Another DME scam?

jaybee72 · Post by **jaybee72** » Thu Apr 12, 2012 6:38 pm

Ok, I have 100% DME coverage with no copay or deductible, and in the past every cpap supply orde was free. I just happened to be logged in to united healthcare and was looking at recent claims and noticed a $60 amount applied to my deductible. Amongst the equipment charges which were all covered there was a $150 "diagnostic fee" which UHC claimed the $60 toward deductible. What diagnostics?!? I said I wanted a resmed Swift fx, they took 2 minutes to try it on - without even connecting to a machine, and I left... Crooks!

GumbyCT · Post by **GumbyCT** » Thu Apr 12, 2012 6:50 pm

jaybee72 wrote:Ok, I have 100% DME coverage with no copay or deductible, and in the past every cpap supply orde was free. I just happened to be logged in to united healthcare and was looking at recent claims and noticed a $60 amount applied to my deductible. Amongst the equipment charges which were all covered there was a $150 "diagnostic fee" which UHC claimed the $60 toward deductible. What diagnostics?!? I said I wanted a resmed Swift fx, they took 2 minutes to try it on - without even connecting to a machine, and I left... Crooks!

Let me show you my E-Trade baby surprised face

Maybe the Secret T will tell you what this is all about?

jaybee72 · Post by **jaybee72** » Thu Apr 12, 2012 7:06 pm

Secret T?

ems · Post by **ems** » Thu Apr 12, 2012 7:07 pm

I'm not quite sure I follow your post... but, if you think you were charged for something you normally don't pay for, call your insurance company and report it. You can always change your DME if this doesn't get the results you are looking for.

retrodave15 · Post by **retrodave15** » Thu Apr 12, 2012 7:13 pm

As a fellow UHC member, I would suggest you call member services. They have gone to bat for me on multiple occasions and resolved a few billing issues.

jaybee72 · Post by **jaybee72** » Thu Apr 12, 2012 7:19 pm

Well, I guess they decided to start charging a "diagnostic fee" under the guise of a mask fitting... I never had such a fee in the past, and feel $150 to not even test the mask at pressure is ridiculous.

Is it common for DME's to charge such a fee for mask fitting?

GumbyCT · Post by **GumbyCT** » Thu Apr 12, 2012 7:20 pm

jaybee72 wrote:Secret T?

jaybee72 · Post by **jaybee72** » Thu Apr 12, 2012 7:23 pm

I guess I'm still not following on the T thing... I have seen her avatar on here, but do not remember her name. Has she had this charge I assume?

jaybee72 · Post by **jaybee72** » Thu Apr 12, 2012 7:53 pm

Took about 7 pages back, but finally saw her avatar - Therapist... But not sure what the significance is...

GumbyCT · Post by **GumbyCT** » Thu Apr 12, 2012 8:01 pm

She knows everything and never even looked at a Holiday Inn.

But when you have to cross every T in a joke it looses something.

jaybee72 · Post by **jaybee72** » Thu Apr 12, 2012 8:14 pm

Sorry - hadn't been on here enough to pick up on it. Her posts are not as prolithic as others like you, spinner, etc...

GumbyCT · Post by **GumbyCT** » Thu Apr 12, 2012 8:21 pm

jaybee72 wrote:Sorry - hadn't been on here enough to pick up on it. Her posts are not as prolithic as others like you, spinner, etc...

You've been here longer than me.

Consider this search.php = "Secret T"

Give it a shot.

search.php?keywords=%22Secret+T%22&term ... mit=Search

jaybee72 · Post by **jaybee72** » Thu Apr 12, 2012 8:30 pm

Yep Gumby - I got a whole half a month seniority on ya! But, you have almost 5300 more posts than me. Actually, I only go on here when I have questions or issues, so I'm not a regular reader.

GumbyCT · Post by **GumbyCT** » Thu Apr 12, 2012 8:38 pm

jaybee72 wrote:Yep Gumby - I got a whole half a month seniority on ya! But, you have almost 5300 more posts than me. Actually, I only go on here when I have questions or issues, so I'm not a regular reader.

So that makes you a Senior?

ems · Post by **ems** » Thu Apr 12, 2012 9:16 pm

jaybee72 wrote:Well, I guess they decided to start charging a "diagnostic fee" under the guise of a mask fitting... I never had such a fee in the past, and feel $150 to not even test the mask at pressure is ridiculous.

Is it common for DME's to charge such a fee for mask fitting?

To try and get back to your original question - I have UHC with a 0 deductible also. I had a sleep study last June and got my machine in July. In December my doctor suggested I try BPAP, so the DME brought me a different machine. I've also ordered various things from the DME since last July. All this to say that I've never paid one penny for any of this.

I suggest that you call UHC... I think that somehow wires got crossed. As with any business - even the best ones - sometimes the left hand doesn't know what the right hand is doing. Could be that the DME was able to push this through without UHC suspecting anything. Call UHC and explain this to them, advising them that you don't have a deductible! You should not have to pay $150, even if the claim is legitimate, if you don't have a deductible.

Another DME scam?

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