Yay! My ASV is finally covered!

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
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Mr Bill
Posts: 532
Joined: Fri Feb 18, 2011 11:56 pm
Location: Grand Junction, CO

Yay! My ASV is finally covered!

Post by Mr Bill » Tue Sep 27, 2011 11:00 pm

My DME is finally resolving the cost of my ASV! They had originally told me that my insurance would only cover renting the unit and that my cost would be $121/month.
Here is my first post...
viewtopic.php?f=1&t=48330&p=568572#p568572

On 6/22/11 I just learned my DME was "renting" me this unit assuming my insurance was covering 70%. Heck no says my insurance and now I find the true "rental cost" is $467/month! I called my insurance provider and noted that I had nearly met my $5000 deductible in 2010 when they decided to "rent" my ASV presumably to avoid paying for it. They said "we would never do that" and told me to tell my DME to re submit the entire cost as of the day I got my ASV in 2010. So, now it should be mostly paid for. Yippie! I certainly cannot afford $467 a month for the ASV, $100 a month for my asthma and blood pressure RX, and $320 (now $450 since turning 55!) a month for my insurance!

So, I got this resolved a couple days ago. The DME main office called to talk with me about how we could resolve this by paying the balance of the ~$4000 (down from the $8750 rental cost) they wanted for the unit. I had written them a letter detailing this whole story. The rep suggested that it was unlikely my insurance provider would be willing to change the original billing designation. I suggested, 'humor me and try calling them and asking'. So, he did and then he called back a few minutes later to say that my insurance carrier indeed told him to re-bill the entire cost as of the time I got the unit last year. So, it looks like this is finally sorted and in a good way. Yippie!
EPAP min=6, EPAP max=15, PS min=3, PS max=12, Max Pressure=30, Backup Rate=8 bpm, Flex=0, Rise Time=1,
90% EPAP=7.0, Avg PS=4.0, Avg bpm 18.3, Avg Min vent 9.2 Lpm, Avg CA/OA/H/AHI = 0.1/0.1/2.1/2.3 ... updated 02/17/12

moresleep
Posts: 371
Joined: Sun Jul 24, 2011 12:14 am

Re: Yay! My ASV is finally covered!

Post by moresleep » Tue Sep 27, 2011 11:11 pm

Congratulations on your victory with the insurance! I hope the AutoSV works out for you. It's a good machine. Mind you, something is wrong when a Cpap machine costs as much as a small car, but this one is almost worth it.

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Paper_Nanny
Posts: 430
Joined: Fri Apr 15, 2011 3:52 pm
Location: Southern Oregon

Re: Yay! My ASV is finally covered!

Post by Paper_Nanny » Tue Sep 27, 2011 11:18 pm

Mr Bill wrote:Yippie!
Yippie, indeed!! I am so happy for you to have gotten that all taken care of, Mr Bill!!

Deborah

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Mask: FitLife Total Face CPAP Mask with Headgear
Humidifier: DreamStation Heated Humidifier
Additional Comments: DreamSTation DSX500
PR System One BiPAP Auto SV Advanced

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Kody
Posts: 336
Joined: Mon Sep 05, 2011 5:18 pm
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Re: Yay! My ASV is finally covered!

Post by Kody » Wed Sep 28, 2011 12:13 am

Glad to hear it worked out for you Mr Bill. I am still new to this and we have the same machine. I also have to rent mine mine for $78.00 a month and the insurance is paying the rest. When I asked them why they told me it's way too expensive machine costing like 10 grand! Then I look it up on the internet and it looks more like half that, so I really got confused. Thought if I have to use this thing for years to come wouldn't it just be cheaper to buy it in the long run? However I was SO tired and brain fogged, I just wanted to take it home plug it in and get some sleep, figure the rest out later.

So Mr Bill in your case it's kind of a rent to own deal and your actually going to be owning the ASV and no longer renting it?
Complex Sleep Apnea

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LittleRedTruck
Posts: 183
Joined: Wed Feb 22, 2006 9:19 am

Re: Yay! My ASV is finally covered!

Post by LittleRedTruck » Wed Sep 28, 2011 4:39 am

Congratulations ! Im so glad you got it worked out to your benefit. I'm going thru the process now with Medicare for a Resmed S9 ASV. My Dme is billing them $750 a month rental. I know they will pay less if its approved. However, its still being processed, so Im sweating it out. Im sure happy for you !

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Mask: Swift™ FX Nasal Pillow CPAP Mask with Headgear
Humidifier: S9™ Series H5i™ Heated Humidifier with Climate Control
Additional Comments: S9 Vpap Adapt SV