Sleep Center thieves

BostonZZZZ · Post by **BostonZZZZ** » Fri Mar 13, 2009 7:12 am

At least according to any definition I know the Sleep Center where I did my study and got my CPAP machine are thieves. I don't know what else to call it. I've had my machine for about a month or so now and just got my bill. I was outraged. Their rates for office visits were their rates and I'm not going to complain about that. But the charge for the equipment was outlandish. It was more than triple what I could buy all the equipment for online, including a $129 charge for the hose from the machine to the mask. The freakin' HOSE!!! I can get it online for $10!!! What really got me angry is that my insurance company has already paid more than I could have bought the whole set up for online (like at CPAP.com) so the Sleep Center is essentially double (triple?) dipping by trying to pick my pocket. I'm going to try to point this out to them and fight them over the bill but I'm not sure how far I'll get. Has anyone else had this experience? What did you do, if anything? And did you have any success?

slacker361 · Post by **slacker361** » Fri Mar 13, 2009 7:17 am

Welcome to our great medical establishment. I tolk to a DMe supplier, and he said that the cost of the resmed s8 elite 2 is about 800.00. When it is sold the cost is 1600.00 to 2400.00. Now you know why medical cost are so outragous in this country. MEDICAL INSURANCE.

SharkBait · Post by **SharkBait** » Fri Mar 13, 2009 7:18 am

BostonZZZZ wrote:At least according to any definition I know the Sleep Center where I did my study and got my CPAP machine are thieves. I don't know what else to call it. I've had my machine for about a month or so now and just got my bill. I was outraged. Their rates for office visits were their rates and I'm not going to complain about that. But the charge for the equipment was outlandish. It was more than triple what I could buy all the equipment for online, including a $129 charge for the hose from the machine to the mask. The freakin' HOSE!!! I can get it online for $10!!! What really got me angry is that my insurance company has already paid more than I could have bought the whole set up for online (like at CPAP.com) so the Sleep Center is essentially double (triple?) dipping by trying to pick my pocket. I'm going to try to point this out to them and fight them over the bill but I'm not sure how far I'll get. Has anyone else had this experience? What did you do, if anything? And did you have any success?

Try to negotiate a deal with them, but failing that pay them 10 bucks a month for like... ever.

BostonZZZZ · Post by **BostonZZZZ** » Fri Mar 13, 2009 7:21 am

Sorry but I don't see what medical insurance has to do with this. If you're talking about my personal insurance (Blue Cross) they paid more than what should have been the full cost of the machine. So essentially they are getting ripped off as well and should be as P.O'd as I am. Do you mean that the sleep Center is jacking the price up as a profit center to cover their own costs of insurance plus?

Slinky · Post by **Slinky** » Fri Mar 13, 2009 8:50 am

Whew! Seems like they sure did get a bit carried away on the billing for that hose!! Here's the billing for a hose that I got in 2008.

1 A7037 - Tubing Used With Positive Airway Pressure Device
Billed amount: $54.00 - Medicare Allowed: $41.02 - Medicare paid: $32.82 - CoPay: $8.20

WearyOne · Post by **WearyOne** » Fri Mar 13, 2009 9:17 am

I'm certainly not trying to take up for the high cost of medical equipment, but I have found that what my insurance company PAYS is not the same thing as they are billed, sometimes by a long shot. For example, the bill from only the hospital for my surgery in December was an unbelievable $20,191.59. But between the insurance company and my copay, the hospital was paid around $1,500.

For the Liberty mask and headgear, my insurance company was charged $250.00. The insurance company paid $156 and I paid $40, which is about $35 more than cpap.com, and less than a couple of other online places.

I know medical providers (physicians, hospitals, DME's, etc.) have different contracts with different insurance companies on what they will accept as payment for something, but I still don't understand the whole concept of billing something like $20,000 for a procedure, but accepting $1,500. Why the huge charge in the first place, I wonder, when they will accept less, sometimes a lot less.

Pam

jules · Post by **jules** » Fri Mar 13, 2009 9:23 am

Your experience is pretty standard. The hose might be excessive but this is the way the Brick and Mortar DME's operate where the prices are 3 to 5 times the online prices.

They do have more overhead than cpap.com. They do provide credit for purchases where cpap.com is a cash and send place. They do provide people to do insurance paperwork.

They are a convenience store.

Welcome to the real world.

dieselgal · Post by **dieselgal** » Fri Mar 13, 2009 9:34 am

BostonZZZZ wrote:Sorry but I don't see what medical insurance has to do with this. If you're talking about my personal insurance (Blue Cross) they paid more than what should have been the full cost of the machine. So essentially they are getting ripped off as well and should be as P.O'd as I am. Do you mean that the sleep Center is jacking the price up as a profit center to cover their own costs of insurance plus?

The insurance companies DO KNOW. I called them before I purchased because I had been on this forum and checked out prices online. They don't care. I even told them that I could get if for less than half of their negotiated price but their response was "If you buy it out of pocket you can send in the bill BUT they would only pay UP to 70% of the total and that isn't guaranteed" Because that Vendor is not in their network.

slacker361 · Post by **slacker361** » Fri Mar 13, 2009 10:25 am

BostonZZZZ wrote:Sorry but I don't see what medical insurance has to do with this. If you're talking about my personal insurance (Blue Cross) they paid more than what should have been the full cost of the machine. So essentially they are getting ripped off as well and should be as P.O'd as I am. Do you mean that the sleep Center is jacking the price up as a profit center to cover their own costs of insurance plus?

Insurance companies will not take the hit, it will be passed on to you , higher premiums, certain things not being covered, so when you say the insurance company is getting ripped off re think that, its you and me that are getting ripped off.

nobody · Post by **nobody** » Fri Mar 13, 2009 10:39 am

BostonZZZZ wrote:Sorry but I don't see what medical insurance has to do with this. If you're talking about my personal insurance (Blue Cross) they paid more than what should have been the full cost of the machine. So essentially they are getting ripped off as well and should be as P.O'd as I am. Do you mean that the sleep Center is jacking the price up as a profit center to cover their own costs of insurance plus?

You (and/or your employer) are the ones who ultimately end up paying for that, so they have no reason to be ticked off, but you do. After my insurance refused to pay for a much cheaper generic asthma inhaler, and would only pay for the expensive brand inhaler from a certain pharmaceutical company, I began to suspect that there are a lot of back room deals going on that do not make the health care system more efficient for you and I and have the effect of lining the pockets of a certain few, again, at our expense.

TheDreamer · Post by **TheDreamer** » Fri Mar 13, 2009 1:11 pm

Part of the high cost is the overhead of billing an insurance company and getting money from them.

I was going to a PT once. She told me it was $50 a visit, if she billed my insurance.....(to cost me $20 + 35% co-insurance = out of pocket total $30.50) Otherwise it was $35 a visit, if I paid her directly.

Hmmm.....

I did find out that she was using an outside company to handle her insurance billing....

The Dreamer.

jnk · Post by **jnk** » Fri Mar 13, 2009 1:19 pm

Re: Sleep Center thieves

Man. It must have taken some very enterprising theives to have been able to steal an entire sleep center like that!

TheDreamer · Post by **TheDreamer** » Fri Mar 13, 2009 1:58 pm

jnk wrote:
Re: Sleep Center thieves
Man. It must have taken some very enterprising theives to have been able to steal an entire sleep center like that!

Probably happened in broad daylight too, eh?

goose · Post by **goose** » Fri Mar 13, 2009 1:59 pm

This scenario is part of what our government faces while trying to reform and provide real medical care to everyone. The big bucks lobbyists will be out like flies on <well you know>.......and we all know "money talks, BS walks"......We also know that our elected officials are money driven greedheads and very weak in moral character -- all of them (I don't care if you're a repugnantcan or a dummycrat - they're all thieves....). If it will get them a few votes, it doesn't matter the morality.
If any of you read or experienced what just happened in California it's only a small example of the corruption in our governments. We all wonder why "Johnny can't read" (sorry Johnny -- it's a figure of speech!!!). California cut $11B out of the education budget instead of taking it from elsewhere. Education is such an easy target.....Take it out of Fire and Safety and see how much money "we the people" are willing to pony up to save it.....

I'm not one that desires "social medicine" - I don't want the same people handling my health care as handles my mail, or my airport safety -- but I'm one that knows that something must be done!!! It's not going to be easy, cheap or happen overnight, but it's these kinds of bills that need to be brought under control....

Like WearyOne, the EOB for my surgery was around $33K, my insurance paid about $4k plus or minus, and I paid nothing!!! If you look at your EOB's you might be shocked at what the doctors and the like bill the insurance companies and accept as payment, despite the contracted rates that have been agreed to. Not being an accountant in the medical profession (or an accountant at all), I have the belief that the difference between what's billed and what's paid is used somehow as a tax deduction to lower the taxes these greedheads pay -- kind of like a "bad debt" write off. "I billed 'x', was paid 'y' and the difference is 'z' so 30% of that is 'a', so 'a' is somehow deductible as a "business expense""......

Until "we the people" are so outraged that we'll actively do something about it (Like vote the bast***** out) nothing will change any time soon.....

Just my cynical side coming out....
cheers
goose

neverbetter · Post by **neverbetter** » Fri Mar 13, 2009 2:12 pm

The reason they charge more is because they can. That is one reason Resmed has such a fit about their products sold online under the guize of "no personal service available online"...bla bla bla. They don't want the onliers undercutting the markup the DME's get,
As far as sleep centers, they get their masks for free or under 15.00
they should pass on the savings

Mask