to be treated? Or would you rather have a doctor Dx your health problems and determine which need to be treated and how?

[donny last]

What upset me the most is my doctor set everything up,by faxing my presription to this medical supply place. It's like the doc and the store have a working relationship. If my insurance did cover this,I would have to pay 20% ,and at thier crazy prices I would have paid big time! My problem is that I was being routed to Jesse James hide out to be robbed. My machine should be here in a few days, and I think I got a good price. I will be learning all I can on this site,because the system sure isn't looking out for me.

[GuyK]

Yeah I know what you mean. Just got a S8 II AutoSet + humidifier and Swift LT mask for $1020.00 and don't even want to know what Apria would have gouged me for it.

Same setup, with a different mask, and the insurance paperwork said (roughly) $1800. But it is all covered by the HMO. (not to gloat, but I feel lucky)

[Wulfman]

My doctor presribed me the Remstar M series auto-pap. He sent me up with the loocal medical supply store,and I about had a cow when I saw what they thought they were going to charge me. They wanted 1500$ for that machine,and that's without a humidifier! I bought that Machine with humidifier,and a nice mask for 803.76 at an online site. I thought Jesse James was shot 100 years ago! this is hi-way robbery,and totally corrupt. Since my doctor sent me to these robbers,I'm not sure I even need a auto-pap. My sleep apnea is so minor,my insurance wont cover it.

Well, at least you have a "progressive-minded" doctor.
When the words "Sleep Apnea" were first spoken by my GP (even before I had my sleep study), I started reading everything I could on the Internet. In the process, I found a number of the online sellers and started comparing prices......didn't make sense to me. I just needed the equipment, not over-priced "local service". I figured I could read the manuals and with the help of the online forums this therapy isn't that hard. I purchased all of my equipment from CPAP.COM and haven't missed anything by not using a local supplier. My insurance provider did reimburse me for 80% of my equipment when I submitted an invoice to them, but I was prepared to absorb all of the cost of it if they hadn't gone along.

Make sure you have your prescription and a copy of your sleep study.

One way or the other....."It's YOUR money" and "It's YOUR therapy". Get a data capable machine and take control of your therapy.
And, hang out here and learn as much as you can.


Den

[Wulfman]

What upset me the most is my doctor set everything up,by faxing my presription to this medical supply place. It's like the doc and the store have a working relationship. If my insurance did cover this,I would have to pay 20% ,and at thier crazy prices I would have paid big time! My problem is that I was being routed to Jesse James hide out to be robbed. My machine should be here in a few days, and I think I got a good price. I will be learning all I can on this site,because the system sure isn't looking out for me.

This happens all too frequently and is a conflict of interest. That's why I said in my previous post to get your prescription and copy of your sleep study. They're obligated to give them to you if you ask. Your prescription is "good for life".....and particularly with the online sellers.
If you don't want your checking account to be gouged, don't fall for it. You have a right to purchase your equipment at a place of your choice.

Den

[packitin]

deleted

[Slinky]

Please understand that the sleep doctor does NOT determine WHAT local DME supplier you get your equipment from - your insurance does. In the case of those on Medicare w/a secondary insurance, the secondary insurance determines what local DME supplier you get your equipment from. Most all local DME suppliers accept Medicare.

Your sleep lab staff "might" have had a preference amongst the local DME suppliers your secondary insurance was contracted w/for whatever reason or that could have been the ONLY local DME supplier your insurance was contracted with. The sleep doctor almost never has anything to do w/WHERE you get your equipment. He doesn't "do" the insurance bit, the sleep lab staff does.

And understand that the price you see on the billing that you are given is NOT the price that Medicare allows, nor is it the price that Medicare and/or your insurance pays.

For instance (from 2006 - Medicare allowances and reimbursement have dropped since then):

CPAP (HCPCS E0601) capped rental for 13 months:
Monthly Billed: $135.00 - Monthly Medicare Allowed $99.95 - Monthly Medicare Paid $79.96 - Monthly CoPay $19.99

Outright Purchase of the rest of the equipment:
Total Billed: $548.00 - Medicare Allowed $499.63 - Medicare Paid $399.70 - CoPay $99.93
Broken down:
a7037 - tubing used with positive airway pressure device - Billed $48.00 - Allowed $32.82
a7034 - nasal interface (mask or cannula type) used with positive airway pressure device, with or wi - Billed $130.00 - Paid $94.11
a7035 - headgear used with positive airway pressure device - Billed $45.00 - Paid $31.80
e0562 - humidifier, heated, used with positive airway pressure device - Billed $325.00 - Paid $240.97

You always have the option of calling your insurance (or secondary insurance if you have Medicare) and ask them what local DME CPAP suppliers they are contracted with. It may well be that you have the option of more than one. But most likely the amounts are going to be today's equivalent if Medicare is your primary.