Apria Healthcare

[Edna]

I want to know if anyone has had to get financial help thru Apria Healthcare for a CPAP machine. How did it work out ?

[DreamDiver]

I want to know if anyone has had to get financial help thru Apria Healthcare for a CPAP machine. How did it work out ?

Edna,
While there are some examples where people have had good experiences with Apria on this forum, I think you'll find that most people have had fairly poor experience with them as a DME and would suggest you avoid them. Consider doing a search on Apria on this forum. I find it hard to think of Apria as giving "financial help" to any client. They are in the business of selling prescription medical equipment, and they sell it at a very high premium, from my own experience. Before you sign anything, get a full financial disclosure of what they will expect you to pay over how many months, including your out of pocket expenses and whatever your increased expenses will be when your deductible renews in January [ itemized by month and in writing ]. Then make a spreadsheet and compare your out of pocket cost with insurance through Apria as your DME with what it would cost to buy the same thing outright from CPAP.com. You may find the difference to be a jaw-dropping experience. Good luck.

[chunkyfrog]

Any financial assistance may come from your insurance, Medicare, or a charitable foundation.
This does NOT describe Apria!

[GTOJim]

I want to know if anyone has had to get financial help thru Apria Healthcare for a CPAP machine. How did it work out ?

Edna,
While there are some examples where people have had good experiences with Apria on this forum, I think you'll find that most people have had fairly poor experience with them as a DME and would suggest you avoid them. Consider doing a search on Apria on this forum. I find it hard to think of Apria as giving "financial help" to any client. They are in the business of selling prescription medical equipment, and they sell it at a very high premium, from my own experience. Before you sign anything, get a full financial disclosure of what they will expect you to pay over how many months, including your out of pocket expenses and whatever your increased expenses will be when your deductible renews in January. Then make a spreadsheet and compare your out of pocket cost with insurance through Apria as your DME with what it would cost to buy the same thing outright from CPAP.com. You may find the difference to be a jaw-dropping experience. Good luck.

I tried going the financial disclosure route, it was worse than buying a new car, I was exhausted when I left, process took hours.
I was quoted a bit over $800 as the total cost, of which my responsibility was 50%. To make a very long story short my insurance started started approving what they called modifiers submitted by Apria approximately 6 months after my machine was paid off. Total cost ended up north of $2,000 of which I was responsible for 50%, machine was an S9 auto.

[Janknitz]

GTO Jim, I'm a little confused by the terminology here, so please bear with me.

Edna was talking about "financial help" through Apria. Is there such a thing?

You spoke of "financial disclosure". Does that mean that the offered you a break in price, dependent upon your financial situation? Did you have to give them financial info as you would to a charity or governmental agency if applying for financial help?? Was Apria itself going to help you, or were they just going to submit an application to Medicaid (Medi-Cal in California) on your behalf???

Then you said that your insurance company started approving "modifiers submitted by Apria". I don't know what that means, could you explain?

What it sounds like (and because I'm not understanding everything I could be very wrong), is that Apria practiced "balanced billing" after your insurer paid. The fact that this all happened 6 months after your insurer paid for the machine makes it sound even more like balanced billing.

In other words, you were told it would be 50% of the insured amount of $800, but after your insurer paid its 50% of $800, then Apria billed you for the difference between it's full price and your insurers covered amount. This is called "balanced billing" and in most states it is ILLEGAL. Even if it's not illegal in your state, it may still be a violation of the contract between your insurer and Apria. I'd call your insurance fraud department and ask them to review this matter. Some insurers allow DME's to charge the full difference but most do NOT, so it's worth checking out. Also, if the insurer allowed that, the DME should have informed you in writing what the difference was BEFORE you received the machine. Something smells very rotten here.

[DreamDiver]

I tried going the financial disclosure route, it was worse than buying a new car, I was exhausted when I left, process took hours.
I was quoted a bit over $800 as the total cost, of which my responsibility was 50%. To make a very long story short my insurance started started approving what they called modifiers submitted by Apria approximately 6 months after my machine was paid off. Total cost ended up north of $2,000 of which I was responsible for 50%, machine was an S9 auto.

So Apria lied in writing about how much you would be required to pay and how much the insurance would have to pay. Why am I not surprised?

[LSAT]

I tried going the financial disclosure route, it was worse than buying a new car, I was exhausted when I left, process took hours.
I was quoted a bit over $800 as the total cost, of which my responsibility was 50%. To make a very long story short my insurance started started approving what they called modifiers submitted by Apria approximately 6 months after my machine was paid off. Total cost ended up north of $2,000 of which I was responsible for 50%, machine was an S9 auto.

So Apria lied in writing about how much you would be required to pay and how much the insurance would have to pay. Why am I not surprised?

Where do you see that DD????

[DreamDiver]

I tried going the financial disclosure route, it was worse than buying a new car, I was exhausted when I left, process took hours.
I was quoted a bit over $800 as the total cost, of which my responsibility was 50%. To make a very long story short my insurance started started approving what they called modifiers submitted by Apria approximately 6 months after my machine was paid off. Total cost ended up north of $2,000 of which I was responsible for 50%, machine was an S9 auto.

So Apria lied in writing about how much you would be required to pay and how much the insurance would have to pay. Why am I not surprised?

Where do you see that DD????

They added "modifiers" six months after the machine was paid off, more than doubling their original $800 estimate for total cost to $2000, of which GTOJim paid $1000 instead of $400 in their original quote. Is my math wrong?

[LSAT]

I tried going the financial disclosure route, it was worse than buying a new car, I was exhausted when I left, process took hours.
I was quoted a bit over $800 as the total cost, of which my responsibility was 50%. To make a very long story short my insurance started started approving what they called modifiers submitted by Apria approximately 6 months after my machine was paid off. Total cost ended up north of $2,000 of which I was responsible for 50%, machine was an S9 auto.

So Apria lied in writing about how much you would be required to pay and how much the insurance would have to pay. Why am I not surprised?

Where do you see that DD????

They added "modifiers" six months after the machine was paid off, more than doubling their original $800 estimate for total cost to $2000, of which GTOJim paid $1000 instead of $400 in their original quote. Is my math wrong?

Where to you see that Apria put the estimate...in writing??

[DreamDiver]

Where to you see that Apria put the estimate...in writing??

In terms of this thread, I suggested that "full financial disclosure" means "what they will expect you to pay over how many months, including your out of pocket expenses and whatever your increased expenses will be when your deductible renews in January."

To my mind, this is an itemized list, including monthly costs to insurance, out of pocket costs, etc. At least in my mind, an itemized quote like this should be in writing. Full financial disclosure hardly means a nebulous sum and a handshake. I don't think that would go over well in a board meeting of any company or its shareholders. Either GTOJim got a nebulous sum and a handshake or the written disclosure. Perhaps I wrongly assumed that GTOJim's idea of financial disclosure and my idea of financial disclosure are the same. We can only ask GTOJim to confirm or deny that the financial disclosure for which he waited hours in their office was written or verbal. If he didn't receive a full written disclosure, then I am wrong and I formally and contritely retract "written" from my statement. If he did receive a written quote, then Apria and/or its employee lied in writing, and not just in the spirit of truthful communication.

I know for absolute certain that Apria has charged my health insurance for a mask package, but at the individual mask parts price. The DME rep handed me the wrong printout to sign - the one with their costs and their charges to the health insurance. I knew the actual price of the mask was less than the mask when bought as parts and knew that they were ripping off my insurance company. And they didn't include all the extra parts that came with my mask, but charged me for them anyway. And they knew I knew. I have to wonder if that's standard practice, since they whisked away that form fairly quickly, red-faced, and printed out a more simplified form with just the stuff they wanted me to see. I felt like I'd been violated as I left. I also ended up paying twice as much for my first CPAP machine as they said I would out of pocket.

[Janknitz]

Yes, parting out the mask is standard practice among most, if not all DMEs. Your tax/insurance dollars at work.

That's why I asked Edna and Jim for clarifications. We're all jumping to conclusions but we may not be understanding what, Exactly, they are saying.

[GTOJim]

Yes, parting out the mask is standard practice among most, if not all DMEs. Your tax/insurance dollars at work.

That's why I asked Edna and Jim for clarifications. We're all jumping to conclusions but we may not be understanding what, Exactly, they are saying.

I'm really sorry for creating some confusion over my post. I wasn't asking for financial assistance, I was merely attempting to get from Apria the total cost of the machine to determine my out of pocket cost for the S9. My request took hours and finally got the price on a handwritten scrap of paper from the branch manager. I attempted to pay my 50% copay at that time but Apria would not allow it, stating I had to make monthly payments over a period of 4 months. Apria actually billed a higher amount than quoted for three months, total cost for the S9 roughly $10 over quoted price. I didn't sweat the $10, considered it close enough.

As I posted above, six months later Apria started submitting what my insurance called modifiers over several months which my insurance kept approving until the total cost was $2,000 for the S9. The Apria branch manager wouldn't help, stating she has nothing to do with billing. Attempts to get the total contracted price for the S9 from my insurance were unsuccessful.

Sorry I wanted to keep this a short story. During this time period Apria made a bunch of billing errors, always in their favor, I spent more hours on the phone than I could count. Finally after contacting a top executive of my health insurance company Apria contacted me and agreed to reduce my portion to the originally agreed upon price I had in writing from the branch manager, so I did not end up paying the full $1000 for my 50% portion of my copay. Apparently my insurance company paid their 50% portion of the $2000 and I was told Apria would not bill my insurance for anymore money for my S9. Sorry wasn't attempting to miss lead anyone, just attempted to shorten a long story.

During this process I contacted Apria head office several times. Each and every time I was told someone from upper management would contact me, they take all complaints very seriously. Every time the the call was returned by someone in India who had no authority. This happened about 3 years ago and fortunately I'm no longer forced to use Apria as my DME.

[pootsie]

A pillow story ...

Apria is my DME. I was due for a new pillow for my Swift FX on the 30-day renewal.
I also joined in the great pillow exchange, since I have sizes I don't use from my original package.

Apria:
Contacted them June 20 and they had my address on June 20, and I received the pillow (after another call) on July 8.

Pillow Exchange:
Contacted member on June 27, gave the member my address on June 28, and received the pillow on July 10.

It took one week less on the pillow exchange.

The real kicker is, the Apria office is within 5 miles of my house, while the member I dealt with on the exchange lives on another continent.

[GTOJim]

A pillow story ...

Apria is my DME. I was due for a new pillow for my Swift FX on the 30-day renewal.
I also joined in the great pillow exchange, since I have sizes I don't use from my original package.

Apria:
Contacted them June 20 and they had my address on June 20, and I received the pillow (after another call) on July 8.

Pillow Exchange:
Contacted member on June 27, gave the member my address on June 28, and received the pillow on July 10.

It took one week less on the pillow exchange.

The real kicker is, the Apria office is within 5 miles of my house, while the member I dealt with on the exchange lives on another continent.

In the 8 years I used Apria the norm was 3 weeks from when I placed the order until it was delivered. My wife's orders from Apria would take about a week. We had the same health insurance. Our orders were shipped from a warehouse in another city, not from the local branch.

[Sir Dave]

Wow, it must a regional pot-luck in getting a bad experience.
I've been using Apria for 3+ years. Billed consistently on my 10%, no billing errors.
I've never had a mask or pillow replacement take longer than 5 business days to arrive.
Just saying......