Has anyone ever gotten reimbursed?

Mikesus · Post by **Mikesus** » Thu Mar 03, 2005 9:25 pm

Sent off my claim 3 weeks ago, of course they say I never sent it... So I refaxed it to them today... Anyone get reimbursed after buying at cpap.com?

Wader, you wade all the way thru?

wading thru the muck! · Post by **wading thru the muck!** » Thu Mar 03, 2005 9:38 pm

Mike,

I submitted my claim, the end of October of last year and just got paid last month. Believe it or not the "idiots" at my insurance company sent the check to cpap.com. The invoice I attched with may claim said "paid in full" I must have called them ten times over the course of the 3+ months I waited. It was not easy but finally got my check.

We will have to all start complaining about the evil insurance companies

Mikesus · Post by **Mikesus** » Thu Mar 03, 2005 9:43 pm

Yikes!! I hope they don't do that to me! Can you give an idea on MAC? The lovely folks at my insurance company have the Maximum Allowable Charge amount kept in the same vault as the Col's special recipe...

Asked 5 different times and all the answers are the same, they do NOT give out that information...

Janelle · Post by **Janelle** » Thu Mar 03, 2005 9:50 pm

Mikeus, I think it depends on the insurance company. Someone, can't remember who, said Blue Cross/Blue Shield says the allowable on the CPAP unit, code E0601, is #1146, humidifier allowable is $327, code E0362, $99 for mask, A7034, and $30 for headgear, A7035.

Mikesus · Post by **Mikesus** » Fri Mar 04, 2005 5:50 am

Thanks Janelle.

I wonder how it will work as the receipt from CPAP.COM has the humidifier and the unit as one line item... Will probably throw them off...

Janelle · Post by **Janelle** » Fri Mar 04, 2005 5:53 am

But what code does it use?

Mikesus · Post by **Mikesus** » Fri Mar 04, 2005 5:54 am

Both codes, combined into one total...

Liam1965 · Post by **Liam1965** » Fri Mar 04, 2005 7:07 am

Mikesus wrote:Both codes, combined into one total...

Oh, that's not good. I barely expect my insurance company to be able to ADD. Subtraction is CLEARLY beyond them.

Liam, algebra whiz since 5th grade. Unfortunately, they taught algebra in 2nd grade.

Janelle · Post by **Janelle** » Fri Mar 04, 2005 7:43 am

As long as both codes are used, there shoudn't be a problem, since they will no doubt pay up to the allowable combined total.

Mikesus · Post by **Mikesus** » Fri Mar 04, 2005 8:05 am

Janelle wrote:As long as both codes are used, there shoudn't be a problem, since they will no doubt pay up to the allowable combined total.

Logic and insurance reimbursement are usually mutual exclusives... I hope you are right!

wading thru the muck! · Post by **wading thru the muck!** » Fri Mar 04, 2005 8:47 am

Mike,

Send them (Ins.) what they ask for. They'll do with it what they want. My insurance company added the "next day" shipping charges to my claim, even though I did not list it on the claim form (it was on the cpap.com invoice). Then they denied "MY" claim for reimbursement of the shipping charges, saying they don't reimburse for shipping charges. I bet if I was standing there they would have slapped that back of my hand too.

Machine	Mask