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Dealing with Insurance, Doctors & DME
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SuperSleeper Offline

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Posts: 10,061
Joined: Feb 2012

Machine: PR System One REMstar Auto (DS560)
Mask Type: Nasal pillows
Mask Make & Model: ResMed Mirage Swift II
Humidifier: none
CPAP Pressure: 12.5 - 18.5 cmH20 (auto range)
CPAP Software: SleepyHead

Other Comments: Have diabetes Type II

Sex: Male
Location: Illinois, USA

Post: #21
RE: Dealing with Insurance, Doctors & DME
CrohnieToo Wrote:Jeffy, online DME suppliers get their money up front before the item is even addressed for shipping.

Billing is one amount, allowed amount is another and paid is often two amounts: insurance payment and patient copay payment.

For instance: Medicare - Bi-level - 2008

DME Billed amount: $239.92 - Medicare Allowed amount: $218.11 - Medicare Paid amount: $174.49 - Patient CoPay amount: $43.62

That $239.92 is the DME provider's "pipe dream" - unless the buyer is uninsured and then Medicare's ruling does NOT ALLOW the provider to give the uninsured a break for less than Medicare's Allowed amount.

All I'm saying is that INSURANCES are the most to blame for the state of health care costs in this country than any other cause.
02-25-2012 02:46 AM
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