DME Billing for rental frustration

[johnmtaylor]

I started CPAP in April. Paid $500.00 up front for my cost. Blue cross coverage. Insurance allowed $340.00. Now my DME is telling me the first two months were rental and ins will only cover 50%. I never agreed to rental and thought I was purchasing the machine.

I should have $150.00 credit but instead DME tells me I owe additional. My ins rep is working with them but I bet I still end up owing!

Very frustrated at this point and want to find any possible way to not work with DME. Any online providers that work with private insurance?

[oak]

sounds like a shell game. find another DME in your area if possible. online companies will have you file your own claims and ins reimbursement. sorry you got stung!

[RandyJ]

Do the math based on what your portion will be over the rental period (usually 10 months). It might be cheaper for you to buy outright through a company like our hosts (cpap.com) and get what you need for $500-600 for a premium Philips Respironics model 550 or 560 without using insurance. You just need a copy of your prescription.

[Pugsy]

It might be cheaper for you to buy outright through a company like our hosts (cpap.com) and get what you need for $500-600 for a premium Philips Respironics model 550 or 560 without using insurance.

Hmm...need to do the math but need to make sure that the math is for the 950/960 and not the 550/560 because that is what OP has in his profile.
That's a big chunk of change for the high dollar machine.

I am not surprised that it is considered a rent to own type of thing. No way would that first $500 payment cover all the expense for that model machine even if the co pay is 50%.
Typically it is rental for the machine and outright purchase for the humidifier. Rental being rent to own after so many months and that depends on the insurance company.

Need to figure out what the insurance company wants to do...rent to own or buy outright since any compliance requirements have likely been met (since got the machine this past April).
Depending on what the insurance company wants to allow for the ASV model 950/960...and the copays...it may or may not be a savings to purchase online and even if it is a savings...that's a big check to write out of pocket.
Do call for the discounted price though...it's quite a bit less than the $3500 MSRP shown.
https://www.cpap.com/productpage/pr-60- ... anced.html

[RandyJ]

Hmm...need to do the math but need to make sure that the math is for the 950/960 and not the 550/560 because that is what OP has in his profile.
That's a big chunk of change for the high dollar machine.

Yikes, I somehow missed that in his profile. I thought I saw "560".

[Stormynights]

I started CPAP in April. Paid $500.00 up front for my cost. Blue cross coverage. Insurance allowed $340.00. Now my DME is telling me the first two months were rental and ins will only cover 50%. I never agreed to rental and thought I was purchasing the machine.

I should have $150.00 credit but instead DME tells me I owe additional. My ins rep is working with them but I bet I still end up owing!

Very frustrated at this point and want to find any possible way to not work with DME. Any online providers that work with private insurance?

Your insurance may be able to work this out for you. I had a bill that I threw a fit over and called my insurance company. They told me I didn't owe it. Just because they charge you doesn't mean you really owe it. They just try to get all they can. If you pay you will not get the money back.

[johnthomasmacdonald]

second wind has a brand new in box DS950 for $1825, the slightly used run around $1400

[johnmtaylor]

To Clarify:

My insurance deductible is paid and the ins will cover 90% of the machine. I am just frustrated they are charging me rent for a machine I bought outright! You are right about them not refunding money, They just give you a "credit". I'll just be patient and see if the 2nd call from my insurance is any more effective.

I may start purchasing online and getting reimbursed at this point but I'm sure that has it's share of minefields also.

Thanks all for the comments.

John