VitalAire Not too happy with them.

[Analog-X]

I seem to have bad luck with CPAP Health care providers.

Well first off, if you've read my posts previously, I did get my RemStar C-Flex with Pillow Mask and am very happy with the unit.

Now comes the un-happy part. I've been dealing with the Mississauga Location in Brampton, Ontario, Canada. The Canadian Government Pays $780 as the balance of your machine and I have to pay the rest. In this case I paid $670, which I hope to have paid off with the coverage I have through work.

So I submitted my Prescription and Original Receipt of Sale, and apparently this info was not good enough for the insurance company and they requested something called ADP Form (Assistive Devices Branch).

So I call the person who I've been dealing with and purchased my machine asking to attain my ADP Form. I waited 1 week after the first call, than I did a follow up call and left another voice mail and waited another 3-4 days, than I made my 3rd call. The persona finally called me back the next day, and was talking about a totally different subject than what I was asking about.. I dont know how they could get that wrong from 3 Voice Mails with clear descriptions of what I was looking for. Anyways, the person tells me that they didnt have the ADP Form and that they have to first fax the from to the Sleep Clinic where I had my study done and the doctor will sign the form and fax it back.

So I wait another week and I get no call and no ADP Form. So I call VitalAire back leaving another voicemail to the person asking what the status is regarding my ADP Form. I wait another week and no call back.

Out of frustration I call the Sleep Clinic and sure enough they have a copy of the ADP form, so I drive there and pick up a copy.

So now I'm looking at this ADP form vs my Receipt and I see a descrepincy the way things are itemized that I'm sure the insurance company will have an issue with.

On my Receipt it shows, Remstar Plus $1450.00 - ADP $780 = Balance of $670 which is what I paid.

on the ADP Form it shows Remstar Plus $1040.00 - Applicant (ME) $260 which is not what I paid.

So there is a discrepancy of $410.

Now I could understand that the $410 could be the price of their services etc.. obviously VitalAire does not work for free... Although I think $410 is too much for simply selling me a piece of equipment and filling out some forms.

I dont like the fact that this $410 is buried in the Price of the Machine and not a separate itemized item.

Tomorrow I submit the forms at work... I'm sure this will be flagged by the insurance company.

Has anyone else experienced this type of thing? Am I wrong to be upset?

[Goofproof]

Would you be any happier, if I told you our host CPAP.com, could have sold you a better machine, for less than you paid on your part out of pocket. It's hard to get a good deal, it takes homework and asking the right questions, and at the time we are at out worst for doing that. Jim

[Paul56]

Has anyone else experienced this type of thing? Am I wrong to be upset?

No, certainly not... as someone at VitalAire has been dragging their heels on your issue.

I live on the Quebec side, so I was not eligible for ADP, but dealt with VitalAire over at their Ottawa, Ontario branch. First I determined what my group insurance would pay... fortunately they would pay 100% of the initial setup. Then I asked the insurance exactly what was required from me when I submitted my claim form... they gave me all the particulars.

When I went in to deal with VitalAire in person to purchase the equipment I told them specifically what the insurance needed... even gave them a copy of the email. I suppose I made it pretty clear that I needed everything that day otherwise I would not be purchasing a machine because they provided everything on the spot.

BTW, it is not the Canadian government who are providing you the purchase assistance but rather the Ontario government under their ADP (Assistive Devices Program). The literature I have on the ADP program suggests that a sleep physician is required to sign the ADP form. If you were referred to the sleep clinic by your family doctor then I would suggest you contact your family doctor who can "grease the wheels" and get you in to see the sleep physician... or at least get the form signed. I would have expected VitalAire to have assisted you with expediting this situation since they stand to gain financially from the sale. Unfortunately, voice mail can be easily ignored by inattentive workers.

[Hawthorne]

You should be unhappy with Vitalaire!

I also live in Ontario and this is not how it should work. Vitalaire should have handled all of the ADP paperwork for you. They should get the necessary paperwork ready and submit it to the Ontario Government. You should then pay the difference (which in you case was way too high) and then you submit the receipt for the difference to your work insurance. By the way, the second figure- $260 is more like it in terms of what your extra insurance shoud pay. That Extra $410 sounds fishy to me. There should not be a hidden fee like that! I called a few months back when I thought I MIGHT get a new prescription ( I didn't get one so couldn't use ADP funding) and got a price on a Remstar Pro ( a more expensive machine than yours that gives data) and Western Pro Health quoted me $1060 ($780 - ADP and $280 which my extended health paln would pay).

The only machine I ever bought using the ADP (which is the Ontario Gov't plan) worked the way I described. I went to the Provider (I used Western Pro Health). They told me what the machine cost (it cost more then -6 years ago)- the prices have come down but NOT MUCH). They did all the paperwork for ADP. I only had to give them my Doctor's prescription (which they copied and gave back to me). I paid the difference and submitted it to my extended health plan. They paid the total difference and it was done.

Fortunately (after a lot of reading on this forum) I had decided last February to buy a machine online. For just about $700 I got a Remsatr Auto with A-Flex AND the software and card reader. Of course that was before the price increase by Remstar and our Canadian dollar was almost at par.

Goofproof is right, though. You probably could have gotten the Remstar Plus that you got for about thew same as the $670 you paid above the ADP.

I would talk to my doctor and check this all out. I would question Vitalaire about that difference in the 2 invoices as well.

[Limestone]

I played the ADP game with Medigas with the same overpriced ,lousy results and moved on to the most wounderful R.R.T. you could imagine at my local Vitalaire.Trouble was she was all about the patient and a hosehead herself and Vitalaire was quick to get rid of her.When I bought my auto I came to CPAP.com, ignored the ADP cashcow that these slimeballs feed on and saved myself and our health care some money,my employee benefits picked up a good chunk of it.
This seems very fishy and if it were me (can you tell i'm very bitter) I'd nail the S.O.B.'s to the wall with the ADP folks.
I'm a couple of hours down the 401 or I'd come by to give you hand.

OOOHHH I feel better now.

[Fredman]

I seem to have bad luck with CPAP Health care providers.

Well first off, if you've read my posts previously, I did get my RemStar C-Flex with Pillow Mask and am very happy with the unit.

Now comes the un-happy part. I've been dealing with the Mississauga Location in Brampton, Ontario, Canada. The Canadian Government Pays $780 as the balance of your machine and I have to pay the rest. In this case I paid $670, which I hope to have paid off with the coverage I have through work.

Analog-X, I am a Canadian too...between my wife's and my work health plans, the total cost of $2,500 for my Respironics Remstar Auto was paid for including hose, humidifier and mask. As I recall the company I went through here also charged some amount administrative/testing fee. I don't have the receipt in front of me. I will look for it and get back to you so that you have a comparison. I have heard complaints aboutVital Aire...my mother, when she passed away had a rental Oxygen Generator and when we had to return the unit they were not helpful and seemed more concerned with getting the last payments and the unit back. Although the RT that she dealt with was excellent, compassionate and always willing to provide advice and assistance.

Now, please do tell me how do you make a claim to the Canadian government? I know some provincial health care plans cover some costs...the only thing I know of is showing a health expense on your Taxes. I didn't have to do that because I was very very fortunate that my wife's plan and mine covered the costs.

[Limestone]

Fredman,
I believe the ADP (Assistive Devices Program ) is only available in Ontario.It is a great plan in helping those that can't afford good equipment ,but gets abused by over inflated prices at the DME's to get the max money out the plan (75% up to$760 or $780 I don't remember the actual amount).Another reason why Ontario tax is so high.

[Hawthorne]

You can't do anything with regard to health care through the Canadian (Federal) Government because health care, in Canada is a Provincial matter.

I agree 100%, Limestone. The ADP program in Ontario is a game and they care nothing for the people who have sleep apnea. We pay for it in our taxes and are told we can get a new machine every 5 years. Just try that! I did and they require a new prescription (will not accept a 6 year old one like cpap.com and other online companies). I jumped through all the hoops for them - referral to a Sleep Specialist, a sleep study (a useless one at that). All this took from last October until August of this year. Then I am told that I will not be given a new prescription. I will only get a new prescription if my old machine is broken and cannot be repaired. All I get is a "note" to the Provider to change my pressure, which (thanks to this forum), I can do myself. It doesn't matter that many new, helpful features are now available on the machines.
The Providers sure want to sell you a new machine but at hugely inflated prices. They, of course, can't even do that without a very recent prescription.
Like you, Limestone, I bought online, with my old prescription and got one of the best machine available for way less than in Ontario, including the reader and software. It's a racket. That 6 year old machine, with no extras except a humidifier, is now an iffy backup. You may have had a new prescription but the game is the same! The patient gets the shaft.

There. I vented too- again!

[trice54]

I also live in Ontario and used VitalAire..maybe the same one (Derry Rd.) ? They did all the filing for the ADP for me. I had a balance (I forget what it was exactly) and submitted it to our private health ins. and they covered it. I am satisfied enough with the machine I got but probably would have gone to other sources (our host probably) had I done more research. The main thing that I kick myself about is the mask. The machine 'came with' a standard (probably low end) mask...it leaked. So I also tried a number of loaner masks from VialAire and thru that process realized I was a mouth breather so needed a FFM. When I settled on one to buy, I got my sleep dr. to write out a prescription for it, thinking that my private ins. would cover it. But they denied it because of the mask that had been included in my 'package deal' with the machine. I called and appealed it, but they wouldn't budge. I bought it anyway, but couldn;t believe that the ins. would not cover it if prescribed. So my grudge is I guess more with them, I guess, but I think that the original mask being included as a package by VitalAire is deceiving. Hindsight, ya know??? Next time........... cpap.com!
Trice

[Fredman]

Warning - In Coming Rant!

At some point these darn Insurance companies have to be taken to task legally! They play god with peoples health and has nothing to do with appropriate treatment and what works for the patient. Let's don't kid ourselves they make tons of money.

Life Insurance, Health, Home and Auto...I don't care they make billions and billions of dollars and quite frankly wheather you are in Canada or the US they whine to regulators that they can't make money. Phooey...who is looking after the consumer? I don't have choice of changing the supplier of my health insurance as that is the choice of my employer.

I guess the best choice is to purchase out of our pocket (save every nickel and dime) and buy what WE NEED.

[Humm]

Boy oh boy!

You people don't know how lucky you are! Good thing you don't live in the US.

This is how I think it should work in Ontario ....

The private insurance companies, the insurance through work etc., should be paying the bulk of the cost and the Ontario government pay the small balance. I am in-fact surprised that it doesn't work this way ... as this is a HUGE expense to the government.

[Fredman]

Boy oh boy!

You people don't know how lucky you are! Good thing you don't live in the US.

This is how I think it should work in Ontario ....

The private insurance companies, the insurance through work etc., should be paying the bulk of the cost and the Ontario government pay the small balance. I am in-fact surprised that it doesn't work this way ... as this is a HUGE expense to the government.

As a tax payer, I would go along with that! The problem with any system, is when folks fall through the cracks...this is where people get excited about who should pay for what....all I know as a hard working consumer of insured and non insured services is that my money is not limitless. Everyone should be entitled to make a profit and I should have choice.

Agreed good point that government health care costs shouldn't burden the tax payer.

[spitintheocean]

Did this thread just get resurrected after an eight month hiatus?

For the record; it's a manager with Ontario's Assisted Devices Program that unapologetically sets all the upset prices. Blame her for the outrageous compensation paid to outfits like Vitalaire.

[Fredman]

Did this thread just get resurrected after an eight month hiatus?

For the record; it's a manager with Ontario's Assisted Devices Program that unapologetically sets all the upset prices. Blame her for the outrageous compensation paid to outfits like Vitalaire.

Ok...so I can blame her for the prices in Alberta too, what about in Texas, Alabama etc....Unfortunately, CPAP pricing seems to be extraordinarily high everywhere.

Ontario is not the only spot in the world where we experience this and issues relating to insurance non insured services.

8 month old thread but important one....

[Paul56]

Holy post resurrection!!!

Someone has been reading WAY back.