Charged for Download?!

[Dazzles]

Hi there!

So it appears as though my sleep doc has billed my insurance for seeing my respiratory therapist and then AGAIN for the doctor to look at my download.

So they send me an after-the-fact bill (months later) saying that the doctor reading the download counts as an office visit and I owe them co-pay for that!

No one told me this! Argh.

I also didn't get any feedback/response from the doctor regarding this so-called "reading". In fact, no one has asked for my data or asked me to make a follow-up appointment at all.

Today the DME portion of their office (they do their own there) contacted me and told me that I need to get replacement supplies -- but first I have to see the doctor because my prescription has expired? How long to CPAP prescriptions last?

I think I am going to pay the co-pays I owe and switch doctors -- to one who wants to see me in the office to help with my issue and not just to charge my insurance company money for supplies.

Frustrating.

[nanwilson]

If I were you I would never go back to that doctor or DME. Charging you for downloading your stats is money grabbing......you can do it by yourself for free. Next time just print them off at home and take them with you ..if there is a next time.

[avi123]

The only way that I can ask a question from my Doc is to set up a 30 min appointmrent with him for which I'll be need to bay by VISA $172. After 10 minutes he lives the room to fill papers. And I don't see him again. There is no other contact with him. Not by phone, email, etc. But I am being reinberesd by Medicare's Medigape for it less $25.

[GumbyCT]

Today the DME portion of their office (they do their own there) contacted me and told me that I need to get replacement supplies -- but first I have to see the doctor because my prescription has expired? How long to CPAP prescriptions last?

It depends on what the doc writes on the script but this is a way to empty your pockets.

It is never good to use a business like this that has a financial gain to have to see the doc. They do know how often your insurance will pay and never consider you. When a doc owns or runs a DME business it should be considered a violation their ethics rules AND be avoided by ALL patients, at all costs.

I would not see this doc or DME again and find another who is not associated with a DME. Best thing is word of mouth.

Good Luck

[jen4700]

I'd call my insurance and see if there really is a co-pay for "reading" the report and not seeing the doc. The DME/doc office may be trying to bill you for something you don't really owe.

[ekubaskie]

It could also be a way to make sure you can't get your supplies anywhere else, writing a prescription that conks out before insurance will cover the next purchase.

Let's see if the new scrip has a short half-life, and if they charge for the renewal itself.

[DagoRed]

I have seen what my DME has charged my insurance company, they break a boxed apap unit down to its components and charge seperatly they also did that with the mask. So far me dme is a big pain in the arse to deal with. After I settle a couple of issues they are so fired.

[jen4700]

What did your insurance company say about the download? Are they really going to charge you a copay?

[Maxie]

I think I'm in a similar situation as I just made a post about how often to see my "sleep" doctor. I was charged for a co-pay and I didn't see a doctor and I had my own download which the RT used to tell me I'm doing fine. I'm ready to skip seeing this pulmonary specialist because I don't have his kind of problems. See my post about how often you see your doctor.

[jen4700]

Some docs really piss me off. My daughter was seeing a psychologist. $50 copay per session. One day my daughter tells me the therapist got an emerg call and had to leave after 20 min. I assumed we weren't going to be charged for the session but therapist said - doesn't matter how long still gotta pay. IT WAS HER ISSUE NOT OURS. TOTAL BS. I hate insurance companies.

[jmedlen]

Hi -

I, too, am being charged over $100 for downloading the data. I'm having a rough transition to this - well *I* dont' think it's so rough, but my doctor does. Regardless. I want to be able to read my data without going ot hte office. Someone here said you can download it for free.

how?

i found a "viewer" for the Resmed system for $99. Is there another way?

I am wondering if I am not better suited to a bipap machine, but have no idea how I'd get to try one. my doctor wants me to go thorugh 6 weeks of psychotherapy for sleep....I don't have time or money for that. I've already had to shell out over $1500 between teh machine and masks and office visits....I have 3 hours a day of "freedom" to do things - I have a son with a disability and the majority of my time includes him. I don't want ot spend my time spending yet another $150/hour going to another doctor....

thank you,

[Uncle_Bob]

Hi -

I, too, am being charged over $100 for downloading the data. I'm having a rough transition to this - well *I* dont' think it's so rough, but my doctor does. Regardless. I want to be able to read my data without going ot hte office. Someone here said you can download it for free.

how?

i found a "viewer" for the Resmed system for $99. Is there another way?

I am wondering if I am not better suited to a bipap machine, but have no idea how I'd get to try one. my doctor wants me to go thorugh 6 weeks of psychotherapy for sleep....I don't have time or money for that. I've already had to shell out over $1500 between teh machine and masks and office visits....I have 3 hours a day of "freedom" to do things - I have a son with a disability and the majority of my time includes him. I don't want ot spend my time spending yet another $150/hour going to another doctor....

thank you,

Check your PMs

[sleepycarol]

jmedlen Your machine may not have any useful data except compliance. I know that the previous versions of the Respironics Plus and Basic machines did not record any thing but hours and days of use.

I was given an M series Plus machine by Respironics and found this forum the same night. Didn't take me long to figure out my DME didn't know diddly squat about the machines as they told me it recorded "all" kinds of important data. Not!! This was a locally owned DME with a respiratory therapist on staff. My script was for a "smart cpap with a pressure range of 8 - 12". They had the nerve to tell me they knew what I needed vs. the doctor. Gave me a Plus machine set at 10. Fired them.

So if they charge you for a download -- I would fight it as they are only checking your compliance data (which is for their benefit in getting paid).

[MidnightOwl]

So if they charge you for a download -- I would fight it as they are only checking your compliance data (which is for their benefit in getting paid).

It's could also be for Dazzle's benefit if he wants insurance to pay for the machine. If insurance is paying they get to dictate what hoops you jump thru including compliance checks. Whether insurance agrees they should get paid for that check or thinks it was included in the original purchase price is between the insurance company and the DME (and I'm guessing it never got addressed in the contract which is why the DME is charging for it).

The expired prescription is another matter and switching doctors sounds like a wonderful idea!

[GumbyCT]

So if they charge you for a download -- I would fight it as they are only checking your compliance data (which is for their benefit in getting paid).

Excellent point Carol.