Medicare DME question

[Sonnyboy]

I started CPAP mid November 2014 under the capped bidding program.
My DME partnered with another DME for supplies over 4 months ago.
I have not received a letter from the first DME cancelling their service or my contract with them.

I just received a letter from the second DME instructing me to sign an Acknowledgement and Assignment of Benefits (AOB) form immediately.
In 2 months I own my machine. Should I be concerned this transfer will start the 13 month rental period over?

[LSAT]

I would call the first DME and see what they say...then call Medicare or your Medicare suppliment carrier.

[chunkyfrog]

Who is your DME?

[Sonnyboy]

I would call the first DME and see what they say...then call Medicare or your Medicare suppliment carrier.

I called Medicare this evening and was told to ask the DME and I have placed calls requesting a call back.
I'm just hoping to be a little better informed before I become engaged in conversation with the new or the old DME.

By Medicare supplement carrier do you mean Medigap?

Thank you

[Sonnyboy]

Who is your DME?

DME #1 is N2 Sleep in Pleasanton.
DME #2 is Versus Healthcare.

Neither DME has called me regarding signing a duplicate contract with the new DME, caught be totally by surprise.

[library lady]

My insurance changed for the last two months of my rental period, but my DME did not. There was nothing I needed to sign, and my new insurance paid the last two months. I would think that since your DME partnered with another DME that you will not have to start the rental period over, as all of the records from DME#1 would have transferred to DME#2, including your original contract.

[Janknitz]

Medicare would not pay to start the contract over as it is for the same HCPCS code. You can't get anything under that code again for 5 years. The 2nd DME just wants you to sign the assignment so they get paid instead of #1. Are they threatening you with anything? If not, I'd be inclined to let them collect the Medicare money from #1. If they are business partners then it's their problem not yours. But, they may not provide supplies unless you sign the AOB.

[Sonnyboy]

Hi Library Lady and Janknitz,

Thank you

I guess the problem that I am having is that their AOB contract goes way further than a simple assignment regarding who gets paid for what.
Personally I feel what they want me to sign goes way beyond their scope of practice as an online supplier. I need to call them and find out if I can edit their contract and if not and I refuse to sign, what happens in terms of my machine and supplies.

[Janknitz]

They will tell you that you can't change it. Not true. Particularly if it has an arbitration clause I would not sign it. Just ignore it. I don't think at this point they are going to "repossess" your machine (I believe they can't because you don't have a contract with them!).

If you feel obligated to sign the contract, cross off what you don't agree to anyway, particularly any mandatory arbitration clause. By the time they realize it and try to argue, your capped rental will be done. They cannot deny you medically necessary care for refusing to agree to arbitration. Especially if you already have the equipment. Don't make a big deal of it and they may never notice.