FYI incase your curiouse about $$$ and DME

[andyomega]

I just talked to the billing department and asked them how much money they make on these things.
Here is what I learned:

Some insurance companies buy them in bulk and charge the MSRP price to the insured account and the DME gets a percentage.
My current insurance company and DME have the agreement to rent it for 3 months at $78 per month and then purchase outright for full price.
My machine is a no frills Respironics Remstar Auto M with heated humidifer and no data slot card, its not like any I have seen on the net. Anyway, The retail price of it is $1100. I am going to guess that places like CPAP.com sell for discount prices.

My previous insurance company did not allow the device to be sold outright, instead they allow the DME to bill monthly for X number of months and then reduce to a quarterly "maintenance" payment for about $85. This "maintenance" payment continues until you change insurance companies and find out they are still trying to bill them when you receive the notice informing you of this.

Is it fair? I don't know. Everyone has to make money. I just wish the people who sold the equipment to end users were better trained.

[RosemaryB]

[quote="andyomega"]I just talked to the billing department and asked them how much money they make on these things.
Here is what I learned:

Some insurance companies buy them in bulk and charge the MSRP price to the insured account and the DME gets a percentage.
My current insurance company and DME have the agreement to rent it for 3 months at $78 per month and then purchase outright for full price.
My machine is a no frills Respironics Remstar Auto M with heated humidifer and no data slot card, its not like any I have seen on the net. Anyway, The retail price of it is $1100. I am going to guess that places like CPAP.com sell for discount prices.

My previous insurance company did not allow the device to be sold outright, instead they allow the DME to bill monthly for X number of months and then reduce to a quarterly "maintenance" payment for about $85. This "maintenance" payment continues until you change insurance companies and find out they are still trying to bill them when you receive the notice informing you of this.

Is it fair? I don't know. Everyone has to make money. I just wish the people who sold the equipment to end users were better trained.

[Snoredog]

[quote="RosemaryB"][quote="andyomega"]I just talked to the billing department and asked them how much money they make on these things.
Here is what I learned:

Some insurance companies buy them in bulk and charge the MSRP price to the insured account and the DME gets a percentage.
My current insurance company and DME have the agreement to rent it for 3 months at $78 per month and then purchase outright for full price.
My machine is a no frills Respironics Remstar Auto M with heated humidifer and no data slot card, its not like any I have seen on the net. Anyway, The retail price of it is $1100. I am going to guess that places like CPAP.com sell for discount prices.

My previous insurance company did not allow the device to be sold outright, instead they allow the DME to bill monthly for X number of months and then reduce to a quarterly "maintenance" payment for about $85. This "maintenance" payment continues until you change insurance companies and find out they are still trying to bill them when you receive the notice informing you of this.

Is it fair? I don't know. Everyone has to make money. I just wish the people who sold the equipment to end users were better trained.

[Guest]

you know, there IS a such thing as an informed patient DEMANDING a certain device up to the amount their insurance will reimburse. There is NO REASON at ALL for a patient to just blindly "accept" whatever machine the DME provides.

This is a strange issue - how can a DME make a normal profit yet at the same time NOT compromise your health and the equipment it supplies you?

That's the issue at-hand.