The call to the DME regarding an APAP vs CPAP (today)

Rastaman · Post by **Rastaman** » Fri Jun 09, 2006 7:26 am

Just because they bill that much doesn't mean they GET that much

snoregirl · Post by **snoregirl** » Fri Jun 09, 2006 10:13 am

Well my case is also about 2x $725 on cpap.com vs about $1450 DME. I am supposed to pay 20% of the negotiated cost and since I paid 20% of the $1450, the insurance had better be paying the DME off the $1450 number or I will be calling for a refund on my copay.
Believe me I am watching closely. May be a month yet before all the paperwork comes through, but I will still be watching.

Had the same experience with my sleep study billed about $3K and paid much less. My copay was off the lesser number. Same when my son broke his leg, hospital bill was $999 and negotiated wast in the $250 range. My copay was 20% of the $250ish number.

So based on these other experiences I am betting the number that the DME gets is the $1450 since that is what my copay was based on.

Guest · Post by **Guest** » Fri Jun 09, 2006 4:36 pm

Rastaman wrote:Just because they bill that much doesn't mean they GET that much

Why are they billing over twice the amount that cpap.com charges? That's crazy.

Guest · Post by **Guest** » Fri Jun 09, 2006 4:58 pm

Anonymous wrote:
Rastaman wrote:Just because they bill that much doesn't mean they GET that much
Why are they billing over twice the amount that cpap.com charges? That's crazy.

Guest · Post by **Guest** » Fri Jun 09, 2006 5:18 pm

So because the DME only gets a percentage of what they bill, they charge double/triple/quadruple what the equipment is worth in order to increase their take?

It may be crazy that they can do that, but it's even crazier that we give them our business so they can continue to do it. We've created a monster.