Another Evil DME Story...Don't let this Happen to you!

Folks:

Before I found this forum I purchased a Puritan Bennet Goodnite 425 Bi-Level unit from my evil DME. They charged more than 200% of what I could have bought the unit from CPAP.com! (I found out too late!)

That's only 1/2 the story....since purchasing the unit, my DME has been charging my Insurance company monthly rental fee of 10% of the inflated price of the unit! Since I purchased the unit I sent them a copy of my invoice showing that the unit was SOLD NOT rented to me. Needless to say...the rental bills kept coming anyway!

When I called to clarify, my DME's billing dept claims that it is standard operating procedure to rent the unit for 1 year before my insurance company will purchase it for me.

"So let me get this straight....you charge 200+% of list, then you rent the unit for 12 months at 10% of your inflated price, then...you want my insurance carrier to purchase the unit for 200% of list? Net cost 420+% of list? Net Co-Pay 84% of list...so why would someone pay insurance premiums for a deal like that?" The DME suggested I contact my insurance company, since it was THEIR policy to rent 12 months then purchase.

Upon calling my insurance company they thanked me for uncovering the DME's dishonest billing practice and they assured me that if the machine was purchase outright, I would be responsible just for the Co-pay on the instrument...not a rental fee. My insurance companies billing records show only a rental fee. The DME was pulling a scam that typically goes unnoticed by many insurance carriers. I sent them my invoice and now they are going to be audited by my insurance company. I hope they get their Butt Kicked!


I will never use a DME ever again! With practices like this....we as an internet community of "hoseheads" should Boycott DME's! Put them Out of business! They don't deserve to steal from our insurance companies...the result is high premiums for all!! If we wan't affordable insurance/healthcare....we need to be be an advocate for our insurance companies. If we all have the additude..."Yeah I know that's alot of money, but, my insurance pays most of it anyway" it will come to the point where no one will be able to afford health insurance! Pay now or pay later!!!

Joe A,

Thanks for passing that along. Some people have found that their co-pay from the local DME is more than the full online price. No wonder health insurance costs are astronomical.

As promised I wanted to pass on my DME story of the day. Was notified wit a form letter about 2 wks ago from the outfit I was pushed ever so''gently'' before I learned about cpap.com and purchasing online etc. The ltr from the D.M.E. said that my ins. would now purchase my unit. Asked me about 1-2 questions "do you wear it", and that was it. I rec'd the EOB yesterday from the ins. The DME billed them 1400 for the PB420E (not sure if this is w/the htd humid. or not) and my company paid $750, you watch, those !@##$^ at the DME will probably try to hose me out of the rest. Don't worry I'm armed and ready to howl if that is what happened. Is this a rip off business or what? Rhetorical question, we know the answer already.

PS--sorry Christine, if you still monitor this board. You're the exception to the DME rule, which is foremost HOSE "EM" and FORGET 'EM".

Well that's my take IMHO of course.

Keep hosin''..


Gailzee

wading thru the muck! wrote:Joe A,

Thanks for passing that along. Some people have found that their co-pay from the local DME is more than the full online price. No wonder health insurance costs are astronomical.

I checked this week with my local DME on the price for a one-month rental of a Auto C-Flex. The DME stated the rental for one month is $461

Since this forum has grown so much and continues to grow, maybe we need a place for ppl to rate DME s they have used. Sort of a referral board. Name names, city, etc. Both good and bad.After all, we have heard some stories about good DME s. What do you think.Maybe if the bad ones hear about it, they will change some.

Anonymous wrote:I checked this week with my local DME on the price for a one-month rental of a Auto C-Flex. The DME stated the rental for one month is $461

WOW! thats more than half the online cost of a new one. I need to get into the DME business.

[quote="gailzee"]PS--sorry Christine, if you still monitor this board. You're the exception to the DME rule, which is foremost HOSE "EM" and FORGET 'EM".

LOL, thanks, Gail!

Again, not all of us are evil. I apologize on behalf of those who are (or maybe I shouldn't!). It's all a vicious cycle as far as healthcare costs are concerned...on my end of it we tend to view the insurance companies as the ones to blame in all of this. I guess it just depends on your point of view.

IllinoisRRT wrote:Again, not all of us are evil. I apologize on behalf of those who are (or maybe I shouldn't!).

Now your getting it. Don't appologize for the EVIL ones, just keep not beng one of them.

I think the expletives would be ''deleted" in many viewers estimation. In mine, I'd like to let them know what I think. But I think that that language would be xxxxx'd out!

and would form a plethora of

loonlvr wrote:Since this forum has grown so much and continues to grow, maybe we need a place for ppl to rate DME s they have used. Sort of a referral board. Name names, city, etc. Both good and bad.After all, we have heard some stories about good DME s. What do you think.Maybe if the bad ones hear about it, they will change some.

I just wonder as why the insurance companies don't have a better negotiated fee structure with the DMEs for CPAP. Even the DME store and service does not support the 100% markup price, or does it? Could it be the potential for the lawsuit, if a patient gets hurt by using the CPAP without the DME personal service !??? And the rental fees seem rediculous.
I just met my dentist who has to replace a crown and wants to charge me a $1000! The insurance negotiated charge for it is $588. I told him to hold on with the service and am shopping for a more reasonable dentist.
I really blame the insurance companies. They are the ones who have all the authority to negotiate the prices. We end up paying for the high cost.

Folks:

If you have a chronic Illnes like Hypertension or Diabetes, many insurance companies will re-imburse higher percentages if you use a mail order or Online prescription service that saves the insurance companies money. I think a similar deal should be made for those who use CPAP.com. For instance if the co pay was 10% for an online service 90% of list is still tons cheaper than 80% of 200% of list!!!

Boycott DME's that is the only way they will get the picture....So long as you have people who don't care, DME's get away with the insurance fraud they perpetuate. For someone in a DME to even think that an insurance company should double pay for a medical device by renting it for 1 year and with an option to buy it at the original inflated price is doing so because they are preying on a weak link in the billing system of an insurance company.

As for DME's...I have tried two in my area and they both $uck....

They Treat you like cattle, have clueless people working for them, and steal from insurance companies and the consumer!

My Brothers DME charged his insurance company $630 bucks for a Resmed Ultra Mirage Full face mask....why because his insurance company pays 100% of the cost of 2 sets of masks and Headgear per year. The better the coverage....the bigger the gouge! They charged his insurance $3000 bucks for a Puritan Bennet Goodknight 420 CPAP list price less than 300 bucks!...why because again 100% payment. Odds are if the consumer doesn't get hit, it is easier to gouge insurance companies because they are big faceless corporations and many CPAP users don't know what most of this stuff should cost.

So there you have it...3 separate DME's all with the same story...there are only 2 other DME's in my area left....After 3 bad ones in a row....I don't like my odds.

Down with DME's! Take your business elsewhere! Educate Insurance companies! Don't get scammed! I can just imagine what DME's must charge for critcal care supplies if they are marking up CPAPs 1000% and FF masks 600%.

My opinion was formed after 5 years of bad dealings with DME's....there were no other places to buy this stuff back then.....you have choices now! That is the beauty of competeition! It brings the best options to the top of the pile! This one that I dialoged was the straw that broke the camels back!

When I went to get my 1st unit at the DME's, I wanted to rent for 1 month, they rented me the HC220LE, until I bought a unit from here at half the price. They charged me for the extra filter(comes with the machine), hose( comes with the machine), mask(comes with the head gear), head gear (mask@150.00 and the head gear for 44.00), and then on the rental of the machine they rented the humidifier seperate(part of the machine) . Now I have the HC220LE and a Comfort FF mask. I own it all and spent 450.00 more than if I would have just ordered it from here.I could of had a Cflex w/humidifier.

Toby

Folks, We've got to dump this attitude that the insurance is some bottomless pit of money. As maany have stated. Its often LESS expensive for all if we just purchase online. That copay of yours is rarely less than the outright purchase price online. Please, Save us all $$$$ .

When I went to my DME to pick up my CPAP machine after learning I had sleep Apnea. The person who took care of me was a hose head himself, as was his wife. I didn’t learn until much later my machine should have come with filters.

I was given the wrong size mask. DME did not return any of my phone calls.

Later my Doc gave me a prescription for a full face mask. A different person at the DME fitted me for the mask and provided me the wrong size mask. I didn’t know this for a while, because I soon discovered the box containing my new mask had been opened and parts were missing which made the mask unusable. Once again the DME did not return any of my phone calls.

My experience with a sleep doc has not been a whole lot better but that’s another story.

I personally know 5 people who have Sleep Apnea and only one person uses a CPAP daily, one person sometimes uses a CPAP and the other three don’t use their machines at all.

Is it possible the medical community has an attitude why bother; the patient probably won’t use the CPAP equipment?

As for me I don’t post often, but I love to lurk. This forum has been a great source of information for me

I'm renting my Bi-PAP from my DME. My insurance pays 90% and I pay $15.78 a month. I was under the impression that after a certain number of months my insurance would convert this to a purchase and the machine would be mine. I was in my DME's office getting filters the other day, and I asked about this again, since I've now been renting for 9 months. Now they say that after the first year the monthly rental will change to a twice a year charge for a maintenance agreement. The machine will continue to belong to the DME, but if there are any problems they will replace it or fix it. This doesn't sound quite right to me, but maybe it's for the best; we'll see. The mask, hose, and humidifier were billed to my insurance the first month, and are now mine. My DME, Walgreen's Home Healthcare Initiative, has been OK; I don't have any major complaints with them.