Lincare "Ethics" (irony in quotes)

[caffeinatedcfo]

So I bet many of you will be shocked at this scum-bag billing practice by Lincare. Of course I will not be paying any more than the S9 rent that they quoted me at delivery. I'll be certain to let CDPHP know that they only charged me $34.11 when I bought a cushion out of pocket.

[LSAT]

IMO...The problem is with the allowable amount by your insurance. It doesn't matter what Lincare charges....they get paid the allowable amount regardless.

[ekubaskie]

Your insurance will send you an EOB (Explanation of Benefits) that lists similar numbers. The difference is that the EOB lists what the insurance company's contract with Lincare legally requires you to pay. Send them a check for the amount the EOB says you owe (less anything you may have already paid) and that is IT.

Now LOTS of providers play a game with this stuff. They send out a bill for the difference between what they billed insurance and what insurance paid. Patients often just send in a check for that, and the provider laughs all the way to the bank. If the patient calls them and says that their EOB says less is owed, they'll just say, "Oh, we're sorry. Our error!" and take the EOB amount as payment in full.

This isn't done just in the sleep biz, but by doctor's offices all over the spectrum. Caveat emptor, eh?

[Pugsy]

Is your co pay for your insurance 50%?
Looks like it from the bill.
It doesn't matter what pie in the sky amount a DME bills if they are under contract with a certain insurance company they have to be happy with what the insurance company says they should be happy with. Insurance has a set allowable amount and any co pays required are based on the allowable amount and not the pie in the sky amount billed.

They could bill $500 for a filter...but they have to be happy with the allowed 3.98...with half coming from insurance company and half coming from the patient in the form of co pay (if yours is 50%). The other 496.02 gets written off.

[RogerSC]

Yes, my DME billed my former insurance company $80 for a single Swift FX nasal pillow. The insurance company paid somewhere around $20 (don't recall the exact amount). Just crazy. I don't know what the DME's get out of the ridiculous billing games that they play, but there must be something that they get from doing that...seems to me that it makes the business look really bad, if you're billing 4 times what you actually get. Maybe that's the game, they're allowed to write off the difference between billed and received as a loss on their taxes?

[Denial Dave]

Those prices are in some case pretty close to out of pocket costs you would have paid via the on line sellers like Cpap.com or 1800cpap .....

If you bought that Quattro FFM from cpap.com, the price would be $176. The paperwork shows that your insurance allowed a charge of 163.72.

When you consider that there is the DME & an insurance company in the middle of the process. The prices on your sheet are'nt all that bad.

[caffeinatedcfo]

Yes my co-pay is 50%. HOWEVER, my Lincare rep told me that I would ONLY pay $173.11 the first three mos while renting the machine, then the 50% balance if I decided to buy this machine. I also know they are over-charging for the mask by breaking it down into components and even those are inflated as I purchased a cushion out of pocket for just $34.11!

I know medical billing and this is just wrong - at least according to Medicare regs.

[caffeinatedcfo]

Just spoke with my insurance co. They just received the bill so it hasn't even been processed. Definately questionable that Lincare would bill a client BEFORE the insurance EOB was received.

I am beginning to form a negative opinion regarding Lincare.

[memapenguin]

Lincare was the company that came and picked up my machine when I lost my Medicaid coverage, found out I lost my coverage that morning they picked the machine up that afternoon. I had supplies in the process of being mailed when this occurred so I refused to accept the package when it arrived so I would not be personally charged(per my DME at Lincare). I called the DME and confirmed that she had had received the package back and the I would not be charged. Last week I received a bill from Lincare for the supplies that I had refused as well as a full months rental for the machine and humidifier (I was only 2 days into that months billing period). The total bill was over $500. Today I received a notice from them stating if they did not have payment in full by Fri May 3rd they were turning my account over to collections (wow a whole week after sending the bill). I just got off the phone with the manger, who I informed not only was I not going to pay her for supplies that I refused to accept delivery on, but that I also thought it was outrageous that they billed me for a entire months rental fee when technically I only had the machine 2 days that I could be held responsible for paying because Medicaid had paid for it previously.I am now waiting for her return call as she is supposedly resolving the issue with the billing department. Needless to say this company will never have my business if I have any say in the matter.

[Pugsy]

I think now you know why some of us refer to LinCare as "LinDoesn'tCare" or "LinIDon'tCare".
I am sure that there are probably some goods ones out there but there's a reason that I choose to drive 12 miles instead of using the local LinCare office closest to my home. They got fired for several reasons before I ever got one item from them...we never even got to the billing nightmare.

[caffeinatedcfo]

Yep. I will never buy from them once the machine is mine. I certainly will not re-order from them. I gave them the benefit of the doubt as they appeared decent in the beginning.

Do many of you use cpap.com?

[Pugsy]

I use cpap.com whenever possible.
I have been known to use EBay when I spot a kick butt deal for something I might need. I once got 4 Swift FX nasal pillows in my size (brand new in totally sealed ResMed original packaging..not just the ziplock bag) for $25 and that included shipping. My co pay with the DME that I do use for mask supplies costs me more than that plus the gas to drive over there.
Got a brand new short hose for the Swift FX for $29 with a nasal pillow included...I sat on that auction and bid at the last 15 seconds to steal that one. Again sealed in original package. Those killer deals are rare though. Got lucky with that one.
The short hose is the most expensive part. Fortunately they are pretty much indestructible with common sense care so no real need to stockpile a bunch of them.
With my insurance I could only get the whole mask once every 6 months. I was giving away a Swift FX more often than I was able to use my insurance to keep me in stock.

Now with the Tap Pap...don't know if my DME is going to carry it. If not, I will use cpap.com for Tap Pap supplies. Already purchased 2 extra nasal pillows in my size. My insurance won't pay...I don't care though. I like it well enough that it is worth it to me. It isn't going to be a high maintenance mask anyway. Coming on 2 months with same nasal pillows and they are showing no signs of getting tired yet.

[jencat824]

Ya'll are making me verryyyyy thankful I have great ins. I'll pray for all of you - the medical system as far as billing is sooooo screwed up. It's really up to us, the consumer to choose wisely the stuff our ins pays for. If everyone was as careful as many patients are, then maybe the system wouldn't be so broken.

Jen

[caffeinatedcfo]

This gets even better. I received ANOTHER bill today from Lincare for rent from 3/27-4/1, plus another mask, cushion, and headgear - the ones they said were free of charge when i picked them up! The rep that fitted me also said the masks were completely covered for the first month and I could swap them for free. Tomorrow's lunch hour will be spent running them over with a bus. This is from their corporate website and is the biggest joke I've ever seen:

"Lincare's Business Integrity and Ethics
Governing Principle
The fundamental principle governing Corporate actions and the actions of employees and officers is that ethics and business are inseparable at LINCARE, that no business objective can be achieved without following the highest ethical standards and complying with all the local and national laws and regulations that pertain to our operations."

[RandyJ]

I use cpap.com for most supplies. My insurance decided it wasn't going to cover 'A' codes (masks, mask parts, etc) but even if they did there wouldn't be a big difference in my out of pocket.