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Almost 3 mths, and no bills or insurance statements since
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macbob Offline

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Posts: 25
Joined: Mar 2015

Machine: AirSense™ 10 AutoSet For Her
Mask Type: Nasal pillows
Mask Make & Model: Nuance Pro Nasal Pillow Mask with Gel Nasal Pillow
Humidifier: HumidAir™ Heated Humidifier
CPAP Pressure: 7-15
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location: Hampton Roads, VA

Post: #1
Almost 3 mths, and no bills or insurance statements since
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?
06-22-2015 06:15 PM
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OpalRose Offline

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Posts: 3,166
Joined: Nov 2014

Machine: PR System One REMstar Auto 560 with A Flex
Mask Type: Nasal pillows
Mask Make & Model: AirFit P10 For Her
Humidifier: REMStar heated humidifier with heated hose
CPAP Pressure: Auto Cpap 10-13 AFLEX 1
CPAP Software: SleepyHead EncoreBasic

Other Comments: Started CPAP Therapy October 23, 2014

Sex: Female
Location: Northeast Ohio, USA

Post: #2
RE: Almost 3 mths, and no bills or insurance statements since
(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
06-22-2015 06:23 PM
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macbob Offline

Preferred Members

Posts: 25
Joined: Mar 2015

Machine: AirSense™ 10 AutoSet For Her
Mask Type: Nasal pillows
Mask Make & Model: Nuance Pro Nasal Pillow Mask with Gel Nasal Pillow
Humidifier: HumidAir™ Heated Humidifier
CPAP Pressure: 7-15
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location: Hampton Roads, VA

Post: #3
RE: Almost 3 mths, and no bills or insurance statements since
(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.
06-22-2015 06:33 PM
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Mark Douglas Offline

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Posts: 513
Joined: Apr 2015

Machine: Sys 1 (60) RemStar BiPAP Auto with Bi-Flex 760P Auto Bi-Level (Variabl
Mask Type: Nasal mask
Mask Make & Model: PR Wisp
Humidifier: PR Sys One heated
CPAP Pressure: RiseTime 3 Fxd E-9.0 / I-11.5
CPAP Software: SleepyHead EncoreBasic

Other Comments: Hashimoto's thyroiditis.

Sex: Male
Location: SW Ohio

Post: #4
RE: Almost 3 mths, and no bills or insurance statements since
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)
06-22-2015 08:25 PM
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DariaVader Offline
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Joined: Nov 2014

Machine: Resmed S9 AutoSet
Mask Type: Nasal pillows
Mask Make & Model: Airfit P10 for Her
Humidifier: H5i humidifier with ClimateLine heated hose
CPAP Pressure: 8-15
CPAP Software: SleepyHead

Other Comments: diabetes II, Thyroidectomized, Primary Immune Deficiency, and the list goes on :P

Sex: Female
Location: Oregon

Post: #5
RE: Almost 3 mths, and no bills or insurance statements since
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
06-22-2015 11:56 PM
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PollCat Offline
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Posts: 1,576
Joined: Feb 2012

Machine: ResMed S9 Autoset
Mask Type: Nasal pillows
Mask Make & Model: ResMed AirFit P10
Humidifier: H5i Cleanable with ClimateLine
CPAP Pressure: 10 - 18
CPAP Software: SleepyHead

Other Comments: CPAP-ing since 1995; Type 2 Diabetes; Chronic Asthma; Gout

Sex: Male
Location: Westfield, IN

Post: #6
RE: Almost 3 mths, and no bills or insurance statements since
(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 OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
06-23-2015 06:37 AM
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Mosquitobait Online

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Posts: 746
Joined: Apr 2015

Machine: Resmed AirSense 10 For Her
Mask Type: Nasal pillows
Mask Make & Model: Airfit P10
Humidifier: integrated, Climate line tube
CPAP Pressure: 9-12
CPAP Software: ResScan SleepyHead

Other Comments: RLS and Bradycardia

Sex: Female
Location: Minneapolis

Post: #7
RE: Almost 3 mths, and no bills or insurance statements since
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.
06-24-2015 02:54 PM
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macbob Offline

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Posts: 25
Joined: Mar 2015

Machine: AirSense™ 10 AutoSet For Her
Mask Type: Nasal pillows
Mask Make & Model: Nuance Pro Nasal Pillow Mask with Gel Nasal Pillow
Humidifier: HumidAir™ Heated Humidifier
CPAP Pressure: 7-15
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location: Hampton Roads, VA

Post: #8
RE: Almost 3 mths, and no bills or insurance statements since
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...
06-26-2015 04:32 PM
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