CPAPtalk.com

Fredman wrote:
Ok...so I can blame her for the prices in Alberta too, what about in Texas, Alabama etc....Unfortunately, CPAP pricing seems to be extraordinarily high everywhere.

Ontario is not the only spot in the world where we experience this and issues relating to insurance non insured services.

8 month old thread but important one....

Ontario is not the only spot in the world with high prices for CPAP equipment but it is the location and the ADP is the issue cited in the original post of this thread.

There are websites such as this one where CPAP pricing is much more competitive and unless someone is trying to take advantage of the ADP in Ontario where the upset prices are posted for the only allowed suppliers, there's really no reason not to take advantage of the lower cost internet suppliers.

I do believe that it would be helpful if a Canadian badged website supplier (perhaps using drop shipping from a central warehouse) started up to avoid the hassle arising from some insurers who are reluctant to support imported equipment purchases even though none of this stuff is made in Canada in the first place.

spitintheocean wrote:

Fredman wrote:
Ok...so I can blame her for the prices in Alberta too, what about in Texas, Alabama etc....Unfortunately, CPAP pricing seems to be extraordinarily high everywhere.

Ontario is not the only spot in the world where we experience this and issues relating to insurance non insured services.

8 month old thread but important one....

Ontario is not the only spot in the world with high prices for CPAP equipment but it is the location and the ADP is the issue cited in the original post of this thread.

There are websites such as this one where CPAP pricing is much more competitive and unless someone is trying to take advantage of the ADP in Ontario where the upset prices are posted for the only allowed suppliers, there's really no reason not to take advantage of the lower cost internet suppliers.

I do believe that it would be helpful if a Canadian badged website supplier (perhaps using drop shipping from a central warehouse) started up to avoid the hassle arising from some insurers who are reluctant to support imported equipment purchases even though none of this stuff is made in Canada in the first place.

Agreed if that is what the Province has stipulated that you must use the ADP. Unfortunately, the inflated costs just insures that your taxes for health care and premiums (I don't think Ontairo pays any longer for OHIP?). In part that is why our National Healthcare is in trouble. Too much governmental interference. Quite frankly, I don't have any solutions, but I am a big believer in dialogue on these issues.

Canadians tend to be a bit apathetic we let our political parties do the debating and "thinking" for us. But on the other hand the US has a problem with Health Care delivery too.

I'm sure glad that that this post has been ressurected! I live in Northern Ontario and currently dealing with Medigas regarding new CPAP equipment for an Auto CPAP machine. I was originally equipped with a Respironics Sleep Easy CPAP machine in October 2008, but then the sleep doctor changed my prescription to an Auto CPAP for my sleep apnea in January 2009. Medigas has provided a used Remstar Auto CPAP machine which is on loan until the approval from Ontario Assistance Devices for my new Auto CPAP. I had my consultation with my sleep doctor on March 2009 and got approval and prescription for my new Auto CPAP equipment. I called Ontario Assistive Devices last month, and to my amazement, they have a backlog of 2-3 months months and they started processing the March 2009 applications. I've been getting the run around from Medigas, the clerk made mistakes on my application and ordered a regular CPAP machine instead of a new Auto CPAP machine. It's getting quite frustrating! This will cause further delays and by the time I get my new machine it will be almost a year! Now I currently need a replacement mask which I have used for about 8 months, Medigas has told me that they never got paid from Ontario Assistive Devices for the first mask. I could not believe the price they charged; $360 for a Resmed Quattro mask! I seen the same mask listed online for about $180-$200. No wonder they are raking in the profits! I can't afford to buy outright because I'm on a disability pension, I have to go through Ontario Assistive Devices to obtain my CPAP equipment. I guess I have no choice to be patient and wait...
I was thinking to go with VitalAire but after reading this post it has changed my mind and would probably cause further delays in obtaining my new Auto CPAP machine. There is very limited selection with Medigas in our area regarding CPAP equipment, they don't let us choose our equipment, we hardly have a say, they basically push what they have in stock. For some reason they are pushing the Respironics Sleep Easy CPAP machine, my mother who also suffers from sleep apnea recently dealt with Medigas and got the same machine that I have! She was replacing her Resmed S7 Elite which I think is a better machine than the Sleep Easy! I thought they would upgrade her to a Resmed S8 Elite, but they sold her the Sleep Easy, I joked with her that she could of had my Sleep Easy CPAP machine! I will trade my Sleep Easy CPAP and ordered a Resmed 8 Autoset II from Medigas, I hope to get this model, if not I will settle for a Respironics M-Series model.
I also read posts from others who ordered their CPAP equipment online like the cpap.com website are satisfied with their purchases. Now if VitalAire or Medigas would provide the same quality service to their customers, instead of thinking of profits! $$$$$...and genuinely care about people who suffer from sleep apnea...wouldn't life be great!

All,

You somewhat understand the situation. Let me clarify a few things for you so that you may understand who has owenrship and responsibilities for your OSA health therapy

1) As an OSA prescribed recipient in Ontario it is law that a qualified general physician along with a qualified and certified Sleep apnea physician perform the proper evaluation in order to ensure that the proper health care and therapy is administered for the patient. A qualified GP will refer the patient to a sleep lab and a specialist in order to run a level 1 2 or 3 study in order to assess the severity of the sleep disorder. Once the results are posted a scoring physician will score the results and pass this on to either the GP or a sleep physician to accurately assess and prescribe therapy. Now just for your information all Sleep labs in ontario are licenced and most of them if not all of them have a physician associated with them (If you want to talk about cash grab look at the physicians and labs first) I am not saying that they do not care but they all stand to gain financially! Important note all of these clinics including the doctors know fully well about ADP (Assisstive Device Program) but some of them pretend or negate to tell or ask the patient if they would like to have coverage. (Would you if you just provided services and got paid for it how important is the patient might get assistance... this goes along with the the Home Oxygen Program (HOP) as well!
2) The physician should either advise the patient and or offer to fill in the ADP form in for them prior to going out and choosing a Vendor (Which by the way all patients have the right to choose vendor by choice) a new OSA patient may not have either the time nor patience to do the investigation so they go by the referral recommendation, hence VitalAire, Medigas or Ma and Pa operation CPAP,com..etc)
3) Once the choice has been made which vendor and machine choice the patient requires a appointment for fitting is necessary, some do this better than others... I know for a fact VitalAire has top notch CPAP specialists and Qualified RRT's to properly fit and advise the patients the best solution not based on cash but rather good long term therapy!! (The vendor should ask the patient before they come to bring the prescription and their ADP form with them in order to process any financial transactions. See the provincial and third party insurances are the culprits of their own devises they openly like to receive funds but hate parting with their sorry I mean our hard earned money!!!. They make all parties work hard to get the cash that's for sure! Of coarse there are optional packages that can be sold with CPAP units but (Mainly service packages like the extra 400.00 that was charged above and beyond the allowed 1040 that ADP will pick up 75% of the cost). The patients should listen and retain the information when advised of the optional packages just like future shop if you buy an expensive piece of hardware you may want to purchase that extra warranty and of coarse it will be 2-3 hundred bucks more but it is a piece of mind, would you not want this for the betterment of your health??
4) Once the choice has been made the vendor can offer a trial with the CPAP for a 30 day period where the patient pays a deposit and signs an agreement to return the machine after 30 days (You would not believe the amount of delinquent people out there that do not return the equipment for months and sometimes years and expect not to pay for the machines) I can tell you there are hundreds of cases (This is why ma and pa shops drop their prices to avoid this possibility as they could not survive if this happened to them) The bigger and more stable vendors can adapt to the situation and enforce more stingent policies for returns but none the less it is an option! the term is called a trial (offered so that the patient can try and adapt to the therapy and see if the right machine has been assigned) if not the vendor can exchange for a better unit at the same price. The vendors that care more about the well being of the patient rather than pushing product are the ones that will stay in the business and prosper!
5) The forms ritual is a PITA let me tell you it takes anywhere from 40mins to 1 hour to ensure the forms are filled in correctly, god help you if you miss a period or forget to dot an i ADP loves to reject as a matter of fact that is the default they start with. The effort involved is massive and the pay period is absolutely ridiculous 60 -90-120 days to pay, how would you like to receive your paychecks every 120 days (I really do not know how the Ma and Pa shops survive?? unless they get their money up front from the patient). Most of the time the patient does not have to deal with this unless they are after their own third party insurance.. so when the comment is made about red flagging I know all about it just multiply the duration 10 fold when dealing with the Ontario Goverment especially (HOP)!!!
6) Follow ups and healthcare management, their are believe it or not great programs coming from the larger CPAP vendors that are doing initial, intermediate and long term follow ups with patients, however, sometimes the patients are the biggest issue as they do not use the equipment that they worked so hard to get and bitch about coverage and "I don't want to pay for my healthcare", yet no hesitation to spend a few bucks at the casino or drop a few bucks on other necessities LCD TV's ...etc believe it or not trying to get payment from O2 patients for their above and beyond covered services is like trying to suck a golf ball through a garden hose...some excuses are well I needed a new tv so you will have to wait for payment next month,, this is usually futile and because we are human we cannot pull their services from the life giving therapy equipment that they so desperately are willing to pay for (Not) this amounts into huge write offs that no one sees and sucks the life out of the business (nasty but another topic all together).
7) Bottom line is the responsibly for patient care is the physicians and the patients first and foremost! the secondary priority is the physicians and patients to understand the payment options and coverage and funding availability and finally the clear resposibility lies with the patient to ensure that they are informed and properly taken care of and to ask questions when they are being fitted and equipment is being admisistered by the vendor of choice, it does not stop at the sale for the vendor it is then upto the vendor to follow up on the healthcare of the patient and not reimbursement issues.
So when the remark goes out not happy with VitalAire, I would like to see how the other vendors match up, they might be good on price but try and followup or get assistance with ADP or third party insurances...you will all get the same answers and they may not be what you want to hear. My preferance would be Patient pays or is 100% covered by insurance submit the claim and retian the dollars, ADP should bud out or assist those in desperate need, no job, welfare...etc. How do Dentists do it, I know mine always asks about coverage and if I do not have one then the pricing schema changes but when I am covered then the price goes up...what do I care as I only pay my portion and if I want gold caps with a maintance buff every 6 months I pay extra and my insurance is not involved as I will not cry if they say no to a service I know is above and beyond coverage and would have informaed myself about.

Well enough of this...I hope this makes sense and I wish all you suffers of OSA to sleep well and ensure you that CPAP equipment is all the same it is the value added therapy and followup care that is most important for you all to get well and sleep!

Pikola wrote:All,

Welcome Pikola to CPAPtalk, I can't seem to see your profile, but certainly appreciate your post.

You somewhat understand the situation. Let me clarify a few things for you so that you may understand who has owenrship and responsibilities for your OSA health therapy (rather condescending tone my friend)

Yup maybe the previous posts has you thinking that we are a bit naive, but as you correctly point out below ultimately...ALL RESPONSIBILITY lies with the Patient and his/her doctor. No one said that we have abdicated this responsibility to the government or a service provider - hence the establishment of this forum! I trust your comment was made in the the most helpful manner as it would be intended?

1) As an OSA prescribed recipient in Ontario it is law that a qualified general physician along with a qualified and certified Sleep apnea physician perform the proper evaluation in order to ensure that the proper health care and therapy is administered for the patient. A qualified GP will refer the patient to a sleep lab and a specialist in order to run a level 1 2 or 3 study in order to assess the severity of the sleep disorder. Once the results are posted a scoring physician will score the results and pass this on to either the GP or a sleep physician to accurately assess and prescribe therapy. Now just for your information all Sleep labs in ontario are licenced and most of them if not all of them have a physician associated with them (If you want to talk about cash grab look at the physicians and labs first) I am not saying that they do not care but they all stand to gain financially! Important note all of these clinics including the doctors know fully well about ADP (Assisstive Device Program) but some of them pretend or negate to tell or ask the patient if they would like to have coverage. (Would you if you just provided services and got paid for it how important is the patient might get assistance... this goes along with the the Home Oxygen Program (HOP) as well!
2) The physician should either advise the patient and or offer to fill in the ADP form in for them prior to going out and choosing a Vendor (Which by the way all patients have the right to choose vendor by choice) a new OSA patient may not have either the time nor patience to do the investigation so they go by the referral recommendation, hence VitalAire, Medigas or Ma and Pa operation CPAP,com..etc)
3) Once the choice has been made which vendor and machine choice the patient requires a appointment for fitting is necessary, some do this better than others... I know for a fact VitalAire has top notch CPAP specialists and Qualified RRT's to properly fit and advise the patients the best solution not based on cash but rather good long term therapy!! (The vendor should ask the patient before they come to bring the prescription and their ADP form with them in order to process any financial transactions. See the provincial and third party insurances are the culprits of their own devises they openly like to receive funds but hate parting with their sorry I mean our hard earned money!!!. They make all parties work hard to get the cash that's for sure! Of coarse there are optional packages that can be sold with CPAP units but (Mainly service packages like the extra 400.00 that was charged above and beyond the allowed 1040 that ADP will pick up 75% of the cost). The patients should listen and retain the information when advised of the optional packages just like future shop if you buy an expensive piece of hardware you may want to purchase that extra warranty and of coarse it will be 2-3 hundred bucks more but it is a piece of mind, would you not want this for the betterment of your health??
4) Once the choice has been made the vendor can offer a trial with the CPAP for a 30 day period where the patient pays a deposit and signs an agreement to return the machine after 30 days (You would not believe the amount of delinquent people out there that do not return the equipment for months and sometimes years and expect not to pay for the machines) I can tell you there are hundreds of cases (This is why ma and pa shops drop their prices to avoid this possibility as they could not survive if this happened to them) The bigger and more stable vendors can adapt to the situation and enforce more stingent policies for returns but none the less it is an option! the term is called a trial (offered so that the patient can try and adapt to the therapy and see if the right machine has been assigned) if not the vendor can exchange for a better unit at the same price. The vendors that care more about the well being of the patient rather than pushing product are the ones that will stay in the business and prosper!
5) The forms ritual is a PITA let me tell you it takes anywhere from 40mins to 1 hour to ensure the forms are filled in correctly, god help you if you miss a period or forget to dot an i ADP loves to reject as a matter of fact that is the default they start with. The effort involved is massive and the pay period is absolutely ridiculous 60 -90-120 days to pay, how would you like to receive your paychecks every 120 days (I really do not know how the Ma and Pa shops survive?? unless they get their money up front from the patient). Most of the time the patient does not have to deal with this unless they are after their own third party insurance.. so when the comment is made about red flagging I know all about it just multiply the duration 10 fold when dealing with the Ontario Goverment especially (HOP)!!!
6) Follow ups and healthcare management, their are believe it or not great programs coming from the larger CPAP vendors that are doing initial, intermediate and long term follow ups with patients, however, sometimes the patients are the biggest issue as they do not use the equipment that they worked so hard to get and bitch about coverage and "I don't want to pay for my healthcare", yet no hesitation to spend a few bucks at the casino or drop a few bucks on other necessities LCD TV's ...etc believe it or not trying to get payment from O2 patients for their above and beyond covered services is like trying to suck a golf ball through a garden hose...some excuses are well I needed a new tv so you will have to wait for payment next month,, Painting a lot of folks with a big brush - are you an employee of Vital Aire or a service provider? this is usually futile and because we are human we cannot pull their services from the life giving therapy equipment that they so desperately are willing to pay for (Not) this amounts into huge write offs that no one sees and sucks the life out of the business (nasty but another topic all together).
7) Bottom line is the responsibly for patient care is the physicians and the patients first and foremost! the secondary priority is the physicians and patients to understand the payment options and coverage and funding availability and finally the clear resposibility lies with the patient to ensure that they are informed and properly taken care of and to ask questions when they are being fitted and equipment is being admisistered by the vendor of choice, it does not stop at the sale for the vendor it is then upto the vendor to follow up on the healthcare of the patient and not reimbursement issues.
So when the remark goes out not happy with VitalAire, I would like to see how the other vendors match up, they might be good on price but try and followup or get assistance with ADP or third party insurances...you will all get the same answers and they may not be what you want to hear. Actually my original DME was excellent with assisting me throughout the process - they were not as forthcoming as they could be - the same with VItal Aire when my mother passed away no freaking compassion and very cold about closing out the account.My preferance would be Patient pays or is 100% covered by insurance submit the claim and retian the dollars, ADP should bud out or assist those in desperate need, no job, welfare...etc. How do Dentists do it, I know mine always asks about coverage and if I do not have one then the pricing schema changes but when I am covered then the price goes up...what do I care as I only pay my portion and if I want gold caps with a maintance buff every 6 months I pay extra and my insurance is not involved as I will not cry if they say no to a service I know is above and beyond coverage and would have informaed myself about.

Well enough of this... (I guess we have been dismissed.I hope this makes sense and I wish all you suffers of OSA to sleep well and ensure you that CPAP equipment is all the same it is the value added therapy and followup care that is most important for you all to get well and sleep!

I would like to see you continue to contribute to this community and it would be beneficial if you would complete your profile and become a member.

Pikola wrote: 3) ... I know for a fact VitalAire has top notch CPAP specialists and Qualified RRT's to properly fit and advise the patients the best solution not based on cash but rather good long term therapy!! ....

Maybe true. But the pair of VitalAire RRT's that I dealt with were the most unprofessional "professionals" that I've ever dealt with in ANY profession. So much so that I dropped Vitalaire after 30 days of frustration and bought my cpap from another DME. The new DME provided little service but was still infinitely better than VitalAire.

I let my sleep doctor know about my complete disatisfaction with VitalAire, too. He had directed me to them!

I also got mine through the one in Montreal - 20 minutes training of which most of it was taken up with filling out the forms.
Later when I asked about an issue I was having I was told it was impossible for my eyes to be affected because she had 12 years experience, this after being forced to "wash" my hands with very smelly anti bacterial soap. Do these twits not know that you use unscented products in medical settings?

Hi,
I worked for VitalAire a few years back ad have an opinion. VitalAre does have some very good RRT's, these are the ones who have been with the compnay since it was the leader in oxygen and sleep therapy, the true work horses. Now, they are all flash, o substance. The best brochures, fancy branding, many locations, with very, very little attention spent of training RT's and improving patient care. But hey, they sure maket the hell out of everything. If employee retention is an indicator of the quality of an organization, VitalAire is a bottom feeder.
Do your homework. Ask some questions:
Follow-up program?
Length of trial?
Training program?
Do they use RT's, RRT's, or admin staff called "CPAP speciialists", a made up title by the way.

Good luck!
TOm

A-X, it sounds like you were simply overcharged $410. I would demand a refund in order to force an explanation of the discrepancy.

Wow, I'm not sure if this post needs a silver bullet or simply a wooden stake

Michael Corleone: "Just when I thought I was out... they pull me back in. ..."

Interesting enough that same location did the EXACT same thing to me as well.

ADP form says $1040.00, real receipt says 1450 + mask etc.

The extra money is for buying the "standard" machine over the basic one, but apparently they don't want the government to know they are HOSING people (punn intended... ) an extra 410 for a couple of little options. Supposedly the standard machine has more options like autostart, EPR (the other one doesnt have EPR?) , printing reports etc AND a service package is supposed to be included along with free rentals if you have issues. Funny enough today I forgot to ask about the "service package" and they also did not tell me about it either...hmmm

I never had a good feeling about this company from the start and their hours suck too, 9-5 m-f. Other places have a night or weekend time available and that was enough for me to go somewhere else and should have but didn't.

The whole system in Canada is totally f*cked up too. First they did a sleep study with NO titration. Then they tell me to go rent a machine and guess at what pressure I use. VA sent me home with an APAP machine but of course everyone wants you to be kept as much in the dark as possible about the machine, how to use it, your pressure, your results, its a total crock of sh*t, excuse my french but I am more than a little pissed off.

So only thanks to my own research did I find out how to use the machine, how to titrate myself instead of sticking with a pressure that was totally useless for me, how to get the data from the machine, etc, etc.

Anyway I better not have any trouble with my insurance company or Vital Aire is going to be sorry I ever came in their door. I will be calling to find out about the "service package" I am supposed to have too, but since nothing was said about it at the time of purchase, I wonder if I will even get it now. I did call a couple other places before I bought, and all were offering the same thing, 1040 basic, 1450 upgraded with more options and service so this is the "standard" that someone set and a way to milk people for extra money, for me, the insurance clearly indicated to me they would cover up to 2000 bucks, regardless of the machine type and options so I sure hope that sticks.

In case it's not obvious to those who are reading this thread, Vitalaire in this case overcharged the amount allowed by ADP. ADP sets the prices for cpap equipment that are covered under the plan. The DME is not allowed to charge above that amount.

Check out the ADP FAQ here:

http://www.health.gov.on.ca/english/pub ... /cpap.html

"How much will ADP pay?

ADP will pay 75% of an ADP approved price. You will be charged for the remaining 25%. You may wish to contact the ADP for the current ADP approved price.

If you are receiving social assistance benefits from Ontario Works (OW), Ontario Disability Support Program (ODSP), ADP will pay 100% of an ADP approved price."

ADP also maintains a list of vendors that it will deal with. Perhaps it would be a good idea if those who get hosed by an Ontario DME to complain to ADP. If enough complain, maybe ADP will remove that vendor from their list!