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[CPAP] DME charges for modem part of Airsense
#1
DME charges for modem part of Airsense
My CPAP supplier is valuing the modem part of a Resmed Airsense 10 Autoset at $260 saying that Medicare doesn't cover this amount then charging a rental fee until this is paid off. Is this a normal procedure with Medicare? Regardless this amount seems to be an unreasonable arbitrary valuation for a component that is included in the CPAP. What value have others seen attached to the modem in the Airsense?
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#2
RE: DME charges for modem part of Airsense
Medicare covers the humidifier, no questions.
Make sure your DME "Accepts Medicare Assignment" use this site to see https://www.medicare.gov/supplierdirectory/search.html

It is a carryover from really old styles of CPAPs that the CPAP and humidifier are separate, that part is normal.
Fred Bonjour - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter 
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#3
RE: DME charges for modem part of Airsense
Caveat that I'm not on Medicare but I've never seen anything on the forums about DME companies charging for the modem on a ResMed. The only remotely similar thing that I've seen is if you buy online some companes don't subscribe your device to AirView or that might cost extra. However they don't charge extra for the modem itself.

I think your supplier is breaking Medicare rules and you should probably call Medicare to ask them and/or report the supplier to them. I'm pretty sure Medicare will help you fix that pretty quick if you file a complaint/grievance about these guys.
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#4
RE: DME charges for modem part of Airsense
I just started Medicare this month, so I'm not certain, but that sounds like it is probably an unaccepted billing practice regarding separate charges for the modem. Call Medicare to see what they have to say about it.
Dave

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#5
RE: DME charges for modem part of Airsense
Since there is no option to delete the modem, this is an additional cost that consumers should consider when purchasing a CPAP with bult in modem. This cost isn't described ahead of purchase it looks to me like an unethical business practice to the detriment of those using medicare/supplement insurance.

After contacting Resmed they had no standard cost that was assigned to the modem, so valuation of the modem, hence the cost to the purchaser, appears to be arbitrary.
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#6
RE: DME charges for modem part of Airsense
I'm sure this is an illegal cost, however the correct term you need to verify is whether your DME is a Medicare "Preferred Provider". Many DME can accept Medicare coverage, but a preferred provider cannot balance bill for extras. There is no way to separate the modem from an Airsense 10, and it does not cost extra to provide it. I would run from that supplier. As bonjour recommended see this site, and if your supplier is on it, complain. If they are not a preferred provider, find one that is. https://www.medicare.gov/supplierdirectory/search.html
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#7
RE: DME charges for modem part of Airsense
(05-05-2020, 10:27 AM)SleepAhead Wrote: Since there is no option to delete the modem, this is an additional cost that consumers should consider when purchasing a CPAP with bult in modem. This cost isn't described ahead of purchase it looks to me like an unethical business practice to the detriment of those using medicare/supplement insurance.

After contacting Resmed they had no standard cost that was assigned to the modem, so valuation of the modem, hence the cost to the purchaser, appears to be arbitrary.

Hang on there, the problem in this case has nothing to do with ResMed or Medicare.

The problem is you are getting your CPAP stuff from a shady company that I believe is blatantly breaking Medicare rules. In this case Medicare is your friend. They will help you. Call them up and report the company that you are getting CPAP stuff from. They will open a dispute/grievance with the company and then that company will almost certainly bend over backwards to make you happy.
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#8
RE: DME charges for modem part of Airsense
(05-05-2020, 10:45 AM)alshayed Wrote:
(05-05-2020, 10:27 AM)SleepAhead Wrote: Since there is no option to delete the modem, this is an additional cost that consumers should consider when purchasing a CPAP with bult in modem. This cost isn't described ahead of purchase it looks to me like an unethical business practice to the detriment of those using medicare/supplement insurance.

After contacting Resmed they had no standard cost that was assigned to the modem, so valuation of the modem, hence the cost to the purchaser, appears to be arbitrary.

Hang on there, the problem in this case has nothing to do with ResMed or Medicare.

The problem is you are getting your CPAP stuff from a shady company that I believe is blatantly breaking Medicare rules. In this case Medicare is your friend. They will help you. Call them up and report the company that you are getting CPAP stuff from. They will open a dispute/grievance with the company and then that company will almost certainly bend over backwards to make you happy.

Right. The only fault that I can find is with the DME.  I'm working on resolving it with the DME and Medicare. It's good to get feedback from others to know whether I'm being reasonable in my expectations.
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#9
RE: DME charges for modem part of Airsense
I believe that I have a good DME supplier. Little to no problems or issues. But......I still keep an eagle eye on them when it comes to billing for the supplies they send me. 

I had to get on them several months ago. They sent me an invoice that wasn't correct. Called um out on it and they apologized, saying it was a "billing error". 

Uh huh............ Thinking-about
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#10
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RE: DME charges for modem part of Airsense
A firmly worded message and phone call to the DME changed the modem rental billing to 0 and no future modem rental charges.

In the process I noticed the unusual way that these machines are broken apart and billed to Medicare. The DME billed Medicare as follows for a Airsense 10 Autoset:  cpap $133, humidifier $400, filter $13.48 and monitoring device $20. Medicare doesn't pay for the monitoring device. I wonder where they pulled those numbers from. When I talked with Resmed they didn't have any breakdown of the charges for the modem as a separate component of the cpap.

For my future DME dealings - pay closer attention to the DME, how they work with Medicare and what I get charged.
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