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Almost 3 mths, and no bills or insurance statements since
#1
Not entirely sure what's going on with my DME. Paid my copay for a Autoset For Her, mask, etc in early Apr. And crickets since then--no bills from the DME or Statement of Benefits from my insurance company.

I should be having monthly copays from the rental of the machine. Should I be concerned, or is this typical?
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#2
(06-22-2015, 06:15 PM)macbob Wrote: Not entirely sure what's going on with my DME. Paid my copay for a Autoset For Her, mask, etc in early Apr. And crickets since then--no bills from the DME or Statement of Benefits from my insurance company.

I should be having monthly copays from the rental of the machine. Should I be concerned, or is this typical?

macbob,
Not sure why you would have monthly copays. If you paid your copay, then that should be it. Your insurance should be paying the DME the monthly rental. You should not be paying anymore unless you buy supplies, like a mask, filters, etc.
Then there may be a copay on your supplies. Check with your insurance.
Find out how many months they pay the rental, and at what point will you own the machine. Surprises aren't fun!
OpalRose
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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.




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#3
(06-22-2015, 06:23 PM)OpalRose Wrote:
(06-22-2015, 06:15 PM)macbob Wrote: Not entirely sure what's going on with my DME. Paid my copay for a Autoset For Her, mask, etc in early Apr. And crickets since then--no bills from the DME or Statement of Benefits from my insurance company.

I should be having monthly copays from the rental of the machine. Should I be concerned, or is this typical?

macbob,
Not sure why you would have monthly copays. If you paid your copay, then that should be it. Your insurance should be paying the DME the monthly rental. You should not be paying anymore unless you buy supplies, like a mask, filters, etc.
Then there may be a copay on your supplies. Check with your insurance.
Find out how many months they pay the rental, and at what point will you own the machine. Surprises aren't fun!

Opal-

I paid my copays on the mask, etc (which were purchased outright) and the first month of machine rental (about $15). The DME indicated that my monthly copays for the machine would be around $15, for 13 months (12 more after my initial payment).

My insurance has always in the past sent me a statement of benefits with what they were billed, what they allowed, what they paid, and what portion of the allowed was my responsibility to pay.


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#4
Yes you absolutely be concerned if you are using a national DME.
If it is crapria doubly so. They have a track record of screwing up their accounts and then turning the accounts they screwed up to a collection outfit.
Might I suggest you search the name of the DME +complaints and see the results.
I use my PAP machine nightly and I feel great!
Updated: Philips Respironics System One (60 Series)
RemStar BiPAP Auto with Bi-FlexModel 760P -
Rise Time x3 Fixed Bi-Level EPAP 9.0 IPAP 11.5 (cmH2O)
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#5
My DME did not bill for the first 3 mo. I had to sign a paper that said I would pay if Insurance refused to pay, and Insurance doesnt pay until you have 90 days of compliance. If you are non-compliant, they don't take the machine back, they bill you for it.
هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه
Tongue Suck Technique for prevention of mouth breathing:
  • Place your tongue behind your front teeth on the roof of your mouth
  • let your tongue fill the space between the upper molars
  • gently suck to form a light vacuum
Practising during the day can help you to keep it at night

هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه
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#6
(06-22-2015, 11:56 PM)DariaVader Wrote: My DME did not bill for the first 3 mo. I had to sign a paper that said I would pay if Insurance refused to pay, and Insurance doesnt pay until you have 90 days of compliance. If you are non-compliant, they don't take the machine back, they bill you for it.

Makes one wonder why we bother to have insurance, doesn't it? Oh-jeez I am not looking forward to my next machine, as I'll have to either deal with Medicare or bite the bullet and pay for the machine myself. oldman
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 OPINIONS ONLY AND NOT NECESSARILY STATEMENTS OF FACT.
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#7
Lincare told me that if I didn't receive anything within 2 months, to call their office. I would suggest you do the same. It does take time for them to get the paperwork settled and your account created and billing and supply schedule set up. Unfortunately, these large DMEs appear not to have a handle on their billings, so you have to really watch out for that.

I also have a monthly copay under $10 a month plus the straight 20% on the mask and humidifier. So, we will see how it goes.
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#8
Thanks, everyone-

I will talk to my DME. I need to talk to them in 2 weeks anyway about ordering supplies, so I'll kill 2 birds...
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