Another DME scam?

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jaybee72
Posts: 155
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Location: Atlanta area

Re: Another DME scam?

Post by jaybee72 » Fri Apr 13, 2012 7:51 pm

I spoke with united today, and they said that the DME billed for "outpatient respiratory therapy" which applies to the deductible. They said tha if I'd had them come to my house it would have been covered 100%, but since it was at their office and billed under this code it gets the deductible!

So, I then told united it was a bogus charge, and asked them to pursue it. 5 minutes at most to pull the mask out, stick it over my head, and say nothing really? No machine to fi at pressure. Showed them I brought my data card, but they had no interest in opening it and looking at how it was going. Oh, and keep the large pillows from the mask bag which I assume they'll put to use elsewhere... $150 charge on top of price of supplies?

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Issac
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Re: Another DME scam?

Post by Issac » Sat Apr 14, 2012 9:39 am

another DME scam?...
Shocking!, (not...) They're just trying to set you up with their free samples or make you pay for the inconvenience of (Oh, God forbid ) doing their job, especially if it involves bending over and having to unstrap a mask (oh, how exhausting).

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chunkyfrog
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Re: Another DME scam?

Post by chunkyfrog » Sat Apr 14, 2012 4:11 pm

Jim's drug won't even quote me a price until DELIVERY!

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ems
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Re: Another DME scam?

Post by ems » Sat Apr 14, 2012 4:54 pm

jaybee72 wrote:I spoke with united today, and they said that the DME billed for "outpatient respiratory therapy" which applies to the deductible. They said tha if I'd had them come to my house it would have been covered 100%, but since it was at their office and billed under this code it gets the deductible!

So, I then told united it was a bogus charge, and asked them to pursue it. 5 minutes at most to pull the mask out, stick it over my head, and say nothing really? No machine to fi at pressure. Showed them I brought my data card, but they had no interest in opening it and looking at how it was going. Oh, and keep the large pillows from the mask bag which I assume they'll put to use elsewhere... $150 charge on top of price of supplies?
I would change my DME in a big hurry!

If UHC said this would be applied to your deductible, then you do have a deductible. If you still insist that you don't have a deductible, I'd suggest you call them back. If you don't have a deductible, then they can't possibly apply this amount toward your deductible.

I pay an additional amount every month in order to not have a deductible. Check this out so you can be sure what coverage you have.
If only the folks with sawdust for brains were as sweet and obliging and innocent as The Scarecrow! ~a friend~

jaybee72
Posts: 155
Joined: Fri Aug 31, 2007 6:06 pm
Location: Atlanta area

Re: Another DME scam?

Post by jaybee72 » Sat Apr 14, 2012 8:05 pm

I do have a deductible, however DME and home health care are covered 100% and do not apply to the deductible. So, all my supplies are covered 100% whether ive met my deductible or not. The DME concocted a fitting charge that has a code that does fall under the deductible in this case. If they had actually provided a service I wouldn't be so mad. But, all he did was open the mask, pop it together, and put it on. Never offered to hook it up and fit at pressure, had no machine in room to do so. I showed him I'd brought my card and mentioned lookin at the data, but he had no interest in that. So, I'm ticked off that he had th audacity to charge me $150 for "outpatient respiratory therapy."

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ems
Posts: 2757
Joined: Fri Jul 29, 2011 12:46 am

Re: Another DME scam?

Post by ems » Sat Apr 14, 2012 8:40 pm

jaybee72 wrote:I do have a deductible, however DME and home health care are covered 100% and do not apply to the deductible. So, all my supplies are covered 100% whether ive met my deductible or not. The DME concocted a fitting charge that has a code that does fall under the deductible in this case. If they had actually provided a service I wouldn't be so mad. But, all he did was open the mask, pop it together, and put it on. Never offered to hook it up and fit at pressure, had no machine in room to do so. I showed him I'd brought my card and mentioned lookin at the data, but he had no interest in that. So, I'm ticked off that he had th audacity to charge me $150 for "outpatient respiratory therapy."
I would be ticked off also. As I said in an earlier post, change your DME.
If only the folks with sawdust for brains were as sweet and obliging and innocent as The Scarecrow! ~a friend~

Janknitz
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Re: Another DME scam?

Post by Janknitz » Sat Apr 14, 2012 9:45 pm

I think you should dispute the charge and report it to your insurer's fraud unit. You may lose the dispute, but it will put this DME on notice that they can't play those games. And definitely find another DME if you can.
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Re: Another DME scam?

Post by Guest » Wed May 13, 2015 5:52 am

Filter the size of a postage stamp, plastic hose and mask with no fitting $193.00.