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Re: Apria is charging insurance 5K for non-compliance

Posted: Fri Nov 24, 2017 10:56 pm
by palerider
Janknitz wrote:I'd be very surprised if that's the amount the insurance company will pay or that you will be responsible for. DME's regularly engage in what I call "fantasy billing". This is what they wish in their wildest dreams they could receive for their goods and services. They do this in part because when Medicare audits their books they want to look like they are losing money accepting Medicare reimbursements (if that was the case, why would they accept Medicare in the first place???).
Pretty much every medical thing does these days.

I see the medicare reports from the dialysis clinic... 4.5 hours, $5,500+a few hudred more for things like bandages and syringes, medicare says "how about $330 instead".

Re: Apria is charging insurance 5K for non-compliance

Posted: Fri Nov 24, 2017 11:14 pm
by Goofproof
palerider wrote:
Janknitz wrote:I'd be very surprised if that's the amount the insurance company will pay or that you will be responsible for. DME's regularly engage in what I call "fantasy billing". This is what they wish in their wildest dreams they could receive for their goods and services. They do this in part because when Medicare audits their books they want to look like they are losing money accepting Medicare reimbursements (if that was the case, why would they accept Medicare in the first place???).
Pretty much every medical thing does these days.

I see the medicare reports from the dialysis clinic... 4.5 hours, $5,500+a few hudred more for things like bandages and syringes, medicare says "how about $330 instead".
Then the dialysis clinic. decides $ 300.00 profit is better than nothing and writes $4,150 off their taxes and sends a bill to the patient for a share, maybe they will pay it. Jim

Re: Apria is charging insurance 5K for non-compliance

Posted: Sat Nov 25, 2017 8:32 am
by DeepFriedDuck
Goofproof wrote:writes $4,150 off their taxes
You have no clue how accounting and tax returns work.

BTW, I always check the forum for your quips - very funny. Keep it up.

Re: Apria is charging insurance 5K for non-compliance

Posted: Sat Nov 25, 2017 12:17 pm
by Goofproof
DeepFriedDuck wrote:
Goofproof wrote:writes $4,150 off their taxes
You have no clue how accounting and tax returns work.

BTW, I always check the forum for your quips - very funny. Keep it up.
I must not, maybe that's why the IRS audited me for 2015, I put my smiley here, but I'm not Smiling. Jim

Re: Apria is charging insurance 5K for non-compliance

Posted: Sat Nov 25, 2017 7:11 pm
by chunkyfrog
A condition of Medicare: the provider is prohibited from billing the patient for the markdown.
Only 20% of the allowable, or 25% of what Medicare pays.
The hospital wanted over $70,000 for their share of costs for my cancer surgery.
Medicare allowable was six grand-ish.
That is all they ever got.