Insurance paying for card reader and software???

[hjjsnell]

Has anyone ever had their insurance company pay for something like EncoreViewer software and USB card reader? Before I call my DME and sound like a complete moron for even asking I thought I'd ask here first. I know I could get reimbursed from my FSA (unfortunately I have none of that left after my sleep study and some dental work) but I mean my actual insurance policy. Thanks!

~Heather

[drubin007]

if your dme is pulmocare then chances are they will have no idea what you are talking about if you ask for software and a card reader... I am probably a few hours South of you and that is my dme... They are very customer oriented and nice, however after finding this site, and asking a few questions and taking some initatiave, I know loads more then they do.
When they called me after a few days on cpap to see how things were going, I asked about software, they had no clue what I was talking about. They said they have their own propertiary software to red the data from the card I will return, but that was it. I also had to inquire about a chin strap, and a few other odds and ends on my own.

[Slinky]

I've only read of ONE person in any of the apnea support forums I've frequented whose insurance paid for the software and card reader. And there have been MANY who got a script from their doctor for it and tried to get their insurance to pay w/absolutely NO SUCCESS. I suppose nothing ventured, nothing gained, but be forewarned, it "ain't" likely gonna happen.

[hjjsnell]

I highly doubt it will happen, I don't exactly have the best insurance in the world...but I figured it wouldn't hurt to ask. Thanks!

[hjjsnell]

Well I knew it wouldn't happen but a girl sure can hope can't she. My DME really isn't even going to look into whether or not my insurance will cover one because he says that they have never covered one before (not my specific insurance but insurance in general) and he's actually never had a patient request one, only doctor's offices. I really can't believe that no patient (this is a DME attached to the hospital) has never wanted to keep track of their own therapy. He uses CPAP himself so at least he understands why I would want one! He referred me to CPAP.com (I found cpaptalk.com because he referred me to it) but I found a cheaper one through another site for only $54, now I just have to come up with that kind of money. Does anyone have one that you no longer want? I'm not even finding one on CPAPauction.com or ebay. Darn it!

Heather

[jdm2857]

cpap.com will price match other legitimate CPAP websites. $54 for the software and card reader sounds awfully cheap, though.

[mattman]

Most insurance companies won't cover it. I've never come across a DME company that would provide it either. There are a couple pretty good reasons for it from their point of view though.

The first reason is simple. You can walk into a DME providers office and get your card read pretty much any time for free. Why would an insurance company pay for software when it can be done for free whenever you want? Hell most providers even have a mail exchange program. They mail you a new card and an envelope to send yours back. Don't even have to leave home.

Also realize that 90%+ either don't give a crap and/or don't know what to do with that data. Seriously. I bet the number is even higher. It's asounding how little the average patient cares about their own treatment no matter what you are talking about - cpap, asthma, diabetic, you name it. Most just don't give a crap. A majority even get pissed off when we'd try to take 5 minutes to instruct them on important features.

Lastly there are some legal ramifications if the data is misinterpreted. It's stupid but it's true. If a patient misinterprets data with equipment provided by a DME company they can (and often are) held liable even if they gave specific instructions to the patient to call their doctor with any concerns. Don't believe me? 2 different companies I worked for - 1 was sued by the family of an oxygen patient who died while smoking and on oxygen even though every single thing we gave them had NO SMOKING signs on it (including 3 for various doors). The other was sued by a diabetic patient who suddenly decided to stop checking blood sugar and based on how he felt started injecting insulin from a pen we provided and wound up in the hospital even though every single lesson we provided and every single document we provided said not to. Both cases everyone still felt we were somehow at fault because we provided the means by which the problems occured.

So anyways - sorry to go off so much but that's the biggest reasons you won't find software at a DME company and why most insurance companies won't pay for it.

[Wulfman]

Actually, the REAL reason insurance won't reimburse/pay for them is because there's no insurance billing codes.


Den

[csellebrecht]

Actually it would be E1399. which is a code for Miscellaneous and it would need to include a statement of neccessity from the Doctor. It will get denied almost 98% of the time..

[Guest]

you want it? PAY FOR IT YOURSELF!!! God.

[hjjsnell]

you want it? PAY FOR IT YOURSELF!!! God.

Gosh, I didn't want anyone to be harsh with me. I would pay for it myself but find that I can barely afford my utility bills much less something extra (we never have extras in my house because we just don't have the money). I thought that maybe, just maybe, I could ask and see if anyone had any success at having insurance pay for it. And I was just kidding with the comment on if anyone had one they no longer wanted. Just a joke! Yes the $54 is a steal for the card reader, I know that. But even $54 is too much for me to handle sometimes. Sorry! I really shouldn't have to defend myself though. I'm actually a very meek and calm person who I like to consider is quite nice and just doesn't understand why some people can't be nice back. Okay off my soapbox. Thanks for listening.

~Heather

[hjjsnell]

cpap.com will price match other legitimate CPAP websites. $54 for the software and card reader sounds awfully cheap, though.

Thanks for letting me know they will pricematch!! I didn't know if I could post another website on here to say where I saw the $54 (oh and it's for the card reader only, sorry if I misstated that).

Most insurance companies won't cover it. I've never come across a DME company that would provide it either. There are a couple pretty good reasons for it from their point of view though.

The first reason is simple. You can walk into a DME providers office and get your card read pretty much any time for free. Why would an insurance company pay for software when it can be done for free whenever you want? Hell most providers even have a mail exchange program. They mail you a new card and an envelope to send yours back. Don't even have to leave home.

Also realize that 90%+ either don't give a crap and/or don't know what to do with that data. Seriously. I bet the number is even higher. It's asounding how little the average patient cares about their own treatment no matter what you are talking about - cpap, asthma, diabetic, you name it. Most just don't give a crap. A majority even get pissed off when we'd try to take 5 minutes to instruct them on important features.

Lastly there are some legal ramifications if the data is misinterpreted. It's stupid but it's true. If a patient misinterprets data with equipment provided by a DME company they can (and often are) held liable even if they gave specific instructions to the patient to call their doctor with any concerns. Don't believe me? 2 different companies I worked for - 1 was sued by the family of an oxygen patient who died while smoking and on oxygen even though every single thing we gave them had NO SMOKING signs on it (including 3 for various doors). The other was sued by a diabetic patient who suddenly decided to stop checking blood sugar and based on how he felt started injecting insulin from a pen we provided and wound up in the hospital even though every single lesson we provided and every single document we provided said not to. Both cases everyone still felt we were somehow at fault because we provided the means by which the problems occured.

So anyways - sorry to go off so much but that's the biggest reasons you won't find software at a DME company and why most insurance companies won't pay for it.

Thanks Mattman for letting me know the reasons behind why they won't cover it. I guess I never thought of it that way. I'm still so new to this whole CPAP business but figured it couldn't hurt to ask! The most I'll get told is no they won't cover it, ya know. This forum has been wonderful to me and I've already learned so much from it. I'll add this to my long list of things learned from here! Thanks, Heather

[Pugsy]

Guest wrote:you want it? PAY FOR IT YOURSELF!!! God.



Gosh, I didn't want anyone to be harsh with me.

"Guest" comments like this warrant no reply in my book. No guts to really register and put some sort of permanent name to harsh comments or inflammatory comments. Smells an awful lot like the other "guest" that has been trolling around here. Try not to let people like this get under your skin.

Hurts nothing to ask if someone has a card reader they won't be using. Never know, someone may have had the occasion to need to switch to completely different system and the reader might not be needed. Long shot of course and no luck but harmed no one to ask.

[ewl]

Hi: I have an FSA too but doubt they would approve reimbursement-- they would require a letter of medical necessity from my doctor, and even then I don't know if they'd agree! But cpap.com does pricematch-- I just bought the EncoreViewer card reader and software from them and they happily matched a $139 bundle price I found elsewhere. But you could at least get some data from the LCD screen until you can afford it, right? Better than no data at all-- good luck!

[Pugsy]

I just bought the EncoreViewer card reader and software from them and they happily matched a $139 bundle price I found elsewhere.

I didn't know about the price matching when I paid the cpap.com bundle price of $199. Darn......