General Discussion on any topic relating to CPAP and/or Sleep Apnea.
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AMC4x4
- Posts: 24
- Joined: Thu Jan 05, 2017 12:25 pm
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by AMC4x4 » Thu Feb 09, 2017 12:09 pm
lwieland11 wrote:I have BC/BS. Went through hell with them to get my AIrSense10 paid for. They had me on the rent to own plan. I started paying 101 a month. BC/BS checked compliance for a month in the beginning. I complied. Five months in, they decided to check me for a 3-month period(hoping I'd fail). I didn't comply then. I was struggling with my mask and some other issues that that the DME could not figure out. BC/BS refused to pay. DME demanded that I pay the balance($463) in full immediately or they would come and get the machine the following day. Yeah, this really happened. All I could do was cry. Felt so helpless. The insurance companies are in charge and no one can stop them from demanding downloads and creating compliance rules that are hard to attain, setting the patients up to fail so they don't have to pay. Never seen anything like it. I spoke to one of the BCBS advocacy nurses to explain the difficulty I was having. Decided that those folks are just there to keep the insurance companies from looking like badasses. She was of no help whatsoever.
So now, I have my paid for AirSense 10 and they are switching me to BIPAP. $2,500 sleep study to pay for out of pocket and now a BIPAP machine. Will this ever end?
OMG. That is just insane. So sorry you've been through all this. My original sleep study was through Empire (BC/BS). Those "advocacy nurses" sound a lot like HR departments that are there not to work on behalf of the employees, but rather, the company.
I hope this all gets straightened out soon for you. We all have enough stressors in our daily lives to have to deal with this crap while trying to get healthier.
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AMC4x4
- Posts: 24
- Joined: Thu Jan 05, 2017 12:25 pm
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by AMC4x4 » Thu Feb 09, 2017 12:13 pm
Physician wrote:
When Apria bills Medicare, they do it monthly as a rental for 13 months. But there's an option for one time billing of the entire amount for non-0Medical non-Medi-cal patients.
Did you try to get through to a billing supervisor?
First of all, thank you to everyone for the comments & advice.
I haven't tried to do that, but I will now. I didn't know they might have that option. I'd say I'd give them a quick call, but they're never really "quick" are they?
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ChicagoGranny
- Posts: 15458
- Joined: Sun Jan 29, 2012 1:43 pm
- Location: USA
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by ChicagoGranny » Thu Feb 09, 2017 12:16 pm
AMC4x4 wrote:they're never really "quick" are they?
Quick to go to lunch and out the door at five.
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Nealbopper
- Posts: 70
- Joined: Thu Dec 18, 2008 9:41 am
- Location: Oakland Twp. Michigan
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by Nealbopper » Thu Feb 09, 2017 12:18 pm
This may be a No, No but I have been buying my machines outright on Craigslist and making my own settings based off what the DME's original settings.
Ain't no one got time for that! I just got tired of the run around and in the long run it's cheaper and I have my peace of mind. I still get my supplies off
CPAP.com. I do not deal with insurance because there's no savings. I got 2 S9's and my most recent purchase, Resmed Airsense 10 Auto for $300.00.
I buy it and I'm done! I have asked for help making adjustments because I want to keep it in auto and use software to see how I'm doing. I just need
7 nights sleep under my belt for a good starting point. I told my sleep doctor to deal with it. I'm not using a medical provider or a DME PERIOD! He
gave me a high brow but that was about it.
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ChicagoGranny
- Posts: 15458
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- Location: USA
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by ChicagoGranny » Thu Feb 09, 2017 12:24 pm
Nealbopper wrote:... my machines outright on Craigslist and making my own settings based off what the DME's original settings. ... I told my sleep doctor to deal with it. I'm not using a medical provider or a DME PERIOD! He
gave me a high brow but that was about it.
- good ways to do it. Many of the veterans do that. We just need to help you with Sleepyhead software so you can optimize your machine settings.
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AMC4x4
- Posts: 24
- Joined: Thu Jan 05, 2017 12:25 pm
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by AMC4x4 » Thu Feb 09, 2017 1:25 pm
Nealbopper wrote:This may be a No, No but I have been buying my machines outright on Craigslist and making my own settings based off what the DME's original settings.
Ain't no one got time for that!
"One Airsense 10 Autoset - slight scratches from falling off truck, but otherwise in excellent condition!"
Yeah, I considered that, but I really need to use my FSA bucks for this because it's almost "free money," or at least it doesn't hurt quite as much as direct out of pocket. I think they'll only reimburse if it's from a supplier.
But it's a good tactic. We have to do what we can to get these costs down for ourselves. I know I'll be buying tubing and filters and stuff off Amazon now that I have my script in hand.
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Nealbopper
- Posts: 70
- Joined: Thu Dec 18, 2008 9:41 am
- Location: Oakland Twp. Michigan
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by Nealbopper » Thu Feb 09, 2017 1:35 pm
Yeah, The medical supply stores need to make money too so you know there's a mark up of costs and when the mark ups exceed what you can pay cash for on line, it's a no brainer.
I'm surprised more medical care providers are not felling the pinch. It's possibly they are, I haven't gone there in 10 years. Neal
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