Oshawa Sleep Center are thieves

I recently purchased my CPAP machine (s9 elite + humi + heated hose + pillows mask + standard tube) and Oshawa Sleep Center charged $1800 for the package, where online they are only charging ~$1100. These people are marking up the costs of CPAP by 80% and making thousands off people like myself, who without knowing ordered where the doctor recommended I should order from. This is a warning for anyone who doesnt have benefits or wants to keep the hit to their benefits and wellness status from being affected.

Sincerely,

Dhtmldude

dhtmldude wrote:I recently purchased my CPAP machine (s9 elite + humi + heated hose + pillows mask + standard tube) and Oshawa Sleep Center charged $1800 for the package, where online they are only charging ~$1100. These people are marking up the costs of CPAP by 80% and making thousands off people like myself, who without knowing ordered where the doctor recommended I should order from. This is a warning for anyone who doesnt have benefits or wants to keep the hit to their benefits and wellness status from being affected.

Sincerely,

Dhtmldude

That is the difference between "bricks and mortar" store (with more overhead) and online store. Theoretically for that extra money you get quality time with a pro who explains all the details with you, does a professional fitting for the mask and hand holds you through the first few weeks. Yes I know I am dreaming or smoking illegal substances.

It's a crazy game. Insurance companies will only pay a certain percentage of the bill to the DME. So the DME decides how much money they want to be paid, and then overbill so that when the insurance company pays them, they get that amount.

Surgical centers do the same. I nearly had heartfailure when my out-of-network surgical center gave me the estimate for my daughter's surgery. They aren't in anyone's network, they explained. My insurance company pays 60% of out of network expenses, so they charged me 40% or so more than what they needed to cover their expenses and make a small profit. Had they charged the "real cost" then they would have operated at a loss (billing at an accurate rate and only being reimbursed 60% of that).

Does your insurance allow you to order on line? Some do, some don't.

GROAN!! I so HATE sticking up for local DME providers:

But ......

They have to shell out a pretty healthy amount of money to have the "inventory" sitting on their shelves to supply you, and others, with when you walk in door w/your equipment order (script).

The bulk of their business is with Mediare patients. Medicare only pays every three months. And in the matter of CPAPs, Medicare insists on a 13 month rent to own basis. So - the local DME provider shells out big bucks to have the CPAPs sitting there waiting for patients, then they get reimbursed 3 months rental every 3 months and it takes 13 months to get paid in full for those CPAPs. Most all insurances only purchase CPAPs w/a similar rent to own purchase of CPAPs altho the insurances will usually make monthly payments instead of quarterly and their rental length may vary from 3 to 13 months, the majority of them insisting on 13 months like Medicare.

In addition, the local DME providers have to have staff knowledgeable and experienced working w/billing and collecting from a myriad of different insurances. They have to deal w/obtaining approval from different insurances. They have to deal w/the proper insurance coding for the items. Wrong billing code and no payment, resubmitting corrections, etc. Every item has a billing code, the script has to have a diagnosis code ..... its really quite a nightmare of paperwork.

Online DME providers on the other hand don't deal w/insurances. They get their money in full, up front, before the CPAP ever leaves their door.

dhtmldude wrote:I recently purchased my CPAP machine (s9 elite + humi + heated hose + pillows mask + standard tube) and xxxx Sleep Center charged $1800 for the package, where online they are only charging ~$1100. These people are marking up the costs of CPAP by 80% and making thousands off people like myself, who without knowing ordered where the doctor recommended I should order from. This is a warning for anyone who doesnt have benefits or wants to keep the hit to their benefits and wellness status from being affected.

Sincerely,

Dhtmldude

Do you need a warning sticker in your mirror that says do the price comparison before you make the purchase?

Most people in the U.S. know how to shop and compare products, services, and prices. But when it comes to medical products and services, our brains go into neutral. We need to change and then the businesses will be forced to change or go out of business.

roster wrote: Do you need a warning sticker in your mirror that says do the price comparison before you make the purchase?

Most people in the USA know how to shop and compare products, services, and prices. But when it comes to medical products and services, our brains go into neutral. We need to change and then the businesses will be forced to change or go out of business.

I definately need to snap out of it when it comes to medical services.

Like Slinky, I also hate to stick up for the brick and mortar DME's..........BUT when you are a newbie and need access to lots of different masks, and different sizes, they are the way to go. They will often let you try masks and continue to trade them in within 30 days for other ones, or allow you to even keep the mask that isn't quite right........

Once you are settled, online is definitely more cost effective.

BUT BECAUSE YOU MADE AN ERROR IN CHECKING PRICES, DOES NOT MAKE THE OSHAWA SLEEP CENTER A THIEF.............no one forced you to buy there. It's just a hard lesson to learn.

If you get good support from them, I'd try to view the additional cost as an investment in your health rather than focusing on how much you could have saved.

I got mine through a contracted, in-network local DME. Because of the contract, the DME had no say in how much they were paid, either by the insurance co or me. They filed for $2300 for an S9 Autoset w/H5i and ClimateLine hose, along with a Mirage SoftGel. Insurance denied $900 of the $2300. Insurance paid about $1100 and I paid a little less than $300. My DME isn't pefect, but, I have direct cell numbers for their RRTs and when I had a problem with my 2-month old S9 in January, I had a new s9 within 3 hours of calling them. So, yeah, they made more than an online source, but I am getting much better service.

If I'd had to pay out of pocket, though, I would definitely have bought online. Without a contracted insurance plan in place, they would have wanted the full $2300. For that much, I could buy 2 setups online, and getting fast service wouldn't have been so important.

Sorry this happened to you. I've been there, and it truly is frustrating. Probably the only good thing is that you'll be far more likely to research and shop around beforehand the next time around. Hopefully, the follow up support you get from them will help to ease things.

Good luck with your treatment!

Are you in Ontario Canada? Oshawa might indicate that.

dhtmldude wrote:I recently purchased my CPAP machine (s9 elite + humi + heated hose + pillows mask + standard tube) and Oshawa Sleep Center charged $1800 for the package, where online they are only charging ~$1100. These people are marking up the costs of CPAP by 80% and making thousands off people like myself, who without knowing ordered where the doctor recommended I should order from. This is a warning for anyone who doesnt have benefits or wants to keep the hit to their benefits and wellness status from being affected.

Sincerely,

Dhtmldude

Welcome to the forum!

Since you are in Ontario, I assume that you're covered by OHIP and that you've purchased your equipment through the Ontario Assistive Devices Program (ADP). Here are some links to ADP to explain the program.

http://www.health.gov.on.ca/english/pub ... /resp.html
http://www.health.gov.on.ca/en/public/p ... b_adp.aspx
http://www.health.gov.on.ca/english/pub ... dp_mn.html

Re the cost of your cpap equipment, you may wish to note the following quote (taken from the first of the above links):

"For continuous positive airway pressure systems (CPAP and Auto-Titrating), suction and tracheostomy products, ADP will pay 75 per cent of the ADP approved price. You will be charged for the remaining 25 per cent."

Note too that ADP approved DMEs are not allowed to mark up the cost of equipment above the price that's approved by ADP.

I'm uncertain of the current costs, but when I purchased in 2008, the ADP approved price for a cpap and humidifier and hose was $1040, of which ADP paid $780. Your 25% would be $260. Purchase of a mask would be in addition to these amounts, with the same 75% amount paid by ADP. Assuming the mask charge was $240 (not uncommon from an Ontario DME), your cost for the mask would be $60. So your total outlay for these items should be no more than about $320. The heated hose that you purchased would likely NOT be covered by ADP.

2011 prices may be a little higher. Contact ADP to find out current prices.

Charges for equipment need to be submitted to ADP by the DME. If Oshawa sleep centre did not submit your charges to ADP, you need to find out why.

I suggest you do a little more digging and find out why you were charged so much. If you were not dealt with fairly, then you also might wish to contact ADP.

Let us know how you make out!

I asked if you were in Oshawa Ontario in Canada because of the Asssitive Devices Program which Hose_Head outlined well.

You should have had 75% of your initial equipment covered. If it wasn't you need to go after your supplier and find out why not!

My DME did not fare so well with my insurance company. Insurance pays rent for three months and then purchases devices. The DME received $1500 in rent, $943 towards puchase from the insurance company, and $1200 from me (nearly all my deductible for 2011). So they received about $3,700 in payments. My ASV retails on cpap.com for $5800.

My doctor's advice on Monday was that I sell the ASV on ebay and buy an auto bipap from cpap.com. I don't need the ASV and could turn a profit.

I just checked the Oshawa Sleep Centre's web site. It is NOT a DME. It's a sleep clinic and it does NOT sell xpap equipment.

Are you sure that you bought equipment from the Oshawa Sleep Centre? What is the name of the company that issued you a receipt for your equipment? Was it Vitalaire or Medigas or something like that?

Bons wrote: My doctor's advice on Monday was that I sell the ASV on ebay and buy an auto bipap from cpap.com. I don't need the ASV and could turn a profit.

You should tell your doctor that eBay doesn't allow prescription medical devices.

Hose_Head wrote:I just checked the Oshawa Sleep Centre's web site. It is NOT a DME. It's a sleep clinic and it does NOT sell xpap equipment.

Are you sure that you bought equipment from the Oshawa Sleep Centre? What is the name of the company that issued you a receipt for your equipment? Was it Vitalaire or Medigas or something like that?

If that is the case, I think this entire thread should be purged from the forum. No use having a business called thieves on this website given what you just described. It hurts the credibility of the forum. Thanks HoseHead.