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tonycog wrote:

jnk wrote:In general, though, the arrangement for renting the machine the first month is not done for the customer--it is done for insurance purposes, as I understand it. The doc and DME have to "prove" to insurance that the patient is "benefiting" from the use of the machine and is "compliant" before insurance agrees to pay. So the one-month rental period is generally for a different purpose from those you mention.

This may be very true, but why should the reasons for DME provider policies and practices matter to us, the end-user? We are not bound by the priorities of the insurance company or the DME provider. They use the system to suit their wishes; in fact they invented the system. There is absolutely no reason we cannot benefit from their system when it suits us. We pay them for that opportunity.

Rent your machine for a month. Use that month to figure out which mask(s) suit you best. If it is your choice, then return the machine after the month and purchase the machine you want from another seller of your choosing. If you paid them rent for one month, then you are entitled to use it for one month. If you did not agree to rent or purchase your machine for any longer, then you have a choice - rent for another month, or return the machine.

Tony

I'm just saying 'know your enemies and know yourself.' Knowing their thought processes and how it relates to what we want gives us the edge.

The problem is that it can be very complicated and deceitful, and a person could rent a machine for a month thinking he knows what the charges will be but find out too late there are all sorts of penalties and ramifications sprung on him that are difficult, if not impossible, to fight. It can be like someone thinking he can outsmart the auto dealer by leasing the car for a month and returning it when the agreement is designed for a longterm "relationship." There are usually safeguards in place for the business to make sure they get their money, and there are few, if any, provisions in place to protect the patient in this racket. How do you fight it when the bill is something you didn't expect because it takes years of training to understand the fine print?

I admit I am paranoid about it, but only because it is the job of local DMEs to be out to get me. I would not attempt to outsmart a local DME unless I was perty dang sure I could pull it off. And how can I know that, when most of the "rules" are hidden from me?

My peace of mind came from opting out of that organized-crime-cartel shell game and going back to the ages-old idea of simply buying something from someone with above-board policies and a reputation to protect and who has proved to be trustworthy. Once insurance is involved, that concept goes out the window, and local DMEs are designed to be in the deal-with-insurance business, not so much the sell-something-to-the-patient business, from what I can tell. So, renter beware.

But I could be wrong. I often am.

jeff

I absolutely understand the paranoia. They seem to win, no matter what, whether "they" are DME providers, insurance companies, or billing departments at the doctor's office. We just need to thoroughly understand the papers we sign. If we don't understand it, we should not sign it.

Tony

Now jnk, I agree with you on that.

On a similar ethics question, what about trying on, for sizing purposes, expensive running shoes at a store with all intentions to go home and order them from an internet supplier?

If I ran a shoe store, I would not object to it.

At Books-a-Million there are always people reading the magazines without purchasing. BaM even put in benches in front of all the racks for sitting while reading. The BaM manager told me the magazine publishers know more magazines will be sold if this practice is encouraged than if the customers are discouraged from "free reading".

We have always had excellent health insurance. We always had to pay our own office calls but in exchange we could always go to ANY doctor, hospital, clinic, etc. in the USA w/o bother of referral, approval, etc. We just went and insurance paid.

THEN we were forced onto Medicare. AND at the same time our family doctor of long-standing died and we had to "doctor shop" for a new family doctor. Were we ever in for some SURPRISES!!!!!

We had been used to paying $35 for an office call whether we saw the doctor for 5 minutes, 15 minutes or whatever. We had never encountered "timed billing", i.e. the office call charged by the amount of time spent w/the doctor. It was the first time we encountered the "initial office call" timed billing and wait for an appointment! It was also the first time we ever encountered doctors and facilities utilizing "outside billing services" instead of doing their own billing!!! The shock the first time a doctor's office couldn't tell us how much our office call was as we were leaving was .... disconcerting to say the least. AND when we received the bill for it a couple of months later I was fit to be tied!!!

Our previous health insurance was now our secondary health insurance so first Medicare is billed, then our secondary is billed. Since our secondary insurance still doesn't pay for office calls they would send a refusal to the billing service which would then bill us for the Medicare copay. Three months after the fact one barely remembers having the office call!!!! In addition to which since my secondary isn't contracted to pay the Medicare copay its none of their dibblety-damn business that I even went to see my doctor. To say nothing of the extra expense of the extra and unnecessary billing.

Its really been an adjustment process for us. Paying a 3 month old copay is like paying for groceries we ate 3 months ago, gas we put in our car and long ago used up, or for a filling in a tooth that has long ago been pulled! We hate it. We are used to paying at time of service and its not been easy adjusting to this new method of doing health care!

I am not going to say it!

I know. Be GRATEFUL.

And I didn't mean to sound ungrateful. As it turns out Medicare is a blessing since our good heatlh insurance was thru GM/UAW and I'm sure you've read where THAT has been going!!! We are now getting an eddy-ka-shun on deductables and annual deducatables.

And, of course, we retired long enough ago that it never occurred to us that we would have to plan for them. After all we had a "legal contract" for those benefits. We didn't know that our "legal contract" wasn't binding like AIG's upper echelon's legal contracts are.

Slinky wrote:I know. Be GRATEFUL.

And I didn't mean to sound ungrateful. As it turns out Medicare is a blessing since our good heatlh insurance was thru GM/UAW and I'm sure you've read where THAT has been going!!! We are now getting an eddy-ka-shun on deductables and annual deducatables.

And, of course, we retired long enough ago that it never occurred to us that we would have to plan for them. After all we had a "legal contract" for those benefits. We didn't know that our "legal contract" wasn't binding like AIG's upper echelon's legal contracts are.

Naw, that's not what I meant. But Santa is making his list and I'm trying to hush my mouth.

Well, we're learning about higher copays too.

Does that help you get off Santa's "good kid" list?? 'Cause I'm willing to help you try for that lump of coal, Rooster!

Well, while Santa is at dinner, I was thinking about all the complaining here about insurance companies and now get involved with guv'ment insurance and then you find out how guv'ment (U.S. government not Canadian) can really screw things up.

Now it is coming back to me. Seems like I heard that Santa is not too happy with how Medicare is treating him.

Well, now. That wasn't so hard, was it? And not so bad either. I was sure you had somethin' worse up yer sleeve.

Secret Agent Girl, if you are even still reading this thread since it derailed, here's my thoughts. I guess in areas that are not explicity right or wrong, all we can do is operate according to our own sensibilities. A part of me wants to rationalize, but I'm trying to do (be) better about keeping things less convoluted, cause I can justify just about anything in my mind if I really want to. So for me it would be about evaluating the proposition on its own merit (or lack of). While I would feel the same qualms as you, the fact would remain that the dealer had been paid an agreed upon amount for 1 month rental.

As far as the shoe illustration, if I try on a shoe in the store, it can still be sold as new. A returned machine is a used machine. I think most DME's keep loaner machines (used) in the store for temporary situations, as in during repairs or for autopap trials. I would be curious how the rental fee compares between a new and used machine.

Best wishes.

Kathy

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