IS THIS REPORTABLE FRAUD?

[srlevine1]

Didn't you mention that your DME lost it's medicare contract? Perhaps the machine is grandfathered in if you took possession prior to 01 July 2016.

Yes, my machine was delivered on March 21, 2016 and I did receive notification that my account was grandfathered until the machine became my property.

I was wondering if I should establish an account with the Medicare-approved vendor now and use it for supplies to keep everything flowing? Great timing because my DME just called me from the Philippines to "remind me" that my supply order was due and that they would be pleased to take the order while I was on the line.

And, while you are writing letters, don't forget to cc Ezekiel (aka E-Z KILL) Emanuel for his efforts in theoretically justifying denials, delays, and death panels.

[zonk]

Q: How should an integrated device be billed since it has only one serial number?

The provider should enter the same serial number for both the CPAP (E0601) line item and the humidifier (E0562) line item. These items are still separately billable and the same serial number is used for both line items. For billing software that asks for two separate serial numbers/ codes for the humidifier and PAP device, the provider may choose to add an “H” to the end of the humidifier‘s serial number to differentiate between the two components. http://www.resmed.com/us/dam/documents/a...gories.pdf

[justMongo]

I was wondering if I should establish an account with the Medicare-approved vendor now and use it for supplies to keep everything flowing?

Yes. It may take you a while to get that setup. The remaining ones don't have the phone capacity for all the transferring patients. Plus, they seem to be leaving it up to the patient to get all the documents to them.

Add to that, the fact that I will be limiting the scope of medical information to they may disclose and for what purpose; and they may just reject it. (Although I doubt it, if one is specific as to type and purpose.)

[Marthajoy7]

It looks from the above statement, that the s10 is rented but the humidifier is purchased. Then why did I need to return the humidifier part when I upgraded from cpap to bipap?

[OpalRose]

If I remember correctly, Medicare does not pay rent on the humidifier, only the Cpap. They usually purchase the humidifier and that's why the billed charge is higher for the humidifier.

[kwhenrykerr]

If I remember correctly, Medicare does not pay rent on the humidifier, only the Cpap. They usually purchase the humidifier and that's why the billed charge is higher for the humidifier.

So it could be resold ?
Double your pleasure
Double your fun
Chew Doublemint Gum
Or sell the same thing two times

[OpalRose]

If I remember correctly, Medicare does not pay rent on the humidifier, only the Cpap. They usually purchase the humidifier and that's why the billed charge is higher for the humidifier.

So it could be resold ?
Double your pleasure
Double your fun
Chew Doublemint Gum
Or sell the same thing two times

According to Medicare, they pay outright for the humidifier, usually within that first 3 month period. It is yours, you shouldn't have to return it.

Rental on machines continues until the 13th month has been reached.

And I don't put anything past a DME.

[robertbuckley]

xPaps are "rented" - i.e. sold to you - with payments over a 13 month period. The humidifier is a one time thing.
xPaps and humidifiers were separate units until recently, and not everyone got/received a humidifier. In fact for those of us old enough, we remember when you would choose between no humidifier, a passive Passover humidifier, and a heated humidifier. Thus the separate codes.
Think of it this way - In 1957 you bought your new '57 Chevy, which did not come with factory air, added an after sale A/C (remember those? sat on the transmission hump under the dash) and you then totaled the Chevy on a levy driving through Louisiana. You would put in an insurance claim for the Chevy and for the A/C separately. The health insurance industry has not progressed much since 1957, except they have refined the ability to say no.

[kwhenrykerr]

Say no and delay till you die. They are not in business to pay out. That job is taken by taxpayers...

[MitchS]

Say no and delay till you die. They are not in business to pay out. That job is taken by taxpayers...