CPAPtalk.com

jtravel wrote:

sfrank0315 wrote: I looked at my paperwork and even though it doesn't explicitly state it, it looks like the rental period is 90 days, so yeah, 3 months. It states that I need to return my SD card after 90 days.

I signed up through CareCentrix's portal for online pay. I just hope I don't have to pay this each month. If the only recurring portion is the unit itself, then that only comes to about $25. I got charged more for the tubing then the unit itself. I just wish this would have come on a day during the week so I didn't have to wait a few days to call. Thanks for the feedback.

If you received six different invoices then it must breakdown what each is for right?
The $25 rental fee is most likely for the 90 day period. It sounded like a titration study was not performed and they are using the 90 day Apap rental period too analyze the data from the machine and then decided what you need.
You said you paid close to $300 for the sleep study and DR visit, is that 20% of the total cost with Cigna paying 80% ?

Hi, yes, it breaks down each one. I added up the totals for what Cigna paid and what I owe and it's 80% that Cigna paid. For the sleep study and dr. appt., I'm not sure what percentage the $300 I paid was.

Okie bipap wrote:Which model of the AirSense 10 did you get? Not all of them are fully data capable. The AirSense 10 CPAP is not full data capable. It will give basic data only. The Elite, Auto, and Auto for Her all are full data capable machines. All four models have SD cards, but only the last three models have full data capability.

Hi, it's the Autoset.

Wulfman... wrote:

sfrank0315 wrote:

Wulfman... wrote:And, be sure to find out that the equipment they're dispensing to you is FULLY DATA-CAPABLE.
Insurance pays by "codes". The code for a high-end machine is exactly the same as the lowest end machine. If they (try to) give you a low-end machine, you'll know that they're putting their profits above your therapy. Don't accept a non-data-capable machine. Know your equipment before they try to give it to you.

Edit: After rereading your original post, I see that you've already had your machine for about a month.
WHAT DID THEY GIVE YOU?


Den

.

I received a ResMed Air Sense 10. Yes, it's a data-capable - I have a card that records everything but the nightly sleep information is also uploaded to my doctor each day, Cigna, and the equipment supplier through cellular data. I've already received a phone call from Cigna saying that I have been compliant with my usage.

WHICH SPECIFIC MODEL? If it's NOT an Elite or Autoset model, it's NOT DATA-CAPABLE.

Just because it's got a "card" in it, doesn't mean it collects anything other than hours used.
"Compliance" is NOT an indication of effective therapy........only that you're using it the required number of hours.

Find out what you have.


Den

.

It's an Autoset model. I look at the sleep report on the machine and a few more specifics online. Both give more than hours used but the ResMed site gives more info on mask leakage. As a result, it collects more than hours used. And by the way, I never said that because it has a card that it collects anything other than hours used. I only wrote that it has a card and that the data is uploaded through my cellular signal to my doctor and insurance provider. I also never said that compliance is an indication of effective therapy, so while I appreciate you replying to my initial post I do not appreciate your condescending lecture and misinterpreting of my words. Please knock it off with the caps, bold and underline, too. It's rude and unnecessary. Thanks.

Sfrank0315 wrote:Hello,

This is my first post. I've had my CPAP machine for about a month. I like it but I received a bill today totaling about $130 from CareCentrix for my equipment. My insurance is Cigna and it looks like they paid 80%. However, I vaguely remember being told that the machine starts out as a rental, so my question is am I going to be billed this money from CareCentrix every month as a rental fee? If so, that seems pretty high and I'm annoyed that no one told me to expect this even after I asked if something like this would happen (I hate sticker shock). I just got finished paying Cigna nearly $300 for my medical appointment and sleep study. My other question - has anyone received separate bills from CareCentrix for each piece of equipment. I received six invoices in one envelope. I really don't want to have to write six checks or fill out my debit card information six times. Why don't they just lump it together in one invoice? This is a waste of paper. Anyway, I am OK paying $130 if this is a one-time fee but I am not OK with paying this every month. Of course, this came on a Saturday so I can't call until Monday.

Any feedback would be appreciated. Thanks!
Steve

$300 isn't really that bad. When I had my cardiac ablation done last year, the hospital sent me a bill for $165K (and change) because insurance refused the OR (operating room) facility stating that it was "medically unnecessary". I guess they thought those types of procedures are done out in the hospital parking lot -- but I persevered and convinced them that that was not the case ... though it took about 6 months of stressful bickering over it.

DreamStalker wrote:

Sfrank0315 wrote:Hello,

This is my first post. I've had my CPAP machine for about a month. I like it but I received a bill today totaling about $130 from CareCentrix for my equipment. My insurance is Cigna and it looks like they paid 80%. However, I vaguely remember being told that the machine starts out as a rental, so my question is am I going to be billed this money from CareCentrix every month as a rental fee? If so, that seems pretty high and I'm annoyed that no one told me to expect this even after I asked if something like this would happen (I hate sticker shock). I just got finished paying Cigna nearly $300 for my medical appointment and sleep study. My other question - has anyone received separate bills from CareCentrix for each piece of equipment. I received six invoices in one envelope. I really don't want to have to write six checks or fill out my debit card information six times. Why don't they just lump it together in one invoice? This is a waste of paper. Anyway, I am OK paying $130 if this is a one-time fee but I am not OK with paying this every month. Of course, this came on a Saturday so I can't call until Monday.

Any feedback would be appreciated. Thanks!
Steve

$300 isn't really that bad. When I had my cardiac ablation done last year, the hospital sent me a bill for $165K (and change) because insurance refused the OR (operating room) facility stating that it was "medically unnecessary". I guess they thought those types of procedures are done out in the hospital parking lot -- but I persevered and convinced them that that was not the case ... though it took about 6 months of stressful bickering over it.

...And stress is especially not good when you had a procedure involving your heart. No, you're right, $300 isn't bad. I was expecting it. It's this bill for the equipment that has me concerned if it's going to be like this every month. The unit itself (not the tubing or humidifier, etc.) accounts for $25 of the $130 so that's totally fine if that's the bill each month.

sfrank0315 wrote:

Wulfman... wrote:

sfrank0315 wrote:

Wulfman... wrote:And, be sure to find out that the equipment they're dispensing to you is FULLY DATA-CAPABLE.
Insurance pays by "codes". The code for a high-end machine is exactly the same as the lowest end machine. If they (try to) give you a low-end machine, you'll know that they're putting their profits above your therapy. Don't accept a non-data-capable machine. Know your equipment before they try to give it to you.

Edit: After rereading your original post, I see that you've already had your machine for about a month.
WHAT DID THEY GIVE YOU?


Den

.

I received a ResMed Air Sense 10. Yes, it's a data-capable - I have a card that records everything but the nightly sleep information is also uploaded to my doctor each day, Cigna, and the equipment supplier through cellular data. I've already received a phone call from Cigna saying that I have been compliant with my usage.

WHICH SPECIFIC MODEL? If it's NOT an Elite or Autoset model, it's NOT DATA-CAPABLE.

Just because it's got a "card" in it, doesn't mean it collects anything other than hours used.
"Compliance" is NOT an indication of effective therapy........only that you're using it the required number of hours.

Find out what you have.


Den

.

It's an Autoset model. I look at the sleep report on the machine and a few more specifics online. Both give more than hours used but the ResMed site gives more info on mask leakage. As a result, it collects more than hours used. And by the way, I never said that because it has a card that it collects anything other than hours used. I only wrote that it has a card and that the data is uploaded through my cellular signal to my doctor and insurance provider. I also never said that compliance is an indication of effective therapy, so while I appreciate you replying to my initial post I do not appreciate your condescending lecture and misinterpreting of my words. Please knock it off with the caps, bold and underline, too. It's rude and unnecessary. Thanks.

Get off your friggin' high horse! It was NOT condescending. It was adding emphasis. It was unclear as to how much you knew about what you had. I wanted you to be more knowledgeable about what you have equipment-wise. If they had given you the non-data-capable "brick", you'd have an even bigger "sticker shock". You have no idea how many unsuspecting suckers get stuck with non-data-capable machines by the DMEs. And, they don't realize it until they find their way here......then have to go back and beg the DME to switch equipment.......and it doesn't always work out well.


Den

.

carecentrix is a 3rd party vendor between the dme and Cigna. Dme submits to carecentrix, carecentrix pays Dme, then adds their fees to the bill and submits to Cigna. Hence why Dme could not tell you what you owed or what to expect because carecentrix adds their stuff in.

Sounds kinda like what my situation was when I got to my DME'S office. No joke, when the lady asked me if I brought my credit card and whether I planned to rent the machine or pay $700 that day, I flat out told her, "You're f*cking with me right now, right?"

Turns out rental of the unit is $150/mo on a 10 month lease. IF I had met my deductible (which thankfully I had), my coinsurance is 10%, but after Jan 1st I'd have been paying the full $150 through April or until I met my deductible for 2017. Since the buyout cost would have been more cost effective, that's why she just assumed that was my preference. She failed to mention (until I asked) why insurance wasn't covering the purchase of the machine.

The 30 day compliance requirement was a "hiccup". I told her I would rent the first month until I pass compliance for insurance purposes then have them run it through as a purchase so insurance pays 90% and I own it. Load of hokey telling me people just paid out of pocket for a machine instead of waiting the 30-90 days for their insurance to cover it. It makes no sense for insurance either. Why would they agree to $150/mo for 10 months at a time for a $700 machine? That means they'd pay over twice as much as it costs and I still wouldn't own it! And all of the masks, hoses, humidifier tank and accessories are all separate. My specific DME said nothing about the rental being capped and at any point the machine being considered paid off.

So... if your insurance has a deductible you have to meet before coverage kicks in, have you met your deductible? If not, the $130 may very well be your rental cost until the deductible is met. If your plan doesn't suck like mine, like others have said, I'd call the DME and/or insurance to get more information.

jtravel wrote:

msla wrote:If the $130 is the monthly co-pay for the rental until bought, then you could pay $589 to the host of this forum, or 4 1/2 months rental for a ResMed S9 Auto set for her, and have no further rental payments. Of course you will have an excellent machine if you go this route. I'm cheap so the pink machine does not bother me in the least.

Is the color the only difference between the two?

Yes, it is just air from a pink or a gray machine. So far the pink air is no different from the gray air. Oh, with the pink one you have included the humidifier. Pink is really a bargain. $589 vs. $1,042 S9 Auto set with heated humidifier.

CareCentrix has their own billing. I work for a DME company that uses Carecentrix. We have our own prices and CCX has theirs. CCX will allow you to purchase the machine as long as you have completed 3 rental months and you are compliant with at least 70% usage. Other than that, CCX will rent the machine for 6 months to the purchase price.