Lied to by DME (Apria), not sure how to proceed

Recently I got a prescription to get a new BiPaP to replace my current Resmed one that's about 4 and a half years old and malfunctioning (though thankfully not in a critical way). I wouldn't have gone for it normally but I won't have my current insurance (I'm on my parents insurance) by the time the biPAP turns 5, and the new work insurance that will replace my current one, is substantially worse since my job is just a restaurant job.

The DME that provided me the biPAP is Apria, and it seems a lot of people on this forum as well as reddit's r/cpap have also had problems with them. Getting the biPAP from them I was deceived multiple times. I admit it was partially my fault not thoroughly checking things over, but I did not have this problem at all when getting my original biPAP from a different DME.

I first approved the payment because they said insurance had already approved it. Later on insurance said they had not even received a claim for it from the DME. Later on when insurance denied it I contacted Apria who said they would appeal it and if it failed I could get a full refund. Now insurance is telling me they did not get an appeal, and when I contacted Apria again, they said they would not be appealing and furthermore, I cannot get any of my so far paid payment back should I choose to return the machine (about $600). My sleep doctor is also refusing to appeal on my behalf.

Right now I am planning on submitting an appeal myself, but am not sure what words to say. I am also wondering if I should cancel my credit card to stop the payment since money is very tight right now, but that might be a bad idea. Please advise. Thanks

You have the machine in your possession, and paid about $600.

You're currently ahead.

Don't make any more payments, keep the machines and return it only after they refund your money. Ensure you have another DME to get supplies from.

When they start harassing you, and they likely will, remind them how they deceived you and you will return the machine only after you get your money back. They won't accept that, and threaten you. Tell them their only remedy is to take you to court.

Taking you to court is not an option for them. Simply put, doing so would cost them thousands upon thousands.

Their next step is to send the account to collections. Upon hearing from collections, inform them you dispute the charges, don't owe them anything, Apria needs to take your to court and to stop calling you.

Ugh, that sounds really frustrating. First off, definitely don't cancel your credit card right away, that could make things more complicated down the line. As for submitting the appeal, I'd focus on sticking to the facts, highlight that you were told the claim was approved, and now the DME is saying the opposite. Mention how you've been misinformed and are left with no clear path forward. Also, make sure to include a clear request for the refund and ask for the documentation they claim to have submitted to insurance. It’s a pain, but keeping things professional and persistent will help. If your insurance has been responsive in the past, it might be worth escalating to someone higher up if you’re not getting anywhere with the regular rep. Good luck!

Could the whole thing have been caused by trying to get it at 4 and a half years instead of the full 5 years? And some miscommunications with Apria, for example, the first person who said "insurance already approved it" might have meant they will approve a 5 year replacement like maybe they had a phone call with the insurance and they took that as approval whereas the person with the insurance company was only giving a verbal approval but there wasn't any official approval yet. Something like that, and then of course another person on the phone said they'd appeal it but there was never an actual claim to appeal and so on and so forth, all triggered by them trying to get you the machine 6 months too early?

Just guessing as to why this all happened, not excusing Apria, they should have their stuff together better than to get you into this situation. Now you're dealing with a faceless bureaucracy, or maybe several faceless bureaucracies (insurance company, credit card company, possible collections agent, and Apria).

"replace my current Resmed one that's about 4 and a half years old and malfunctioning (though thankfully not in a critical way).

My 2 cents.....
If the Resmed was still functioning and delivering therapy I don't believe you were eligible for a replacement paid for by insurance. If was malfunctioning to the point of not delivering therapy the first step that should have been done is to contact the DME to see if a repair can be done (I believe insurance may have paid for a repair) and if a repair can't be done the DME likely should initiate the replacement and insurance coverage.

Crapria has a well earned reputation.
I have delt with them for almost 15 years. If I order 4 items, like a mask, hose, water chamber and filters it usually takes at least 5 shipments to get it all right. It is common for them to take an order, wait a month then cancel the order. When I call they say we don't have an order. I am in the middle of that issue now.
I would NEVER EVER provide Crapria with a credit card for any reason. I would likely cancel any credit card Crapria has ever had access to. I always pay them by going on line to MY bank and having my bank issue a check. That means Crapria has no access to my credit card or my checking account number.
Sorry to contradict other answers, but this is my experience.

Dog Slobber wrote: ↑

Sat May 03, 2025 6:15 am

You have the machine in your possession, and paid about $600.

You're currently ahead.

Don't make any more payments, keep the machines and return it only after they refund your money. Ensure you have another DME to get supplies from.

When they start harassing you, and they likely will, remind them how they deceived you and you will return the machine only after you get your money back. They won't accept that, and threaten you. Tell them their only remedy is to take you to court.

Taking you to court is not an option for them. Simply put, doing so would cost them thousands upon thousands.

Their next step is to send the account to collections. Upon hearing from collections, inform them you dispute the charges, don't owe them anything, Apria needs to take your to court and to stop calling you.

Thanks for the advice. This sounds like a good plan, appreciate it!

GrandmaA wrote: ↑

Mon May 05, 2025 8:21 am

Could the whole thing have been caused by trying to get it at 4 and a half years instead of the full 5 years? And some miscommunications with Apria, for example, the first person who said "insurance already approved it" might have meant they will approve a 5 year replacement like maybe they had a phone call with the insurance and they took that as approval whereas the person with the insurance company was only giving a verbal approval but there wasn't any official approval yet. Something like that, and then of course another person on the phone said they'd appeal it but there was never an actual claim to appeal and so on and so forth, all triggered by them trying to get you the machine 6 months too early?

Just guessing as to why this all happened, not excusing Apria, they should have their stuff together better than to get you into this situation. Now you're dealing with a faceless bureaucracy, or maybe several faceless bureaucracies (insurance company, credit card company, possible collections agent, and Apria).

Thats possible, I dont generally chalk things up to malice immediately. But Apria is just so well known for being such a shady company. And also lying that I could get a full refund, setting up automatic billing for replacement parts (thankfully I saw this and turned it off), not even offering to refund it in full even though it was their mistake giving me incorrect info. The 4.5 year thing might very well have been the cause, but if it was, I would have just accepted that insurance denied it and either asked my doctor to appeal (although he refused to appeal or even give the DME any information on my condition) or not bought the machine. My dad got his machine replaced at only 3 years; he got it via a different dme. Insurance is unpredictable and run by people untrained in medicine, so I figured I'd just see if I could get an approval since I was so close to 5 years, which I accept was my fault.

SirGaspAlot wrote: ↑

Sat May 03, 2025 7:48 am

Ugh, that sounds really frustrating. First off, definitely don't cancel your credit card right away, that could make things more complicated down the line. As for submitting the appeal, I'd focus on sticking to the facts, highlight that you were told the claim was approved, and now the DME is saying the opposite. Mention how you've been misinformed and are left with no clear path forward. Also, make sure to include a clear request for the refund and ask for the documentation they claim to have submitted to insurance. It’s a pain, but keeping things professional and persistent will help. If your insurance has been responsive in the past, it might be worth escalating to someone higher up if you’re not getting anywhere with the regular rep. Good luck!

Great advice. I appreciate your help and will keep that in mind. Thank you!

algebraicBarometer wrote: ↑

Tue May 06, 2025 5:04 pm

GrandmaA wrote: ↑

Mon May 05, 2025 8:21 am

Could the whole thing have been caused by trying to get it at 4 and a half years instead of the full 5 years? And some miscommunications with Apria, for example, the first person who said "insurance already approved it" might have meant they will approve a 5 year replacement like maybe they had a phone call with the insurance and they took that as approval whereas the person with the insurance company was only giving a verbal approval but there wasn't any official approval yet. Something like that, and then of course another person on the phone said they'd appeal it but there was never an actual claim to appeal and so on and so forth, all triggered by them trying to get you the machine 6 months too early?

Just guessing as to why this all happened, not excusing Apria, they should have their stuff together better than to get you into this situation. Now you're dealing with a faceless bureaucracy, or maybe several faceless bureaucracies (insurance company, credit card company, possible collections agent, and Apria).

Thats possible, I dont generally chalk things up to malice immediately. But Apria is just so well known for being such a shady company. And also lying that I could get a full refund, setting up automatic billing for replacement parts (thankfully I saw this and turned it off), not even offering to refund it in full even though it was their mistake giving me incorrect info. The 4.5 year thing might very well have been the cause, but if it was, I would have just accepted that insurance denied it and either asked my doctor to appeal (although he refused to appeal or even give the DME any information on my condition) or not bought the machine. My dad got his machine replaced at only 3 years; he got it via a different dme. Insurance is unpredictable and run by people untrained in medicine, so I figured I'd just see if I could get an approval since I was so close to 5 years, which I accept was my fault.

Yeah that is sneaky. In fact I'm with Apria myself but have only been on CPAP for 3 months. So far, some of their "respiratory therapists" have been great, but dealing with the company in general I have found confusing and very clunky. I got a text implying they were automatically shipping supplies and when I called them they said they had not yet shipped any, and asked which mask I want and so on. I got a box full of stuff. Okay, fine, but maybe I better find out if they have me on that automatic plan, if so I need to cancel. My hose is perfectly fine and they sent me a hose, okay I have a spare, but don't send me another one every three months. The hose shows no signs of degradation whatsoever. Same with the headgear. I don't need stuff piling up in my closet that I don't need, that's simply making them money off my insurance.

I'm taking your story as a heads up, I need to be careful with them.

In my opinion everyone should keep a backup supply of one of everything, mask, hose, water chamber filters and maybe even machine.
Things break. They usually break on Friday evening of a 3 day weekend. Having a spare relieves a lot of anxiety.
Having an autoship pilling up multiple extras creates anxiety.