How do DME's work? (Is that an oxymoron?)

LinkC · Post by **LinkC** » Tue Mar 03, 2009 11:48 am

It appears I (and Blue Cross) am "renting" my equipment from the DME. It also appears that the combined monthly charge would BUY that equipment in about 4 months time. Just my co-pay would buy it in about two years. Do we ever reach a point where it's mine, and the "rent" stops? (rent-to-own..)

Also, I note that the billing code is the same for ANY of the M-series machines. Does that mean BC and I pay the same whether I have the basic "Plus" or a tricked-out "Auto"? Then why do they always have to run everything by "your insurance" before they order it?

tmbarber4 · Post by **tmbarber4** » Tue Mar 03, 2009 12:10 pm

Our ins. BC of Fl. only rents. Rent forever. Then when the new year comes along you start over with your deductable, In 2 years you could have bought at least 2 machines plus lots of extras. Such a rip off.

JoyD. · Post by **JoyD.** » Tue Mar 03, 2009 12:16 pm

In Kentucky, it is mine after 13 months of Medicare's renting it, as long as I have met all Medicare's compliance requirements.

docfox · Post by **docfox** » Tue Mar 03, 2009 12:35 pm

That is why CPAP.com does not take insurance and simply tells you that it is cheaper in the long run to buy it. And it is (maybe not under Medicare).

I bought my machine after my sleep study from my sleep doc's "store". Cost me a fortune and the insurance paid only about 1/4 of the costs. Never again am I going to pay those prices again. And renting-- come on. That is always a rip off.

If you can afford to buy a machine, tell BCBS to stuff it, buy your own and a few years (maybe months) you will be richer.

Jim

DreamStalker · Post by **DreamStalker** » Tue Mar 03, 2009 12:55 pm

LinkC wrote:It appears I (and Blue Cross) am "renting" my equipment from the DME. It also appears that the combined monthly charge would BUY that equipment in about 4 months time. Just my co-pay would buy it in about two years. Do we ever reach a point where it's mine, and the "rent" stops? (rent-to-own..)

Also, I note that the billing code is the same for ANY of the M-series machines. Does that mean BC and I pay the same whether I have the basic "Plus" or a tricked-out "Auto"? Then why do they always have to run everything by "your insurance" before they order it?

As Den always says ... "It is your treatment!"

It is also your money.

You decide how long you want to take it. When you get mad as hell, then you flip them off and go buy your own stuff online and live happily ever after.

All you need is the Rx (doc must provide you with original). While you are at it, get a copy of your PSG and keep it for your own records.

LinkC · Post by **LinkC** » Tue Mar 03, 2009 1:03 pm

Yeah, but it's a fine line between the desire to stick it to Blue Cross and the reality that the DME is ripping us BOTH off!

Gerryk · Post by **Gerryk** » Tue Mar 03, 2009 1:14 pm

Link, I have BCBS of Illinois. My insurance wasn't billed for a couple months then they were billed and paid the whole thing. I have an auto BiPap and they paid about $5000.00 for the machine, humidifier, humidifier chamber, hose, mask and headgear. Yes when you purchase a humidifer at most places it comes with a chamber but the insurance allows them to bill for it and pay it so they do. The real sad part of this is that I contacted my insurance because I had a quote to buy online the complete same setup for under $1700.00 and the insurance said no. It will be out of network and I will have to pay more. They actually told me that I get punished and end up paying more by trying to save them money.

Gerry

Nephi · Post by **Nephi** » Tue Mar 03, 2009 2:34 pm

I have BCBS of CA (now called Anthem) and they did a purchase instead of a rent when I picked up my machine last Friday. In my case, BCBS acts as a health care manager for my employer. My employer ends up paying for everything and can override denied claims when BCBS messes up. It would appear that BCBS can be different depending on what function they are preforming. All really murky. I wish things were a little more upfront.

OldLincoln · Post by **OldLincoln** » Tue Mar 03, 2009 10:34 pm

You can check with your insurance, but if like mine, they rent for 13 months and then I own the machine. Also, they are billed $250/mth but actually pay less than $80/mth. I started Medicare several months ago and they do the same thing.

Machine	Mask	Humidifier

Additional Comments: 11-14 cmH2O

Machine	Mask	Humidifier

Additional Comments: 11-14 cmH2O

How do DME's work? (Is that an oxymoron?)

How do DME's work? (Is that an oxymoron?)

Re: How do DME's work? (Is that an oxymoron?)

Re: How do DME's work? (Is that an oxymoron?)

Re: How do DME's work? (Is that an oxymoron?)

Re: How do DME's work? (Is that an oxymoron?)

Re: How do DME's work? (Is that an oxymoron?)

Re: How do DME's work? (Is that an oxymoron?)

Re: How do DME's work? (Is that an oxymoron?)

Re: How do DME's work? (Is that an oxymoron?)