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Is this the Norm???
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05-14-2017, 05:41 PM
RE: Is this the Norm???
My sleep dr owns the sleep lab, and he's also his own DME. Corupt to the core. So I've fired him and found my own DME.
05-16-2017, 05:01 PM
RE: Is this the Norm???
Back to update my original post, so I've told you guys that I've involved my insurance company's representative. He called me today and told me he has called the DME several times, and was told there was no one there that could speak to him about my claim, or lack of a claim on the AirCurve ( they have submitted 2 claims on the AirSense and 1 was denied). I believe he is now seeing my frustration with this DME. He told me today that instead of asking for someone to go over my claim ( he has been giving them my name) He threw them a high speed curve ball . He left a message that he had a new high $$ claim that they would not be able to approve unless he spoke to someone.(my name wasn't mentioned) He called them after 4pm today. If I was a betting man, I would wager that he gets a call back no later then noon tomorrow. It was the best thing I have heard all day.
"I say, you work eight hours, and you sleep eight hours - be sure they're not the same eight hours."
05-16-2017, 05:14 PM
RE: Is this the Norm???
Hydrangea, It wouldn't surprise me if I find out that my Dr. owns the lab and the DME.
I have enough gear right now to last me for a while. I did this intentionally. I will no longer be using this DME and more then likely this Dr. All the DME's in my network in this area doesn't offer a decent selection of products. I have the insurance rep. looking into some of the supplier's on the supplier's list. I would really like some input from anyone that has dealt with any of the supplier's on the list. in advance. "I say, you work eight hours, and you sleep eight hours - be sure they're not the same eight hours."
05-16-2017, 05:25 PM
RE: Is this the Norm???
To let you know, Medicare normally won't allow the doctor to act as the DME. I ran into this problem when I received my CPAP while on the last 3 months of private insurance and on the 12 month "lease" to own. We had to ask for an exception in order to pay the remaining months.
Crimson Nape
Apnea Board Moderator Project Manager for OSCAR - Open Source CPAP Analysis Reporter www.ApneaBoard.com ___________________________________ Useful Links -or- When All Else Fails: The Guide to Understanding OSCAR OSCAR Chart Organization Attaching Images and Files on Apnea Board Apnea Helpful Tips INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
05-16-2017, 06:51 PM
RE: Is this the Norm???
crimsonnape, Thanks for the input, I didn't know that. I do know they are using medicare's billing codes. But in today's world it wouldn't surprise me if the DME is running under other names to hide the connection. I have no proof at this point, so this is just an assumption.
"I say, you work eight hours, and you sleep eight hours - be sure they're not the same eight hours."
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