[How to] Conversation with DME

[kb8rzvadw]

Must be a common occurance with DME's. Just this week mine called to ask why I only paid $XX (the agreed upon amount) to them this month. I told them that was what the paperwork they gave me when I got my machine said I had to pay each month. I also told them that after 2 monthes I had yet to recieve an invoice. I was paying the agreed amount without being invoiced. They wanted another $261 more than I already paid. Their Rep said he would get me an itemized invoice out and check to see why they never applied payments. Turns out even though all my checks have my acct. number on them they applied one of them to somebody elses acct. Further research by the Rep found that the credit card payment collected by them at the time i picked up my machine was applied to yet another acct. I finally got the itemized list today and they billed my insurance for $223 for my mask, then bill billed them agaian for each component seperately. I never got any spare parts at all. I can't wait to hear them try and explain that. I'm suprised the insurance didn't cacth it. These companies must not be very good at basic accounting. At this point i am just laughing at the shear incompetence displayed by these people. They are so confused I don't know how they could balance their checkbook let alone handle several hundred acct. on a monthly basis.Well, I guess by shear numbers somebody has to be the worst accountant in town and I think I know where they work. LOL.

[JJJ]

Must be a common occurance with DME's.

It's not just DMEs. I kept getting bills from an eye surgeon for an operation he canceled because I refused to sign a Medicare (US) form that he presented to me the day before the surgery. Medicare rules require him to present the form at least a month before the procedure, so he was in violation even by asking me to sign it. And then he started sending me bills for the co-pay as though he had done the operation. When I got the first bill I called his office and explained. The lady said she would "look into it." A month later I got another bill marked "past due" with a warning that failing to pay would affect my credit rating. At that point I called Medicare and discovered that he had billed them as well, and they had already paid him. I blew the whistle. Just the other day I got a letter from Medicare stating that they had disallowed his bill and were demanding that he return the payment to them.

I keep reading about similar cases. I think this crap is more common than we realize. It's true that doctors cannot accept very many Medicare patients lest they go broke. Medicare does not pay enough to cover their costs. But that is not an excuse for fraud.

[Schnauzers 5]

A friend of mine, years ago, had trouble with her car. She kept taking it in, paying for repairs, but it was never really fixed. Finally, she got her kid and several other kids and she and their parents gave them permission to be brats. No outright damaging of anything, but running around, being loud, was fine. So she took these five kids to the repair place. Told them she had a new job of babysitting these kids after school. And wasn't it a shame they had to come with her every time she needed repairs?

Wouldn't you know, not only was it finally fixed, but it was her lowest bill yet. And she didn't have to go back. The kids got some good ice cream on their way home!

Is that really true? Great Idea I have 3 very noisy little boys next door.

[Sleepster]

See, you won't even have to get their parent's permission!

[PaulaO2]

Yes, true story. And it worked. They were tricking her and she knew it but couldn't prove it. We all thought she proved it when they miraculously fixed her car finally.

I get statements from Medicare/Medicaid and I always check them to make sure the billing is right. And I've sent letters to several congressfolk about the "renting" Medicare does with CPAP machines. And that for the same price, they could have bought two or three.

Last year or so, I got a phone call from someone saying she was from Medicare. I didn't believe her and didn't return the call. She called back when I was home and she said who she was, that I didn't need to tell her anything personal, just confirm my name and mailing address. I figured they could get that from the phone book so I agreed. She then said she worked for a company that kind of audited whatever Medicare asked them to, chased down discrepancies, etc. She asked me about when I broke my leg the previous year. And did I remember who the Ortho was. Heck, I couldn't remember his name because I see so many. She said she had a list of orthos in the area and she would read from the list. The first one she mentioned was him. She asked how many knee braces had he given me. I said two. She said was I sure? That maybe one was the wrong size? No, definately just two. The big huge brace was from the ER, the others were from him. We talked about how awful ER rooms are and then she asked me again how many braces. I assured her it was just two. She thanked me for my time.

I needed to go to an ortho a few months later and remembered him. I looked him up and he is no longer in practice. A part of me was not surprised. I think someone must have been adding to the bills. This is why I now look at each bill I get.

[Shastzi]

Theft by incompetance seems to he what I am reading about here.
It works quite well because the theif can always go: "Oops! My bad! Oh my, I am such a goober with numbers..." but the perpetrator really hopes that the discrepencies do not get caught. (and most of the time they don't)
***
The way to handle that is by dumping a truck load of rampant auditors on the place and after a fair trial, close them down for good.

=^.^=

[kb8rzvadw]

Turns out their policy for pricing the mask does not include the cushion or headgear. So here is the breakdown for their pricing of a Resmed Quatro FX mask.

$232.67 Mask
$ 74.19 Cushion
$ 37.96 Headgear
Total $344.82 for a mask that can be bought from one of our suppliers for $185.00

Can you say "Holy profit margin Batman"

[Shastzi]

Yow.
I can get 2-3 masks fully equipped for that $$ and I don't even have to go down the street to Slim Cognito's Bargain Basement.

[Sleepster]

Those are jacked-up unreal insurance prices. Nobody pays them. If you have insurance your insurance company will make sure they get nowhere near that amount. If you don't have insurance you'll go online and pay the real price.