my insurance was billed over 3000.oo and now I am being bill

bratt122 · Post by **bratt122** » Tue Mar 15, 2005 8:38 am

I was wondering if anyone is having the same problem I a. My insurance was billed over 3000'.. dollars and now I am being billed four hundred plus dollars. I was wondering if anyone else had or has this problem and if so what to do about it. The machine total with all accessories online is only about 700.oo dollars and change.what should I do. The machine really works well.

Guest · Post by **Guest** » Tue Mar 15, 2005 9:12 am

bratt122 wrote: I was wondering if anyone is having the same problem I a. My insurance was billed over 3000'.. dollars and now I am being billed four hundred plus dollars. I was wondering if anyone else had or has this problem and if so what to do about it. The machine total with all accessories online is only about 700.oo dollars and change.what should I do. The machine really works well.

More then likely your share of the cost, or deductable.

What machine is it?

Guest · Post by **Guest** » Tue Mar 15, 2005 9:25 am

What kind of insurance do you have? Is it an HMO, PPO, or major med? Be sure to check with your insurance company to see if you are liable for the deductible. A couple of years ago, we had Texas Aetna HMO and my son had to have some diagnostic testing done in the hospital. I received a statement from the hospital showing that insurance had paid all but $700 of the total bill. I called the hospital and they said that was the amount I owed. I didn't think that was right because my insurance was supposed to pay 100% of the bill as long as I went to a member hospital which I did. I called the insurance company the next day and they told me that I was not responsible for the overage the hospital charged. They said they contracted with hospitals and other medical providers to pay a certain amount and the patient was not resposible for anything over that amount and definitely not to pay it. I called the hospital again and they backed off. Check with your insurance. Sometimes I think doctors and hospitals just try to make an extra buck on unsuspecting people.

Guest · Post by **Guest** » Tue Mar 15, 2005 2:15 pm

insurance paid a total of 5296.64 I am being billed 413.08 i don't understand why but now I know why health insurance is so expensive in Florida and probably all over.Aetna HMO. I am so angry about this is this a scam or is this really allowed to happen?

Zees Pleez · Post by **Zees Pleez** » Tue Mar 15, 2005 3:14 pm

Does that amount include charges for sleep lab?

Get the detail from you insurer abot what was billed, what was paid and why there is a gap. If they just pay a percentage, then you owe. But if the bill was "more than customary" and you used a preferred/contracted provider, they should not bill you.

Disclaimer:

Please note that I am not a lawyer, but I sometimes play one the Internet.

Additional disclaimer:

Did not!

chrisp · Post by **chrisp** » Tue Mar 15, 2005 6:32 pm

WOW, Unfortunately we see posts like this at least once a month., Too bad you found this forum after you found your DME.

I'll say it again for the new guys. Often you are money ahead by purchasing from cpap.com . Pay cash out of pocket and know that you have saved yourself and your insurance and the rest of us that pay for insurance some money. Very often you will pay less ! Not to mention you will get state of the art equipment that you choose not what your DME can make the most profit on. You know the price up front with the click of your mouse.

Not to mention the heartache caused by those Evil DMEs

You probably could have purchased a fine auto system for under $1000 !

Sorry to hear you (and us who pay for insurance) got ripped off. (Again)

Cheers,

Chris

nodding off · Post by **nodding off** » Tue Mar 15, 2005 7:49 pm

Were you perhaps dealing with LinCare? They were going to charge $2,050 for my ResMed Spirit (w/o humidifier they had already sold me). After they hit my limit (1500 per yr less the humidifier and mask) I was responsible for the rest. It would have been cheaper for me to just buy the machine!!

rock and roll · Post by **rock and roll** » Tue Mar 15, 2005 9:16 pm

Guess what, tell them you don't want it and if they don't waive your deductable come get it. They will waive it if you stand firm. I had this happen to me and I let them know I am on to their overbilling anf I know the true cost and they can come get it and I would buy on line. They gave in and waived my fee. Try it.

Janelle · Post by **Janelle** » Wed Mar 16, 2005 2:41 am

Look at you Explanation of Benefits from your insurance company when you get it. Especially check the line where it says "YOU OWE". If it says Zero, then you make a copy and send it to the DME with that highlighted. I've had this happen a few times, and once they receive that they quite harassing you. Or whatever amount it says.

my insurance was billed over 3000.oo and now I am being bill

my insurance was billed over 3000.oo and now I am being bill

Re: my insurance was billed over 3000.oo and now I am being

insurance paid over 3000.00 for HC220CL