Insurance and DME Charges - What's the Process/Scheme

(Moved after accidentally posting on another thread. Thanks for the replies at that location.)

After cruising along for nearly 6 months with insurance seemingly paying, I've found that I may be being taken for a a nasty ride. Let's see if this is regular process for new users (January 06):

-- monthly rental of CPAP unit and separate rental of humidfier,

-- after X months the DME charges for purchase of the unit(s),

(here's where it starts getting weird)

-- the insurance company adds up the rental charges to see if the purchase price equivalent has been met, and if it has, the purchase claim is denied.

-- the DME claims the one set of costs is rental the other is purchase and a circular argument is created with me owing (or maybe not owing) an unaffordable sum and, in the event the insurance co. acquiesces, my deductable that is met for this insurance year rolls back to unmet on July 1. Hmm seems like lose-lose for Chris.

?? Any suggested actions?

?? Is it advisable to think about turning the "rental" unit back to the DME; using the original (or new) perscription to purchase the same (or different) unit online for much, much less; then fighting the insurance over reimbursment. It seems there may be an economy even if the insurance paid at its non-preferred provider rate. Of course any rates become somewhat moot in 8 days with renewed deductable. Back to lose-lose and no vacation trying to pay for essential medical equipment.

Snoozing Gonzo wrote:(Moved after accidentally posting on another thread. Thanks for the replies at that location.)

Chris,

Your other post of this subject WAS a new post to begin with. It was not a post to another thread.

Den

I'm not sure I follow all of your posting, but maybe you've hit upon a solution in your last paragraph. cpap.com is fast and has great prices, and could put through an order for a machine before your deductible renews and ship it fast. Then you could return your rented machine to the DME? Do you still have a prescription in hand to send to cpap.com?

You'd think after all this time on this board I could perform a simple posting! Maybe I need more pressure at night.

On advice from the previousl post, I have approached the insurance company and DME and think the insurance company will pay and the DME will accept the difference in the amounts paid previously in rentals and the DME listed price and will do so before July 1. So, no $1776 charge to me... more like $50.

I als talked the insurance rep. into considering preferred provider pricing for internet purchases in certain cases.

Great day if everyone follows through!

Glad to hear that, Chris.

Now, like you said......"if everyone follows through!"

Den