Is this the Norm???

[smiledog]

After my second study they issued me a Resmed AirCurve 10 Vauto. I picked it up blindly (my Fault). I paid a fee of $117.00 then was told there's a monthly charge of $54 for 13 month. Really!! That comes to $819.00. I contacted my insurer and they said they rejected the claim because after my first study they paid for a Resmed AirSense 10 Auto (on that machine I put out $90 upfront then $21 a month for 7 months I never got charged the $21 because I didn't have that machine but for a month) After speaking to my insurer they said the DME billed them for the AirSemse 10 the second time, that's why they denied the claim. They told me that they have not received a claim for the AirCurve.
       I have great insurance they pay the 80% I pay the 20% If I do the math they are charging $4000.00 for the AirCurve . I only picked up the machine, no hose, no mask ETC. When I asked the DME for the break down of costs they conveniently couldn't find it, and gave me a delivery ticket. I sent all the paperwork I have to my insurer and they are investigating these charges.
       Has anyone else dealt with this type of billing? If so is it the norm???

[justMongo]

Unfortunately, in too many cases that's quasi-normal.
Who is the DME? You can name them as long as it's not a link or a quasi-link.
Perhaps Apria or Lincare?

When I picked up my first machine in 2009, it was an 80%/20% split with my coinsurance picking up the 20%. It was also a 13 month "rental" before it became mine. They gave me a brick. My present machine was bought with a prescription through an online source. I paid out-of-pocket; but got it for about 25% of the list price. And, it was the machine I wanted.

Medical billing is hard to decipher because the rules are like the US Tax Code.

You did receive a very good machine. And $4k is approx. the list price.

[silversnore]

I bought a brand new Aircurve Vauto on craigslist for $500.00!! The fellow that sold it to me was in the medical supply buisness and buying overstock, liquidations, etc. It arrived in the Resmed Box, brand new, plastic still on everything and zero hours. I bought it as I thought I could outsmart my insurance company, but I still wanted them to pay for the mask and supplies. I will use it as a backup until I meet compliance and then turn it in. By the way I have had my DME supplied device a few months, the serial number on the one from craigslist indicated that it was newer than the DME issue.

[xxyzx]

After my second study they issued me a Resmed AirCurve 10 Vauto. I picked it up blindly (my Fault). I paid a fee of $117.00 then was told there's a monthly charge of $54 for 13 month. Really!! That comes to $819.00. I contacted my insurer and they said they rejected the claim because after my first study they paid for a Resmed AirSense 10 Auto (on that machine I put out $90 upfront then $21 a month for 7 months I never got charged the $21 because I didn't have that machine but for a month) After speaking to my insurer they said the DME billed them for the AirSemse 10 the second time, that's why they denied the claim. They told me that they have not received a claim for the AirCurve.
       I have great insurance they pay the 80% I pay the 20% If I do the math they are charging $4000.00 for the AirCurve . I only picked up the machine, no hose, no mask ETC. When I asked the DME for the break down of costs they conveniently couldn't find it, and gave me a delivery ticket. I sent all the paperwork I have to my insurer and they are investigating these charges.
       Has anyone else dealt with this type of billing? If so is it the norm???

DMEs are imho evil scammers only out to suck money out of your wallet and the insurance company

[smiledog]

Justmongo,  You have to Sleep well in Georgia only. My Dr's front door is 5ft from my DME's. I've looked up that machine, and I do realize it's a top of the line machine. But I have seen the same machine on several of this forums suppliers list for $1700.00.
I have a gut feeling I'm getting scammed some how. You know what they say about gut feelings, If you have one most of the time you are right. They won't return calls to me or my insurer, they conveniently can't find my paperwork when I standing in front of them. They say thing like "it's a prescription you can't change your pressures or you will be non compliant"  I've asked questions to there nurse tech when picking up equipment. It seems like she wants to tell me whats up, but can't risk loosing her job.
         This is way out of my norm for dealing with people. I'm not the type that thinks everyone is out to get me.
          I have found out they own the sleep lab where I had my tests done. I originally thought the Dr controlled the lab.

[smiledog]

I'm learning the hard way of the evil of this DME. I have read where people love there DME but not to often.

[PaytonA]

Justmongo,  You have to Sleep well in Georgia only. My Dr's front door is 5ft from my DME's. I've looked up that machine, and I do realize it's a top of the line machine. But I have seen the same machine on several of this forums suppliers list for $1700.00.
I have a gut feeling I'm getting scammed some how. You know what they say about gut feelings, If you have one most of the time you are right. They won't return calls to me or my insurer, they conveniently can't find my paperwork when I standing in front of them. They say thing like "it's a prescription you can't change your pressures or you will be non compliant"  I've asked questions to there nurse tech when picking up equipment. It seems like she wants to tell me whats up, but can't risk loosing her job.
         This is way out of my norm for dealing with people. I'm not the type that thinks everyone is out to get me.
          I have found out they own the sleep lab where I had my tests done. I originally thought the Dr controlled the lab.

Talk to your insurance company and see if they can talk the DME into charging you at the insurance companies negotiated rate. If that does not work, it may be cheaper to buy online out of your own pocket. All you need is a copy of your prescription.

Best Regards,

PaytonA

[smiledog]

PaytonA, I have a copy of the script. I last spoke with my insurance company this past Wednesday. They have appointed me a representative so I don't have to go through there auto system when I call, and having to go over the whole thing every time. He called me Wednesday, and said when he called there was no one there that could speak to him about my account. MMMM That they would call him back. I haven't heard from him yet. I've sent him all the paperwork I have. When I picked up the AirSense they gave me a copy of the payments, $90 upfront then it was worded as 3 payments of $21. I went back the next week and said just let me pay you all of it. I'm thinking $63, no they came back and said $700 something dollars. They explained to me it was a insurance thing and it was $21 for 7 months. But when I asked them for the new AirCurve paperwork all they gave me was a delivery ticket.
           I'm stepping back for a minute to let the insurance company get to the bottom of it. We will see. 
           I have seen this machine on several sites selling new from $1700.00 (most of them) to $2800.00 I've checked the supplier's on this forum to see if any of them are in my network, and none of them are. I reviewed a list of supplier's that are in my network, and it seems that my DME carry's a better selection.

[speed3914]

Wow I'm realizing how fortunate I am to have good insurance as my machine was free.  Some of the prices mentioned are insane...especially with insurance!

[speed3914]

sorry duplicate post