outrageous

My DME charged my insurance company seven times the amount that cpap.com charges for the same equipment. I even called the insurance company to tell them they are getting ripped off, and they said they just pay what is submitted. In the end I had to pay, because it applied to my deductible. Argh.

Yup. Common story. I fired my DME, told my insurance I wanted to open a fraud investigation over the whole thing, spent NUMEROUS HOURS screaming on the phone and writing letters, and finally bought online from cpap.com and never looked back.

I only get 70% reimbursement from my insurance, but my FSA picks up the other 30%, and at this point, I am too tired to fight with my insurance to get them to reimburse me more. I figure some day I'll go to bat with them about that, but not today.

Good luck!!!!!!!!!!!!!!!!!!!!!!!!!!
Babs

Tcamillemars wrote:My DME charged my insurance company seven times the amount that cpap.com charges for the same equipment. Argh.

It is outrageous, but it should be illegal.

I just got an UM ffm from the Big A.
They charge my insc. $1,313.00 for the mask and headgear.....

....yes, I typed that correctly. $1,313.00

Insc. paid them $160.00

As long as this continues, health care is never going to be fixed or changed.

carbonman wrote: They charge my insc. $1,313.00 for the mask and headgear.....

....yes, I typed that correctly. $1,313.00

HOLY @#$%

My child was getting physical therapy for a while. They charged my insurance for services they didn't provide and sessions the therapist had cancelled, to the tune of a couple thousand dollars. I called our insurance company and they didn't care. They said I had to get the therapists to reverse the charges. Nope- I did my part by checking my EOB letters and notifying the co. They had been defrauded, they had written the check, they had the contract with the therapists. They never did a thing, except raise our group's rates the next year.

carbonman wrote:

Tcamillemars wrote:My DME charged my insurance company seven times the amount that cpap.com charges for the same equipment. Argh.

It is outrageous, but it should be illegal.

I just got an UM ffm from the Big A.
They charge my insc. $1,313.00 for the mask and headgear.....

....yes, I typed that correctly. $1,313.00

Insc. paid them $160.00

As long as this continues, health care is never going to be fixed or changed.

It sounds like the DME has to inflate the price to make it on what the insurance company pays. Private payers get stuck.

Sounds more like a fishing expedition than anything else - bill $1313, get paid $160 by some insurance companies while others refuse to even respond to customer complaints....

Speaking of fisherman, sounds like robbing Peter to pay Paul.

Take a deep breath.
Another deep breath.

CHILL OUT.

RELAX

Insurance companies pay a contracted amt.
DME can bill a billion bucks if they like.
Insurance will only pay a contracted amt.
Now, you should feel better.

Here is another one. My husband was an optician for over 20 yrs. When he would order frames for glasses they would cost them from 7$ up to 30$. Has anyone ever paid so little for frames??? I highly doubt it because the mark-up price is many times the actual cost of the frames. It seems so unfair when a whole family is wearing glasses and prices are so high when in fact they don't need to be for companies to make a profit!

cost them from 7$ up to 30$. Has anyone ever paid so little for frames???

$8.00 for frames and lenses plus $4.95 shipping. I got 2 pair for $31 (including shipping) one regular and one tinted for sunglasses.

http://www.zennioptical.com/cart/home.php

Enjoy

When I first started CPAP I found the same thing, called my insurance and they basically told me the same thing.
This is exactly why the average Joe can't afford insurance! We have our own small business and I was not working out of the house but 3 years ago I went back to work for a company just so I could afford health insurance. Even then every year everything goes up. This is the reason.....legalized THEFT.

And that my friends is exactly why I no longer have anything to do with Lincare, our local Home Health Care provider.

I buy everything from CPAPAUCTION.com - have not been disappointed yet.

Skittles

I've heard the same thing from my insurance company - they paid the fraudulent duplicate bills, but they wanted ME to straighten it out with the supplier. I called their fraud department, and they talked to me for a long time, and sent me a letter saying they would look into it, but I never heard anything further. Until a year later, when the DME called to remind me it was time to re-order supplies....

Sigh......
B.

bap40 wrote:Here is another one. My husband was an optician for over 20 yrs. When he would order frames for glasses they would cost them from 7$ up to 30$. Has anyone ever paid so little for frames??? I highly doubt it ...

Stop doubting
I've been buying glasses at four eyes ( $99 for two sets, including lenses) for ~30 years now ( since before the internet)

I buy my glasses on-line - took a couple attempts to get a good pair, but the total cost was still about 25% of what my optometrist quoted me...mine come from Hong Kong, are of good quality, cost about $35.

I do get my prescription updated - I suppose one could keep using the old one for more than the legal two years - but, well...they're my only eyes.