Carecentrix/Apria

[Sundog]

I am new to this. I was diagnosed with obstructive sleep apnea a few weeks ago. I have been reading a lot on sleep apnea and CPAP since then. I did a titration study last week. They said I need to get a CPAP.

I’m somewhat anxious about having to use CPAP, but I’m having more anxiety over the process of getting the equipment.

The instructions they gave me at the end of the sleep study said to call my insurance company and get the name of their DME and call them back. My insurance is Cigna. They said the DME is Carecentrix and transferred me to them. They gave me their fax number and what information they need from the doctor.

I called back to the hospital sleep center at the phone number that was on the sheet they gave me and told the woman the DME is Carecentrix. She said she had never heard of them and that people usually go through an online place.

I called back Carecentix last week to see if they got the fax. At first they said they didn’t, but then said they did and I waited while the woman put the information into the computer.

She told me I would be getting a call from their supplier, Apria. Even with just my little bit of reading I have come across horror stories about Apria. I asked her if I could go through someone else, just some online place. She said Apria is their preferred supplier so I have to go through them first. I am not sure what “first” means. She said the “start date” would be November 9. I said the sooner the better.

I’m overwhelmed with everything to learn about sleep apnea and CPAP, and now trying to learn even more about the business of insurance and suppliers and whatever the heck Carecentrix is. When I got a nebulizer and oxygen concentrator the doctor just set everything up through my local pharmacy and someone showed up with the equipment and no problems.

I’m worried that I am going to get the run around or the wrong equipment or get ripped off.

I’ve read the article at https://maskarrayed.wordpress.com/what- ... me-part-i/ but I am still confused.

The nearest Apria location is over 80 miles away and I have no car. Will somebody show up at my house? Can I pick which machine and mask I want? How do I know if I am being charged fairly?

I’m confused and worried.

[Janknitz]

Carecentrix is a middleman that brokers the deal with Crapria to save your insurer money (I still don't get how paying a broker helps save money). Crapria will probably drop ship the items to you, or perhaps send someone to your home with the initial set up to "teach" you how to clean and use the machine. You will probably get a dataless CPAP unless your prescription says otherwise.

So you need to get a copy of your prescription in your hands.

Then call your insurer to ask what your coverage is (outlined in my Maskarrayed blog). You need to know if they cover:
Any E0601 machine or only specific models
Purchase or rental
Capped rental or perpetual rental
Deductibles
Co-pays
Replacement schedule.
Mask replacement.

BEFORE you allow Crapria to supply anything, calculate your out of pocket costs. Don't forget that you will have a new deductible to meet beginning January 1.

Choose what machine YOU want to sleep with for the next five years (NOTE machines on my blog are out of date). What will it cost with insurance? WhAt will it cost without? Does it really make sense financially to use insurance for this? Then you may be stuck with Crapria. Don't forget to factor in the aggravation they will cause you.

[SewTired]

Pick the machine(s) you want now and ask your doctor to have that machine specifically listed on your prescription and have them send the update to the provider. I personally think everybody should get an auto machine unless they know that a single pressure works better for them (no way to know until you've tried) or there is a medical reason (fragile blood pressure or some heart condition). As mentioned, this is the machine you will have for at least the next 5 years. You may have to wait longer to get that machine as your local office may not stock it.

Any of these machines would work fine (and work with sleepyhead): Respironics 560 series Auto, Dreamstation Auto, Resmed 9 autoset, Airsense Autoset, Airsense Autoset for Her.

[JimW159]

To all the good advise already given, I might offer the following:
1) Always keep in mind YOU are the one who suffers if things go sideways - be as assertive as you can be.
2) Find out from your insurance if Carecentrix is the only path to getting your equipment - you may find an alternative in your policy - read it.
3) If Carecentrix is it, refer them back to their initial statement that Apria is THEIR preferred - ask them "what if it is not MY preferred?" - be prepared to challenge them to arm wrestling if necessary. If they ask why it is not your preferred, refer them to Apria's horrible reputation among the cpap user community.
Failing all this, your first step - even before calling the insurance - should be to contact your doctor as suggested by SewTired and get the most specific prescription you possibly can. If you go to cpap.com's prescription form https://a0fa1b452dd65abe2907-3115b881cb ... on-LMN.pdf you will find salient points to cover with your doc. If you are in control of the specifications in a transaction, you are in control of the transaction - take control.
There is a lot of good advice, information, and experience on this forum; as you have already started doing, gather your resources and be prepared to stand up for yourself.

[chunkyfrog]

Stick around, read much, and learn whatever they forget to tell you.
My dentist was not told about changing filters on his AirCurve Bipap.

[Janknitz]

Any of these machines would work fine (and work with sleepyhead): Respironics 560 series Auto, Dreamstation Auto, Resmed 9 autoset, Airsense Autoset, Airsense Autoset for Her.

Resmed 9 autosets are still around, but the Airsense Autosets by Resmed are newer.

[Sheriff Buford]

I have been dealing with Care Centrix and Crapria since 2010, I initially dealt with Praxair, but Crapria bought them out. I have a Cigna HMO. Anyway, Care Centrix handles the medical equipment for Cigna. They are not the DME. Let Apria (Crapria) deal with Care Centrix, unless they start to say you have or have not benefits you know you are due. Previous threads make excellent points.
- Be sure your doctor writes the specific machine YOU want. Crapria will try to dump a brick to you.
- I don't have any deductibles, but Crapria always ask for a credit card number. NEVER (did I say NEVER?? ) give them a credit card number, unless you have to. I don't know if you have deductibles or not. When they ask me for a credit card number... I just laugh and laugh ...
- They'll probably get someone to come by and drop the machine off and set it up for you. Look the machine over and make sure it's the right model. I ordered my third machine from them. It was suppose to be a Bipap, and they were trying to pass off the S9 Autoset. Great machine, but it was not what I ordered.
- YOU choose what mask YOU want. They always try to dictate what mask they want me to have, not the one I want.

Keep us updated, we'll help you. This is a BIg Adventure for you. We will help you along the way.

Sheriff

[Guest]

- I don't have any deductibles, but Crapria always ask for a credit card number. NEVER (did I say NEVER?? ) give them a credit card number, unless you have to. I don't know if you have deductibles or not.

To expand on the excellent points made by the Sherrif...
Do NOT give Apria a credit card for any reason, period.
Tell them you don't have a credit card.
Or if they are stubborn get and give them a pre-paid debit card with say 25$ on it.
Once they double bill or over bill you you may never see the refund they are promising you.
So if you have already given your credit card to Apria the only way out of it is to report the card lost BEFORE they charge on it.
I guess you could dispute charges with the CC Company, I don't have much faith in that.
Then never, ever make that mistake again.
Do NOT give Apria a credit card for any reason, period.

[JimW159]

Be sure your doctor writes the specific machine YOU want. Crapria will try to dump a brick to you. They'll probably get someone to come by and drop the machine off and set it up for you. Look the machine over and make sure it's the right model.

To expand on the Sheriff's good advise I would suggest you ask them to first detail the specific machine they will be bringing. Ask for the specific brand, model name, model numbers, all details that will help you later. Then ask if you can get back to them to set an appointment because you have to clear your schedule. In that time research the information you were given to make sure of what to expect. As I said earlier in this thread: "If you are in control of the specifications in a transaction, you are in control of the transaction - take control."

[chunkyfrog]

I foolishly gave them my debit card number.
Fortune smiled on me--I had shopped at Target during the time their system was compromised,
and my credit union issued me a new card at no charge.
Apria never had an excuse to try my card until THEY messed up.
According to Medicare protocols, they were legally obligated to eat their mistake.

When they demanded a valid card number, I changed to another DME.

[JimW159]

...gave them my debit card number.

This is a general comment, not specifically to chunkyfrog, I only referenced her situation as an example: Where possible, NEVER use a debit card in a transaction unless you want cash back; even then make the transaction small. This is particularly true in transactions where the chances of error and returns are common such as online. This is because debit cards offer none of the protections required of credit cards. It is virtually impossible to challenge a debit from your bank account unless you can prove theft or fraud; even then, it is all on you to prove, the bank will typically do nothing.

[palerider]

https://www.mastercard.us/en-us/consume ... ndard.html
https://www.mastercard.us/en-us/about-m ... tions.html
https://usa.visa.com/support/consumer/debit-cards.html
https://www.visa.com/chip/personal/secu ... bility.jsp

[JimW159]

https://www.mastercard.us/en-us/consume ... ndard.html
https://www.mastercard.us/en-us/about-m ... tions.html
https://usa.visa.com/support/consumer/debit-cards.html
https://www.visa.com/chip/personal/secu ... bility.jsp

Thanks to PR for continuing my education. I must have been operating on old tapes. It seems that the MC and Visa branded debit cards have changed.

[palerider]

Thanks to PR for continuing my education. I must have been operating on old tapes. It seems that the MC and Visa branded debit cards have changed.

they have indeed, much less dangerous to your funds than they used to be

[klv329]

Here's a backup 2014 resmed s9 autoset for $50 in grand rapids, mi....not sure if the seller will ship. It is a month old ad though.

https://offerupnow.com/item/detail/1633 ... ap-machine