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Apria - Charging me separate for CPAP Humidifier on the Resmed A10
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Isadore44 Offline

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Posts: 2
Joined: Dec 2014

Machine: ResMed Airsense A10
Mask Type: Nasal mask
Mask Make & Model: ResMed Mirage
Humidifier: included in A10
CPAP Pressure: 6-14
CPAP Software: SleepyHead

Other Comments: 10+ years of restful nights

Sex: Male
Location: Derby City

Post: #21
RE: Apria - Charging me separate for CPAP Humidifier on the Resmed A10
Agreed but have no choice to avoid "in Network DME". Same problem in Louisville with Humana. The breakdown of various multiple cpap components is insane and like others, my A10 humidifier had to be a separate billings. The most of the cpap components are included in an obligatory 13 month rental but humidifier was not. It is not part of the rental even though firmly attached to the unit that will not start without it. There are very few vendors in the Humana DME network in Louisville that I am obligated to use so the game continues. The race to documenting the most spent is increasing at a furious pace, mostly based on seemingly inflated/bogus prices. These "costs" are used to justify appropriate rates for next years acceptable premiums and government payments to the insurance companies. Without knowing who owns who it is impossible to guess which side is up. Used cars is simple in comparison. Does everyone realize the automated reporting of usage to the DME is the basis of DME rental invoices to the insurance provider? These statistics although interesting are the basis for the insurance company to continue payments and determine my co-payments. It is to be 20% of their approved amount. If, for whatever reason, they determine my usage is not documented according to their needs matrix, I could be paying the entire rental, unable to return the machine to satisfy whatever bogus rate was on initial papers. Rave on...
(This post was last modified: 03-01-2015 04:01 PM by Isadore44.)
03-01-2015 03:56 PM
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Adoniscmj Offline

Advisory Members

Posts: 168
Joined: May 2015

Machine: Resmed AirSense10 Autoset for her
Mask Type: Nasal pillows
Mask Make & Model: Resmed Airfit P10
Humidifier: Integrated
CPAP Pressure: 6 to 9
CPAP Software: ResScan SleepyHead

Other Comments:

Sex: Male
Location: Everett, Washington

Post: #22
RE: Apria - Charging me separate for CPAP Humidifier on the Resmed A10
(02-16-2015 01:12 PM)heyheyrayray Wrote:  Lincare just did the same thing to me. I don't see how they can charge you for a humidifier for the A10 when it doesn't exist outside of the actual machine! You can't get on an online DME and search for A10 humidifier because it doesn't exist. I think its criminal. I put in a complaint to the Ohio Attorney General about this. They are doing an investigation.

I did the same thing in WA. state and waiting for them to investigate it. When I called the DME they tried to justify the charge and told me if I don't like it I can bring it back. How does this help me get a machine for my health? I told her that I will bring it back and I will purchase it online as they don't charge separately for the humidifier on the Resmed Air Sense 10 Auto set. I talked to the online Cpap supplier and she couldn't believe the local DME charges for the humidifier separately. Well the DME lost my business and now I don't have to worry about compliance checks. i also don't need to see the sleep doctor any more as they said the follow up was only for compliance and they don't care about the data on the card in my CPAP machine. I thought this was odd. I guess they don't care now that they got their money.
06-10-2015 01:54 AM
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krelvin Offline

Advisory Members

Posts: 155
Joined: Jul 2014

Machine: Resmed S9 VPAP Auto BiLevel
Mask Type: Full face mask
Mask Make & Model: Quattro Air
Humidifier: S9 Series H5i Heated Humidifier with Climate Control
CPAP Pressure: 10.6cm - 18cm - PS 4cm
CPAP Software: ResScan SleepyHead

Other Comments: FlashAir WiFi SDcard with SleepMaster/FlashPAP - Weather Nut

Sex: Male
Location: Mesa AZ

Post: #23
RE: Apria - Charging me separate for CPAP Humidifier on the Resmed A10
(06-10-2015 01:54 AM)Adoniscmj Wrote:  I did the same thing in WA. state and waiting for them to investigate it. When I called the DME they tried to justify the charge and told me if I don't like it I can bring it back. How does this help me get a machine for my health? I told her that I will bring it back and I will purchase it online as they don't charge separately for the humidifier on the Resmed Air Sense 10 Auto set. I talked to the online Cpap supplier and she couldn't believe the local DME charges for the humidifier separately. Well the DME lost my business and now I don't have to worry about compliance checks. i also don't need to see the sleep doctor any more as they said the follow up was only for compliance and they don't care about the data on the card in my CPAP machine. I thought this was odd. I guess they don't care now that they got their money.
The Insurance company says they can under the negotiated pricing plan they have. If you bypass the Insurance you don't have to go through those rules.

They do the same thing when you buy a mask, they will bill for each piece even if the mask comes as a whole.

Both are not uncommon or atypical.

Current Settings PS 4.0 over 10.6-18.0 (cmH2O) BiLevel Auto
TNET Sleep Resource Pages
CPAP Machine Database
06-10-2015 02:11 AM
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Mosquitobait Offline

Advisory Members

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: #24
RE: Apria - Charging me separate for CPAP Humidifier on the Resmed A10
Most of the insurance companies follow Medicare codes. Medicare does not have a separate code for an integrated machine (yet). Therefore an integrated machine has two codes. You get rental on the one code and flat out pay for the other. The Airsense is higher priced than other other Cpaps in their code because the humidifier cannot be separated. So you aren't being ripped off. It's the only way the DME gets paid for the full unit.

But, you were dealing with Capria who can pretty much screw up everything because they are so badly managed. You should never have been charged a separate rental fee for the humidifier code. That should have been a flat payment on the same schedule as a mask.

I hate the way medical pricing is done. It's one of the few areas where it is extraordinarily difficult to make decisions to stay in your budget.
06-10-2015 08:53 AM
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Mosquitobait Offline

Advisory Members

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: #25
RE: Apria - Charging me separate for CPAP Humidifier on the Resmed A10
(06-10-2015 01:54 AM)Adoniscmj Wrote:  
(02-16-2015 01:12 PM)heyheyrayray Wrote:  Lincare just did the same thing to me. I don't see how they can charge you for a humidifier for the A10 when it doesn't exist outside of the actual machine! You can't get on an online DME and search for A10 humidifier because it doesn't exist. I think its criminal. I put in a complaint to the Ohio Attorney General about this. They are doing an investigation.

I did the same thing in WA. state and waiting for them to investigate it. When I called the DME they tried to justify the charge and told me if I don't like it I can bring it back. How does this help me get a machine for my health? I told her that I will bring it back and I will purchase it online as they don't charge separately for the humidifier on the Resmed Air Sense 10 Auto set. I talked to the online Cpap supplier and she couldn't believe the local DME charges for the humidifier separately. Well the DME lost my business and now I don't have to worry about compliance checks. i also don't need to see the sleep doctor any more as they said the follow up was only for compliance and they don't care about the data on the card in my CPAP machine. I thought this was odd. I guess they don't care now that they got their money.

So now you're complaining that you don't have to see the doctor again? Laugh-a-lot It's true though. Unless you have certain health issues, there's no reason to see the sleep doc again unless you have more sleep problems. Most insurance companies and Medicare REQUIRE a follow-up, whether needed or not. My prescription expires after a year, but my primary can write me a new one.
06-10-2015 09:03 AM
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Adoniscmj Offline

Advisory Members

Posts: 168
Joined: May 2015

Machine: Resmed AirSense10 Autoset for her
Mask Type: Nasal pillows
Mask Make & Model: Resmed Airfit P10
Humidifier: Integrated
CPAP Pressure: 6 to 9
CPAP Software: ResScan SleepyHead

Other Comments:

Sex: Male
Location: Everett, Washington

Post: #26
RE: Apria - Charging me separate for CPAP Humidifier on the Resmed A10
(06-10-2015 09:03 AM)Mosquitobait Wrote:  
(06-10-2015 01:54 AM)Adoniscmj Wrote:  
(02-16-2015 01:12 PM)heyheyrayray Wrote:  Lincare just did the same thing to me. I don't see how they can charge you for a humidifier for the A10 when it doesn't exist outside of the actual machine! You can't get on an online DME and search for A10 humidifier because it doesn't exist. I think its criminal. I put in a complaint to the Ohio Attorney General about this. They are doing an investigation.

I did the same thing in WA. state and waiting for them to investigate it. When I called the DME they tried to justify the charge and told me if I don't like it I can bring it back. How does this help me get a machine for my health? I told her that I will bring it back and I will purchase it online as they don't charge separately for the humidifier on the Resmed Air Sense 10 Auto set. I talked to the online Cpap supplier and she couldn't believe the local DME charges for the humidifier separately. Well the DME lost my business and now I don't have to worry about compliance checks. i also don't need to see the sleep doctor any more as they said the follow up was only for compliance and they don't care about the data on the card in my CPAP machine. I thought this was odd. I guess they don't care now that they got their money.

So now you're complaining that you don't have to see the doctor again? Laugh-a-lot It's true though. Unless you have certain health issues, there's no reason to see the sleep doc again unless you have more sleep problems. Most insurance companies and Medicare REQUIRE a follow-up, whether needed or not. My prescription expires after a year, but my primary can write me a new one.
Yes, not all of my sleep issues are from Apnea's. I have a severe twitching problem that causes me to nearly jump out of bed when they happen, but my sleep doctor seems to only want to treat apnea.
06-10-2015 11:46 AM
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krelvin Offline

Advisory Members

Posts: 155
Joined: Jul 2014

Machine: Resmed S9 VPAP Auto BiLevel
Mask Type: Full face mask
Mask Make & Model: Quattro Air
Humidifier: S9 Series H5i Heated Humidifier with Climate Control
CPAP Pressure: 10.6cm - 18cm - PS 4cm
CPAP Software: ResScan SleepyHead

Other Comments: FlashAir WiFi SDcard with SleepMaster/FlashPAP - Weather Nut

Sex: Male
Location: Mesa AZ

Post: #27
RE: Apria - Charging me separate for CPAP Humidifier on the Resmed A10
(06-10-2015 11:46 AM)Adoniscmj Wrote:  Yes, not all of my sleep issues are from Apnea's. I have a severe twitching problem that causes me to nearly jump out of bed when they happen, but my sleep doctor seems to only want to treat apnea.
Most likely because that is all he is qualified to treat. You might need to see another specialist to deal with the twitching.

Current Settings PS 4.0 over 10.6-18.0 (cmH2O) BiLevel Auto
TNET Sleep Resource Pages
CPAP Machine Database
06-10-2015 12:55 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: #28
RE: Apria - Charging me separate for CPAP Humidifier on the Resmed A10
I put my 2cents here http://www.apneaboard.com/forums/Thread-...tional-DME

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)
06-10-2015 01:05 PM
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krelvin Offline

Advisory Members

Posts: 155
Joined: Jul 2014

Machine: Resmed S9 VPAP Auto BiLevel
Mask Type: Full face mask
Mask Make & Model: Quattro Air
Humidifier: S9 Series H5i Heated Humidifier with Climate Control
CPAP Pressure: 10.6cm - 18cm - PS 4cm
CPAP Software: ResScan SleepyHead

Other Comments: FlashAir WiFi SDcard with SleepMaster/FlashPAP - Weather Nut

Sex: Male
Location: Mesa AZ

Post: #29
RE: Apria - Charging me separate for CPAP Humidifier on the Resmed A10
Example of multiple billing for the same thing...

[Image: dVTEyGHl.png]

You see above is the delivery ticket. You can see the first item lists the ref number of the part 62702. Then you see a charge for the headgear and for the cushion.

Below is a sealed package that arrived. Note that the ref # is the same as Item #1 so it includes all three items in it.

[Image: qN94PjYl.png]

The interesting thing is that you cannot purchase the frame from Resmed without the cushion. You can get it without the headgear, but it is a different ref # and price. You can order just a cushion though.

Also notice that in the Ref# for the cushion (#3 item on the list) is listed as part the the sealed package.

Current Settings PS 4.0 over 10.6-18.0 (cmH2O) BiLevel Auto
TNET Sleep Resource Pages
CPAP Machine Database
(This post was last modified: 06-10-2015 01:08 PM by krelvin.)
06-10-2015 01:07 PM
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Sleeprider Online
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Advisory Members

Posts: 3,376
Joined: Dec 2014

Machine: Resmed Aircurve 10 Vauto
Mask Type: Nasal pillows
Mask Make & Model: Resmed Airfit P10
Humidifier: Resmed Climateline
CPAP Pressure: Auto Bilevel 18/9, PS 3
CPAP Software: ResScan SleepyHead EncoreBasic

Other Comments:

Sex: Male
Location: Where they make Respironics

Post: #30
RE: Apria - Charging me separate for CPAP Humidifier on the Resmed A10
When buying the Autoset through Apria you probably were also billed separately for a hose, fine filter and prefilter. All considered fair game by the DMEs under their billing structure, in spite of the fact those starting items are included by the manufacturer. And how about the carry case?

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06-10-2015 01:47 PM
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