Am I being screwed by my DME?

[NoSleep4u]

I picked up my equipment last week. At first glance, it looked like my Autoset was not brand new and they gave me a standard tube rather than a slimline. Thanks to all the help on this forum I was able to access the clinician menus. The software on the S9 was SX474-0602, which is an older version. I was also able to determine that this machine had almost 600 blower hours of use on it when I got it.

Is this normal? Should I have received a brand new machine instead? Is it time for me to push back on Apria?

Thanks.

[Grand-PAP]

Hi NoSleep4u,

I had the same problem, but fewer hours. My S9 Elite had about 150 hours on it. Mine was through Medicare. The DME (Apria also) told me that Medicare neither required a "new" machine nor even the current model.

I don't know if that was true or not. Evaluating the "relatively" low number of hours, I didn't feel that it was worth dealing with the Medicare bureaucracy. I'm not sure how I would have felt about 600 hours -- at 8 hours per night, that's only about 2.5 months.

[Otter]

If you have to ask this question, the answer is usually yes.

SecondWindCPAP.com sells used machines, but only if they have less than 500 hours on them. And they sterilize them with ozone first. They also charge a lot less than the going rate for new machines.

If the machine was billed as new, then Apria is committing fraud. If you ordered a new car from a dealer and when you went to pick it up it had 3000 miles on it, what would you think? It sounds like Apria assumed you wouldn't know how to check the hours on the blower. Good thing they were wrong about that.

[NoSleep4u]

Thanks everyone. I would never have known what to check (and probably wouldn't even have this machine) if it wasn't for the helpful people here. I think I will check with my insurance agency and probably push back on Apria.

[greatunclebill]

you need to speak with your insurance company. insist on a new machine because after 13 months of payments it will be yours and you will be liable for all repair or replacement until 5 years when they will give you a new one. you should start out with new. it is outrageous that apria gave you a used machine, but then from my past experience with them, i would expect it. run away from them as fast as you can run, but get this sorted out with your insurance company first. i believe this to be fraud and if your insurance is government you can probably do something about it easily.

ask your insurance if you can turn in the cpap to apria and then come in with a new prescription to another dme for a new machine.

[archangle]

If it's the usual insurance arrangement, you're renting the machine. Yes, you're renting to own, but you ARE renting. You pay monthly for using the machine. If you give up on CPAP after a month, or find you need a different type of machine like a bilevel, you don't ever pay the full purchase price for the machine.

What do you expect a DME to do with your rental machine if you don't end up buying it? Throw it away and eat the cost? Or rent it to another CPAP user?

[idamtnboy]

If it's the usual insurance arrangement, you're renting the machine. Yes, you're renting to own, but you ARE renting. You pay monthly for using the machine. If you give up on CPAP after a month, or find you need a different type of machine like a bilevel, you don't ever pay the full purchase price for the machine.

What do you expect a DME to do with your rental machine if you don't end up buying it? Throw it away and eat the cost? Or rent it to another CPAP user?

It's kind of a dilemma really. I agree, when you rent a piece of equipment of any kind you can expect it more than likely to be used. But in the case of CPAP the intent from the get-go is the payer is in fact buying the machine. In that case it ought to be a new one. That's all part of the argument about how much the DME ought to be reimbursed. I suppose one could argue that after 13 months rent the value of the machine is zero since it's been paid for. So if you start out with a used machine then maybe the rent period before it's paid for should be reduced. There ain't no good clear cut answer, really.

How does the RTO business model operate with appliances and TVs? Anyone know? If you sign an RTO agreement do you always get a new unit? If you get a used one is the price reduced?

[NightMonkey]

. I think I will check with my insurance agency

That's the correct step. Find out if they are paying for a rental, a purchase of a new machine, or a purchase of a reconditioned machine.

[NightMonkey]

There ain't no good clear cut answer, really.

You are just posting guesses.

There is a clear cut answer and it is in the contract the insurance company has with the DME.

[LSAT]

I understand that with some insurance it is a permanent rental. Not a rent to own. Check with your insurance company.
I have a friend that received a used machine and I told him that it "must" be a new unit. He checked with his insurance and they confirmed that it was a rental and a used machine was acceptable.

[Roger2]

Hi NoSleep4u,

I had the same problem, but fewer hours. My S9 Elite had about 150 hours on it. Mine was through Medicare. The DME (Apria also) told me that Medicare neither required a "new" machine nor even the current model.

I don't know if that was true or not. Evaluating the "relatively" low number of hours, I didn't feel that it was worth dealing with the Medicare bureaucracy. I'm not sure how I would have felt about 600 hours -- at 8 hours per night, that's only about 2.5 months.

Like most issues with Medicare matters, it is best to ask them direct. That usually circumvents a lot of confusion. Try this link for contact information;

http://www.medicare.gov/Publications/Pubs/pdf/11386.pdf

pax
Roger

[greatunclebill]

If it's the usual insurance arrangement, you're renting the machine. Yes, you're renting to own, but you ARE renting. You pay monthly for using the machine. If you give up on CPAP after a month, or find you need a different type of machine like a bilevel, you don't ever pay the full purchase price for the machine.

What do you expect a DME to do with your rental machine if you don't end up buying it? Throw it away and eat the cost? Or rent it to another CPAP user?

It's kind of a dilemma really. I agree, when you rent a piece of equipment of any kind you can expect it more than likely to be used. But in the case of CPAP the intent from the get-go is the payer is in fact buying the machine. In that case it ought to be a new one. That's all part of the argument about how much the DME ought to be reimbursed. I suppose one could argue that after 13 months rent the value of the machine is zero since it's been paid for. So if you start out with a used machine then maybe the rent period before it's paid for should be reduced. There ain't no good clear cut answer, really.

How does the RTO business model operate with appliances and TVs? Anyone know? If you sign an RTO agreement do you always get a new unit? If you get a used one is the price reduced?

i have used rent to own to buy, and rent to own to rent. if i rent a bed for a month for a guest, i expect it might be used. if i rent to own with the intent to buy i expect new and will not accept used. i often rto to avoid delivery charges on big ticket items because they are competitive regarding quality and price. i go in and start a rent to own, pay the initial week or month, get the new item delivered and set up, then pay it off within 90 days to save all interest charges. most of them have 90 days same as cash.

[robysue]

If it's the usual insurance arrangement, you're renting the machine. Yes, you're renting to own, but you ARE renting. You pay monthly for using the machine. If you give up on CPAP after a month, or find you need a different type of machine like a bilevel, you don't ever pay the full purchase price for the machine.

I bed to differ.

I was switched to BiPAP at the end of three months of therapy. My insurance company and I were charged the full cost of the BiPAP---although the rental fees for the first three months of the S9 AutoSet were applied towards the rental of the PR S1 BiPAP Auto. My copays and the insurance company's fee were recalculated so that by the end of the 10 month rental period the BiPAP was paid for in full.

Now, it's true that my DME took the S9 back and didn't charge me or my insurance company for it. What they did with it is anybody's guess I suppose. I do know that it was new when I got it---the tech showed me the blower hours when she was in the clinical set up menu.

What do you expect a DME to do with your rental machine if you don't end up buying it? Throw it away and eat the cost? Or rent it to another CPAP user?

As to what a DME might do with returned machines?

It does appear that some of them try to pass them off as "new" machines and send them out the door with new customers. My take on this? If the DME charges the same amount for the used machine that they would charge for a brand new machine, they're committing insurance fraud and should be called on it. So to the OP, I'd call the insurance company and tell them that Apria has given you a machine that is clearly NOT new because it has 600 blower hours on it. And ask them how much they're being billed for the machine while you're at it. My guess is that Apria is collecting significantly more than the machine costs brand new at a place like cpap.com.

Seems to me that at least some of those returned machines are likely stored as "loaner" machines---machines the DME gives you temporarily if they need to send your in for repairs. The returned APAPs can also be temporarily given to folks with bricks or straight CPAPs if the doc orders a couple of weeks of autotitration. Or the DME could sell them legitimately as used machines to folks without insurance; the DME would have to discount the price, but some money for the machine is better than no money.

[BlackSpinner]

What do you expect a DME to do with your rental machine if you don't end up buying it? Throw it away and eat the cost? Or rent it to another CPAP user?

You see them on Craigslist all the time here, and they expect more the what our host charges for them.

[greatunclebill]

What do you expect a DME to do with your rental machine if you don't end up buying it? Throw it away and eat the cost? Or rent it to another CPAP user?

You see them on Craigslist all the time here, and they expect more the what our host charges for them.

my nationwide dme, pm for name, has a central location where everything used or returned goes from all branch offices. if i walk in the door as a patient and can't afford the new product they are selling, they will scan the warehouse inventory and if they have what i need, they will sell it to me used to save me money. i have personal experience with this. in my case i was within 5 yrs for a new machine that i had to have (long story), pr sys one auto aflex, so insurance wouldn't pay. if they had it in the whse used it would have probably been in the $300 range. but they called and didn't have one immediately and i needed it asap, so i went on line and bought one new for $600.

don't get me wrong, they are there to sell new equipment, not used. the only reason i found out was because i had a real need, couldn't afford their new price out of pocket and had to have it. i told them what i was paying on the internet so they told me of this and tried to help lower my cost.