got my 1st bill today from performace home medical

[k_ogre]

got my 1st bill for $162.00 witch is funny because the invoice I took home when I got my machine was $102.00 kinda wondering where the extra $60 came from. it's to bad because AJ at the local office is great with helping out but I'm not going to be on the screw me list. I sent a email asking why but I know it going to be some kinda ya ya ya BS reply. looks like I need to find a new DME that takes Medicare.

[chunkyfrog]

Use my link, and punch in your zip code to find out who nearby takes Medicare.
The green "M" indicates those who accept assignment.
Others are allowed a LIMITED additional charge.
Run the $60 upcharge past Medicare and watch the fur fly.
If they exceed the maximum allowed, Medicare is not amused!

[Krelvin]

got my 1st bill for $162.00 witch is funny because the invoice I took home when I got my machine was $102.00 kinda wondering where the extra $60 came from. it's to bad because AJ at the local office is great with helping out but I'm not going to be on the screw me list. I sent a email asking why but I know it going to be some kinda ya ya ya BS reply. looks like I need to find a new DME that takes Medicare.

Email is okay, but you should call, ask for the billing dept and talk to them about what the bill is compared to the paperwork you received. Keep track of the conversations (Date, time, who you talked with).

It is quite possible that something got messed up and they will resolve it. If they are billing you for something that there is no paperwork on, ask them where the paperwork is and who authorized it.

[k_ogre]

I do think I'm going to call Medicare I'm really pissed I would dump them and return the machine but I' lose to much money. I tried to get a bill from them for a month and a half now I know why, the 30 day is pass can't return with out a big loss. but I would like to see how they are going to give me the humidifier I paid for on a A10.

[chunkyfrog]

Even though the humidifier on the Airsense models is integrated, the standard allows breakdown pricing.
Otherwise, the companies that do this would not be paid for the humidifier.
Why penalize a company for improving their product?

[LSAT]

Medicare allows a separate payment for a machine and a humidifier whether the units are separate or integrated. There are several machines that have integrated humidifiers. It works the same way for masks. The DME charges separately for mask and headgear even though they come together in a sealed package.

[chunkyfrog]

Medicare, (and some insurance plans), allow a new "mask" every three months, but
the headgear once every SIX months. If you need the mask frame--("mask")--WITHOUT the headgear--
good luck finding a DME who will break up the package.
Mine might, but they are golden.

[Sonnyboy]

Use my link, and punch in your zip code to find out who nearby takes Medicare.
The green "M" indicates those who accept assignment.
Others are allowed a LIMITED additional charge.
Run the $60 upcharge past Medicare and watch the fur fly.
If they exceed the maximum allowed, Medicare is not amused!

Punch in your zip code.
I believe you are in a "capped bidding" area.
If so, I do not believe they are able to tack on an upcharge.

[WSHenry]

Hi,

They've been my DME provider for the past 1-1/2 years, as they are an approved provider for Regence (BCBS) Washington. They are NOT an approved Medicare-direct provider. I currently have a Medicare Advantage plan with Regence.

The amounts shown on their delivery tickets and invoices are "fantasy" numbers. The amounts that are important are the contracted prices agreed to between DME Provider and Insurance Company.

I've had some issues in the past with incorrect and duplicate billing with PHM. They were minor, and were eventually cleaned up.

They should be able to explain the difference between the $102 and they $162. If you have insurance, they and your insurer should also be able to give you the contracted price(s) and what amount(s) you are responsible for,

I hope this helps.

[SewTired]

It works the same way for masks. The DME charges separately for mask and headgear even though they come together in a sealed package.

This is good information! I would not have known that (I already knew about the humidifiers being charges separately even if integrated). Not to steal your thread, but mask parts can be bought without a prescription, right? Meaning I could buy them anywhere?

[chunkyfrog]

Yes. But maybe not everywhere, you need to check with the seller.
But why? Any medical professional who can write a prescription can do this for you.
Even your dentist. As long as you are paying out of pocket, nobody cares if the Rx is written by a vet.

[k_ogre]

Well after waiting for a response to my email I called them directly. What I got was 20 mins of I don't know and numbers different from both my invoice and the bill! And a promise to call me back. Well that pissed me off even more so I went to another company told them what's going on and we are going to try to switch company's just don't want to give a dime more to the dishonest proformance home med.

[k_ogre]

the latest update Friday I went to a local dme (not a big company) and I'm getting my A10 for 1000.00 so my share is going to be 200.00 today(Monday) I return my machine to the other guys hope it goes easy

[BlackSpinner]

I return my machine to the other guys hope it goes easy

Don't sign anything without reading it. They will try to get you to sign that you are refusing medical treatment - don't sign that, scratch it out and initial it.

[chunkyfrog]

And if the name on the machine says "CPAP",
DON'T TAKE IT