DME extra charge for mask upgrade

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
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provider
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Joined: Fri May 29, 2009 1:17 pm
Location: Cleveland, OH

Re: DME extra charge for mask upgrade

Post by provider » Tue Aug 11, 2009 1:11 pm

Sounds a tad fishy. HOWEVER, are you switching from a nasal mask or nasal pillows to a full face mask? It is actually a different billing code and is covered at a higher rate so it does cost more.
~ Your friendly skulking DME provider hoping to offer some clues to the mysteries for patients.

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cinco777
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Location: Bay Area, CA

Re: DME extra charge for mask upgrade

Post by cinco777 » Tue Aug 11, 2009 1:34 pm

mattman wrote
There's more as well, but the fact remains that it's simply not a fair comparison and it's not accurate to paint all DME companies as money grubbing scum, or as cheats or as people trying to screw anyone over. Are there some that are? You're damn right there are. However - I'd be willing to wager that 90%+ of them are genuinely trying to help patient as best they can in a system that's screwed up thanks to Lawyers and Insurance companies.
Based on my DME experiences, I would be willing to wager a "night on the town including dinner" that over 90% are money grubbing scum. That is their "business model".

It was entertaining, however, to read Mattman's long post at the beginning of this thread as it has been a long time (decades) since I've read such a good fairy tale.

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mattman
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Re: DME extra charge for mask upgrade

Post by mattman » Tue Aug 11, 2009 3:35 pm

cinco777 wrote:mattman wrote
There's more as well, but the fact remains that it's simply not a fair comparison and it's not accurate to paint all DME companies as money grubbing scum, or as cheats or as people trying to screw anyone over. Are there some that are? You're damn right there are. However - I'd be willing to wager that 90%+ of them are genuinely trying to help patient as best they can in a system that's screwed up thanks to Lawyers and Insurance companies.
Based on my DME experiences, I would be willing to wager a "night on the town including dinner" that over 90% are money grubbing scum. That is their "business model".

It was entertaining, however, to read Mattman's long post at the beginning of this thread as it has been a long time (decades) since I've read such a good fairy tale.
Out of curiousity, what are you basing your 90% guess on? And you are of course welcome to your opinion that it's a fairy tale. I genuinely hope that you (or anyone) are never have the kind of life altering health problems come up that would put you in a position to find out if it's true or not.

mattman
Machine: REMstar Pro 2 C-Flex CPAP Machine
Masks: 1) ComfortGel Mask with Headgear
2) ComfortSelect Mask with Headgear
3) Swift
Humidifier: REMstar Heated Humidifier

Really
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Re: DME extra charge for mask upgrade

Post by Really » Tue Aug 11, 2009 4:04 pm

mattman wrote:Out of curiousity, what are you basing your 90% guess on? And you are of course welcome to your opinion that it's a fairy tale. I genuinely hope that you (or anyone) are never have the kind of life altering health problems come up that would put you in a position to find out if it's true or not.
mattman
Maybe the hunch that you would take the parts that he has already paid for. Really!

It seems like Matt owned a DME business which is why he spends all his time defending the illegal things they do. It also seems like he ran them out of business but fails to get the connection to illegal practices. Really!

Unless he is Muse-Inc.
mattman wrote:Speaking from the perspective of a DME provider:

In my years and with the various business I've either worked for or with it's never been from a standpoint of trying to "rip people off". I'm certain that there are, sadly, some companies out there that do rip people off. Just like I'm certain there are internet companies that rip people off and there are fast food restaurants that rip people off and on and on.

However, here is my reasoning. I'm betting something on the order of 95% of patients don't worry about extra sizes of nasal pillows (for instance). They don't even care much less want to organize swaps of unused sizes for extras of the sizes the use. However, I can absolutely use those sizes. Then when I get that Saturday afternoon call from someone whose cat has just decided that thier Swift looks exactly like that fuzzy caterpillar that it's been wanting to kill and now their pillows are confetti - I now have a spare. I don't have to worry about trying to figure out if insurance will cover a whole new mask yet (And try doing that on a weekend anyways.) I can just give them a new set of pillows at no charge and everyone is happy.

Or for someone who doesn't want, have or give two twigs about a smart card I now have a spare for the guy whose parrot pulled his smart card out and pecked it until it no longer worked (True story). Though to be honest those are still usually left in the machines anyways.

We keep these extra things that the vast overwhelming majority of people never use so that we have extras for the wierd things that can and do happen on a daily basis. So yeah, I like to keep a little bin full of extra sizes of pillows and most other people I know do as well.

mattman
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