Perhaps a complaint to the Better Business Bureau is in order?? Also, does her state have a Consumer Protection Division in their State Attorney Gemeral's office? In Maryland, they have a subdivision of the Consumer Protection Division for health complaints. I worked there for a bit. We would try to mediate disputes between health care providers and consumers in an informal manner. Now that it has gone to court, they may not be able to help, but it is worth trying.
If she requested a letter from Medicare stating the regulations and/or that she cannot be help responsible in perpetuity, or anything that helped her case, they MAY help her.
I hope I don't have the same scumbag DME.
ABN Question--Is this common?
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MarylandCPAPer
- Posts: 438
- Joined: Fri Jan 15, 2010 1:15 pm
Re: ABN Question--Is this common?
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| Mask: AirFit™ P10 For Her Nasal Pillow CPAP Mask with Headgear |
| Additional Comments: Have also used Opus 360, Swift LT for Her, Optilife, and Breeze Nasal Pillows masks. |
Started CPAP 12/18/09 Pressure 13. Changed to APAP 1/18/10, Pressure 10-16. 4/2014:Switched to AirFit P10 mask. PR System One REMstar Auto Series 550 with A-Flex for 5.5 years. 7/2015 to present: AirSense 10 AutoSet FOR HER. Range: 10-20
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library lady
- Posts: 1116
- Joined: Wed Feb 05, 2014 11:10 am
- Location: Rochester, MN
Re: ABN Question--Is this common?
If anything, all she should have to pay for is the cost of the equipment... not monthly in perpetuity. I did not get an ABN; my DME (Mayo Clinic Rochester) did tell me they bill the equipment over 13 months, I would pay just 20% of the monthly payment each month. I asked "why 13 months?" and was told that Medicare/Insurance doesn't pay the full amount unless you're in compliance within the first 90 days. I was told nothing about having to turn the machine in if compliance wasn't met, and that is the way they set it up... 13 months is Medicare decision, private insurance may be different.
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| Machine: PR System One REMStar 60 Series Auto CPAP Machine |
| Mask: AirFit™ F10 Full Face Mask with Headgear |
| Additional Comments: Sleepyhead |
Now using AirFit F10 mask; Quattro Air is backup mask. RemZzzz mask liners with both.
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Cpappappy
Re: ABN Question--Is this common?
Has nothing to do competitive bid or noncompetitive bid. She needs to file a grievance with Medicare. She now knows that that they had her sign a blanket abn, which is not permitted. She should not be responsible for anything after the first 90 days, unless they had her sigh the abn after day 60. Medicare should make dme refund the monies paid as it fraud.
The guideline is: must meet usage compliance and see physician for face to face visit within first 90 days of usage. If both aren't met, Medicare does not pay after the initial 90 days. Patients are to return equipment, but they don't. This is why Medicare says competitive bid saved them $2 billion dollars......cause dme's can't bill and when they do, they aren't getting paid. Sorry there are more competitive bid areas coming and lower rates.....thanks government.
The guideline is: must meet usage compliance and see physician for face to face visit within first 90 days of usage. If both aren't met, Medicare does not pay after the initial 90 days. Patients are to return equipment, but they don't. This is why Medicare says competitive bid saved them $2 billion dollars......cause dme's can't bill and when they do, they aren't getting paid. Sorry there are more competitive bid areas coming and lower rates.....thanks government.