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Change in Medicare [replacement supplies]
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JJJ Offline

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Post: #11
RE: change in medicare
(11-08-2012 04:53 PM)StuUnderPressure Wrote:  Letting me buy online & then file my own Medicare claim could be the best solution. But then, who wants to deal with paperwork with Medicare?

I was under the impression that Medicare does not do reimbursements.
11-08-2012 06:08 PM
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StuUnderPressure Offline

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Post: #12
RE: change in medicare
(11-08-2012 06:08 PM)JJJ Wrote:  
(11-08-2012 04:53 PM)StuUnderPressure Wrote:  Letting me buy online & then file my own Medicare claim could be the best solution. But then, who wants to deal with paperwork with Medicare?

I was under the impression that Medicare does not do reimbursements.

They don't.
Sorry I was not clear on that point. Oops

I was merely stating that letting me buy from an online DME & then letting me file my own medicare claim "should" be an option.
(This post was last modified: 11-08-2012 06:42 PM by StuUnderPressure.)
11-08-2012 06:42 PM
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cbramsey Offline

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Post: #13
RE: change in medicare
(11-08-2012 06:42 PM)StuUnderPressure Wrote:  
(11-08-2012 06:08 PM)JJJ Wrote:  
(11-08-2012 04:53 PM)StuUnderPressure Wrote:  Letting me buy online & then file my own Medicare claim could be the best solution. But then, who wants to deal with paperwork with Medicare?

I was under the impression that Medicare does not do reimbursements.

They don't.
Sorry I was not clear on that point. Oops

I was merely stating that letting me buy from an online DME & then letting me file my own medicare claim "should" be an option.

I agree that we should have the ability to shop around ourselves. However, common sense is not required to work for the Center for Medicare Services. Dielaughing

I should edit my response as well. My DME does call me approximately every month to see if I need any supplies. If I say "Yes", they send me what I request and I pay my portion of the cost to my DME.

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.
(This post was last modified: 11-08-2012 09:39 PM by cbramsey.)
11-08-2012 09:30 PM
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Ugly Offline

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Post: #14
RE: Change in Medicare [replacement supplies]
(11-08-2012 09:27 AM)hgite@cox.net Wrote:  my supplier says that medicare now requires reasons for ordering replacement supplies instead of just going by the recommended schedule(which they say is the minimum ) --does anyone know what is going on and --i use a quattro fx mask --what reason would i give to get replacements

They do change rules now and then. For example I was told that while my Healthdyne unit still worked I didn't need to replace it. Once I began having breathing issues at night I went to my supplier, VitalAire, and they admitted that the 14 year old buzzard needed to be replaced. But that's what I would suggest for your mask. Take it to them. Seeing is believing. It will be harder for them to deny your need if it is physically brought to their attention
I'm pleased that as a bonus that although I had to pay a portion of the cost back in 1997, my new machine was totally without extra cost to me. But I guess if I wanted a higher end version I would have had to pay the difference. Part of me wonders if it would have been worth it. But yeah, they change the rules sometimes. Irrational as it seems. What reason do you give? The thing doesn't work anymore!
What more can you say?
11-09-2012 12:50 PM
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PaulaO2 Offline
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Post: #15
RE: Change in Medicare [replacement supplies]
Yes, if you ever get the chance, get rid of that S9 Escape you have. It is well worth whatever extra you have to pay. If it is more than $400, go to Supplier #2 and get one from them. You can get it without the humidifier and use the one you have.

PaulaO2
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www.ApneaBoard.com


Breathe deeply and count to zen.

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.
11-09-2012 01:30 PM
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cpapbiller Offline

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Post: #16
RE: Change in Medicare [replacement supplies]
(11-08-2012 09:27 AM)hgite@cox.net Wrote:  my supplier says that medicare now requires reasons for ordering replacement supplies instead of just going by the recommended schedule(which they say is the minimum ) --does anyone know what is going on and --i use a quattro fx mask --what reason would i give to get replacements


This is correct..Medicare DOES want a reason, due to many people getting supplies that do not need them, or are "stocking up on them for just in case" The company that you get your supplies from should be asking questions about why you are getting new supplies, IE cushion torn, worn out..ect. Same for tubing..ALL supplies.
11-16-2012 04:50 PM
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Allen Offline

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Post: #17
RE: Change in Medicare [replacement supplies]
I'm so glad I don't have any of those issues as pay for everything myself from online suppliers from here in Australia and also from the US, that way I get what I want when I want without arguements or prescriptions
11-16-2012 05:01 PM
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cpapbiller Offline

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Post: #18
RE: change in medicare
(11-08-2012 01:30 PM)archangle Wrote:  Scuttlebutt is that this is because a lot of DMEs were milking the system by always ordering many parts automatically every time they could.

Apparently, Medicare doesn't really care that much as long as the patient is initiating the request, not the DME.

Look at your mask parts and see if they're getting yellow and not sealing well. If this is happening, tell your DME and request replacements.

It may take a while before the DMEs figure out the best way to ease the process for patients to order replacement parts.


Medicare does care..about how often supplies are getting replaced, and the reason why they are getting replaced. IF you are getting yours just "sent automatically" that is NOT correct. Per Medicare, they do NOT want that done. As a DME provider, WE have to wait for the patient to call up, and request supplies to be sent, and we have to documenate WHY they are getting new supplies. The reason "because its been a month" for replacement cushions..is NOT good enough. Medicare is getting very VERY tough on there guidelines.
11-16-2012 05:08 PM
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zonk Offline

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Post: #19
RE: Change in Medicare [replacement supplies]
I prefer the US insurance system ... cover machines and other stuff including replacements
My insurance only pay some $500 toward the purchase of new machine
That is all ... nothing for masks, hoses, other stuff or replacements
Beside I've to buy the machine locally to get the rebate and pay inflated prices ... what a rip-off
Shame on you .. insurance companies, CPAP manufactures and CPAP sellers
11-16-2012 05:24 PM
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Allen Offline

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Post: #20
RE: Change in Medicare [replacement supplies]
(11-16-2012 05:24 PM)zonk Wrote:  I prefer the US insurance system ... cover machines and other stuff including replacements
My insurance only pay some $500 toward the purchase of new machine
That is all ... nothing for masks, hoses, other stuff or replacements
Beside I've to buy the machine locally to get the rebate and pay inflated prices ... what a rip-off
Shame on you .. insurance companies, CPAP manufactures and CPAP sellers

I bought my S9 autoset from supplier number 10 for $999.00 US and it came with the carry bag, a climate line hose, SD card and the dishwasher safe water tub for the humidifier. My nasal mask was only $104.00 US and because I bought from a US online store I didn't need to send a copy of my prescription, the postage was $84.00, but even if you take your lousy $500.00 rebate off the cost of a machine supplied in Australia you are still paying more than I did.
I currently have another mask and climate line hose on order which cost $192.99 US including postage and should arrive next week as the USPS tracking showed it had arrived in Australia yesterday.
The only things I buy here are my filters and chin straps when needed
11-16-2012 05:40 PM
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