03-25-2019, 08:29 PM
(This post was last modified: 03-25-2019, 08:30 PM by Creosote.)
My DME company has vanished(?) without billing me
[First off, I'm not entirely clear whether the board rules permit naming the DME company one is talking about. So I haven't, but if that's okay I can identify them in a followup comment. I'm calling the company "BigCompany" below, and the local DME they purchased "LocalCompany".]
I'm wondering what, if anything, to do about an odd situation where the DME company that provided my CPAP machine has gone silent without attempting to bill or invoice me for the last (final?) three payments on the machine.
- I contracted with them for a CPAP machine in April 2018, private insurer, rent-to-own provisions with I thought a total of 13 payments, but it may be that my insurance company capped that at 10.
- The first 8 payments through last November were billed to my insurance and processed as expected, with a 20% coinsurance for which I was billed by BigCompany. The billing company was listed as LocalCompany, accepted as In-Network by my insurance company.
- Payment #8 in November was billed to my insurance, but BigCompany hasn't invoiced me for it yet.
- For payments #9 and 10 (December/January), the billing company was listed as BigCompany, but my insurer listed them as Out of Network on both claims, meaning that in theory I owed a much higher Out of Network deductible.
- But BigCompany has never billed me for anything since October. Nada. My credit card is even on file with them for autopay but they haven't touched it. I haven't heard a peep out of them in five months.
I have just contacted my insurer to ask why I would be assessed Out of Network charges for a company that was In Network when I contracted with them (doesn't seem a bit fair, especially since I was never notified). I'm wondering what to do about BigCompany, however. I strongly suspect they're having major problems, which I suppose could mean I slip through the cracks and have a CPAP machine to use for another few years while buying supplies elsewhere. But is there an argument to make for calling their billing number (if it's still in service) and asking what the heck is going on, instead of just waiting?
03-25-2019, 08:47 PM
(This post was last modified: 03-25-2019, 08:52 PM by Sleeprider.)
RE: My DME company has vanished(?) without billing me
You can name any company, and even list their phone number but you can't post a URL link to their business. So you can name big companies like Lincare, Apria, or Home Medical Equipment in xx town and it's no problem without the link.
More to the point, I think that when a large company that is out of your network, buys out a smaller supplier that is in-network, and most of the contract has been satisfied, they simply will forgive the remaining rental period. It's just too difficult to adjust a contract retroactively, and your insurance protects you against such practices. On the other hand, you may have no service or warranty coverage. The best approach would be to call your insurer and ask these questions. That way you are covered for doing your part, and the insurance company can probably help hook you up with a new in-network provider.
This is all to do with contract law, and the fact your remaining 2-months will cost more to transfer than it is worth, or cannot be transferred to an out-of-network provider. I suspect you are a free agent, but still need to find an in-network provider for your supplies and continuing support if that is what you want.
RE: My DME company has vanished(?) without billing me
Thanks, Sleeprider. The big company is Aerocare. My experience with them hasn't been great--they made billing errors the first time I ordered replacement supplies from them. The odd thing about the situation, though, is that they had already acquired the local DME provider when I first bought my CPAP machine--my agreement was with Aerocare, and that was also the branding on the local office I dealt with. Only the name for billing purposes was still the old local company's.
I'll wait to see what I hear from the insurance company, but am less worried than I was about getting hit with the full cost of two month's rental (at inflated prices).
RE: My DME company has vanished(?) without billing me
I would be sure your on-file credit card is setup with a notification to you for any new transactions that may occur unexpectedly. At least you would know if a charge is made and can decide what to do about it. Having your card on file should make it hard for them to make the case you are late with payments or a non-payer. Maybe just let that sleeping dog lie since by now your contract period is over.
