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Dealing with a dishonest Healthcare provider
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kfujioka Offline

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Posts: 63
Joined: Aug 2014

Machine: Bipap system one auto
Mask Type: Nasal mask
Mask Make & Model: Air fit P10 and The Hybrid
Humidifier: System One heated humidifier & heated tube
CPAP Pressure: 12/07 for bipap
CPAP Software: SleepyHead

Other Comments: New to sleep apnea however think I have had it for a year because started having symptoms a year ago

Sex: Female
Location: Oahu, Hawaii

Post: #1
Dealing with a dishonest Healthcare provider
I have to fight my health care provider constantly. They lie to me all the time. Today I went in to pick to up a heated humidifier, for System One 60 series and a heated tube. (I fought for that for 2 weeks, even though it was on the original prescription.) When I got home and tried to use it , it would not heat. In addition, the setting was locked for heated tube and the setting for humidifier was turned off. (This is just the beginning.) I read the user manual and discovered more. In order to use the heated humidifier, there has to be a 80W power supply but they gave me a 60W power supply. Of course I called them immediately. They said I could go back in tomorrow. (a 2 hr drive). I bet when I go in tomorrow they will tell me I have to wait for 2 weeks for the 80W power supply to be approved by my insurance agency. Bull Crap! There is no way I will listen to that load.
This is the kind of jacking around that I have to go through. I am still in my first 2 months of compliance; and they have been jacking me around constantly. (I asked them to fit me for a mask that I purchased online because they did not carry it. But they said since I did no buy it from them, they did not have to, "by law", fit me for it.)
I have a sinus infection I think because I was using a non heated humidifier and tube for the first 3 weeks even though a heated humidifier and tube was ordered from the get go.

It is unbelievable !

Oh-jeez

When I go in tomorrow, I am taking my machine, my favorite mask and I will sit there for 4 hrs if that is what it takes. I will put my mask on and try it out each time. I am so sick of being constantly screwed by them.

I found out today that they "double billed" my health insurance agency and they double charged me too (co-pay) for two humidifiers, even though the first one was wrong.

I am so Angry. And so tired of fighting when all I want to do is breathe and sleep at the same time.
Kim

Kimberly from HonoluluSleep-well
09-11-2014 11:21 PM
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Galactus Offline

Advisory Members

Posts: 1,388
Joined: Jan 2014

Machine: Phillips Respironics System One PRS1 DS760P Auto BiPAP
Mask Type: Nasal pillows
Mask Make & Model: ResMed Airfit P10 Nasal Pillow
Humidifier: System One Heated Humidifier + Climate Line
CPAP Pressure: E/I 13/20 PS 4/7 BiFlex 3
CPAP Software: SleepyHead EncoreBasic

Other Comments: Sleep can be a good thing.

Sex: Male
Location: USA

Post: #2
RE: Dealing with a dishonest Healthcare provider
Kim welcome to the board. Sorry to hear you are having such a hard time. I hope you get it straightened out and they take better care of you. Maybe time to find a different DMME if they aren't treating you right.

If everyone thinks alike, then someone isn't thinking.
Everyone knows something, together we could know everything.
09-11-2014 11:45 PM
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Gabby Offline

Preferred Members-2

Posts: 665
Joined: Dec 2013

Machine: ResMed AirSense 10 AutoSet For Her
Mask Type: Nasal pillows
Mask Make & Model: Philips Nuance Nasal Mask
Humidifier: ResMed AirSense 10 For Her
CPAP Pressure: 8-14
CPAP Software: SleepyHead

Other Comments:

Sex: Female
Location: Sunshine Coast, Qld., Australia.

Post: #3
RE: Dealing with a dishonest Healthcare provider
Kim, I am very sorry you are being put through all of this rubbish, it's not right they are able to get away with treating people like this.
Is there anyway you can change Healthcare Providers?
I hope things change for the better for you.
Sorry I have nothing of value to offer.

Sleep Tight...
Gabby
09-12-2014 04:04 AM
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me50 Offline

Advisory Members

Posts: 2,559
Joined: Aug 2013

Machine: resmed S9 VPAP Auto
Mask Type: Nasal mask
Mask Make & Model: Wisp and Silicone Head gear
Humidifier: resmed H5i
CPAP Pressure: 18/8
CPAP Software: SleepyHead

Other Comments:

Sex: Undisclosed
Location: USA

Post: #4
RE: Dealing with a dishonest Healthcare provider
sounds like crapria. I left them last year, giving them their cpap machine back. This just made me realize that they took my humidifier back and I believe that my insurance company paid for that all at once.

That being said, if they do NOT correct their errors today, then I would be prepared to leave your equipment behind IF you have another DME that you can use (if you are driving 2 hours, you may not).

Sorry they are giving you so much trouble and hope you can get it all fixed when you go back.
09-12-2014 06:00 AM
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trish6hundred Offline

Advisory Members

Posts: 6,452
Joined: May 2012

Machine: Resmed S9 AutoSet for Her
Mask Type: Full face mask
Mask Make & Model: Fisher & Paykel Simplus
Humidifier: H5i Heated Humidifier
CPAP Pressure: 10 - 7-20 Cm H2O
CPAP Software: Not using software

Other Comments: I started CPAP in 2008. Totally blind since birth.

Sex: Female
Location: Missouri, USA

Post: #5
RE: Dealing with a dishonest Healthcare provider
Hi kfujioka,
I'm sorry to hear that you are having such trouble with your DME.
Is there any way you could switch to another one?
I hope you get your problems straightened out, do keep us posted.

trish6hundred
09-12-2014 09:17 AM
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bwexler Offline

Advisory Members

Posts: 563
Joined: Mar 2012

Machine: PRS 1 BiPAP autoSV Advanced, with Heated Tube humidifier
Mask Type: Nasal mask
Mask Make & Model: Sleepweaver Élan
Humidifier: Resperonics Heated Tube humidifier
CPAP Pressure: Max pressure 25.0 cm H20, Max
CPAP Software: SleepyHead EncorePro

Other Comments: CMS 50i with Software for SpO2

Sex: Male
Location: San Marcos, CA, USA

Post: #6
RE: Dealing with a dishonest Healthcare provider
This is why it is so important to find this forum BEFORE you go to your DME. You have to do your homework first.
When I got my new machine from Crapria last Oct they tried to pull the same stunt on me. I had done my homework first. When I walked into the room to get my machine which was set up on the table so they could show me how to use it, the first thing I saw was "no heated hose". I already knew I needed the 80 watt power supply and the upgraded humidifier.
The girl told me I didn't order that option. I convinced her I did. Then she said they did not have it in stock, etc. I told her to go check. She came back 15 minutes later with the proper equipment. After all the hardware was settled, she asked for my credit card. I asked why. She said in case the insurance doesn't cover everything. I asked how much everything cost. She did not know, that is handled by billing department In another state. I said no card until I knew how much they might charge, since my insurance was paying 100% anyway. She asked for the card about 15 more times before we were done. When I returned for supplies they asked for my CC again (a few times each visit). They know me now and have given up on the CC. They will NEVER get my credit card number.
If I ever owe them any money, I am even Leary of paying by check. I will probably pay cash only in spite of the sign that says no cash or checks accepted.

There is a saying around here. If it's midnight and a DME says its dark outside, go out and check yourself.
This applies to every word out of there mouth.

I would advise you to cancel the credit card they have on file for you, before they drain it. I am serious. Google Apria and Crapria if that is in fact your DME and you will begin to understand.
If it is Lincare I understand they are about equal, but I have been lucky enough to never have used them.
09-12-2014 09:33 AM
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Galactus Offline

Advisory Members

Posts: 1,388
Joined: Jan 2014

Machine: Phillips Respironics System One PRS1 DS760P Auto BiPAP
Mask Type: Nasal pillows
Mask Make & Model: ResMed Airfit P10 Nasal Pillow
Humidifier: System One Heated Humidifier + Climate Line
CPAP Pressure: E/I 13/20 PS 4/7 BiFlex 3
CPAP Software: SleepyHead EncoreBasic

Other Comments: Sleep can be a good thing.

Sex: Male
Location: USA

Post: #7
RE: Dealing with a dishonest Healthcare provider
(09-12-2014 09:33 AM)bwexler Wrote:  This is why it is so important to find this forum BEFORE you go to your DME. You have to do your homework first.
When I got my new machine from Crapria last Oct they tried to pull the same stunt on me. I had done my homework first. When I walked into the room to get my machine which was set up on the table so they could show me how to use it, the first thing I saw was "no heated hose". I already knew I needed the 80 watt power supply and the upgraded humidifier.
The girl told me I didn't order that option. I convinced her I did. Then she said they did not have it in stock, etc. I told her to go check. She came back 15 minutes later with the proper equipment. After all the hardware was settled, she asked for my credit card. I asked why. She said in case the insurance doesn't cover everything. I asked how much everything cost. She did not know, that is handled by billing department In another state. I said no card until I knew how much they might charge, since my insurance was paying 100% anyway. She asked for the card about 15 more times before we were done. When I returned for supplies they asked for my CC again (a few times each visit). They know me now and have given up on the CC. They will NEVER get my credit card number.
If I ever owe them any money, I am even Leary of paying by check. I will probably pay cash only in spite of the sign that says no cash or checks accepted.

There is a saying around here. If it's midnight and a DME says its dark outside, go out and check yourself.
This applies to every word out of there mouth.

I would advise you to cancel the credit card they have on file for you, before they drain it. I am serious. Google Apria and Crapria if that is in fact your DME and you will begin to understand.
If it is Lincare I understand they are about equal, but I have been lucky enough to never have used them.

I agree 100000000000000000000% they tried that CC thing on me as well, insurance covers it all but they want a CC "as a backup" I said there is no backup, if the insurance doesn't pay don't send it to me there's your backup. They have routinely tried to get me to give them a CC, and what they are notorious for is if the insurance doesn't pay for something or heaven forbid not fast enough they charge you, and then it's your problem to go get the refund. I think it's their problem to get paid, and to do their jobs. I had switched coverage and had no lapse but they didn't bill the correct company or didn't bill it right (not sure) they would send a bill every week for their $80 and I had to sit on hold for over an hour to get them to fix it. If they had my CC they would have just billed me. No thank you.

My wife has the answer for this situation by the way, it is far easier than arguing, go to any store by a prepaid V/MC card for $25 spend $23 of it then keep it in your wallet. Any time someone wants a CC# and you don't want them to have one you give them that card. They stop annoying you, and they can never charge you, win/win.

If everyone thinks alike, then someone isn't thinking.
Everyone knows something, together we could know everything.
09-12-2014 09:51 AM
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justMongo Offline

Monitors

Posts: 3,855
Joined: Sep 2013

Machine: ResMed VPAP Auto (S9)
Mask Type: Full face mask
Mask Make & Model: ResMed Mirage Quattro
Humidifier: ResMed H5i
CPAP Pressure: 18 IPAPmax - 11 EPAPmin, PS=5
CPAP Software: Other Software

Other Comments: μολὼν λαβέ

Sex: Male
Location: Калифорния

Post: #8
RE: Dealing with a dishonest Healthcare provider
Double billing and accepting double payment from an insurance company is insurance fraud.
You should contact your state's Insurance Commissioner; and your Attorney General.
One call to the provider by either usually gets their attention.

Also, call your insurance company and point out the double billing.

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.
09-12-2014 10:34 AM
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me50 Offline

Advisory Members

Posts: 2,559
Joined: Aug 2013

Machine: resmed S9 VPAP Auto
Mask Type: Nasal mask
Mask Make & Model: Wisp and Silicone Head gear
Humidifier: resmed H5i
CPAP Pressure: 18/8
CPAP Software: SleepyHead

Other Comments:

Sex: Undisclosed
Location: USA

Post: #9
RE: Dealing with a dishonest Healthcare provider
(09-12-2014 09:33 AM)bwexler Wrote:  This is why it is so important to find this forum BEFORE you go to your DME. You have to do your homework first.
When I got my new machine from Crapria last Oct they tried to pull the same stunt on me. I had done my homework first. When I walked into the room to get my machine which was set up on the table so they could show me how to use it, the first thing I saw was "no heated hose". I already knew I needed the 80 watt power supply and the upgraded humidifier.
The girl told me I didn't order that option. I convinced her I did. Then she said they did not have it in stock, etc. I told her to go check. She came back 15 minutes later with the proper equipment. After all the hardware was settled, she asked for my credit card. I asked why. She said in case the insurance doesn't cover everything. I asked how much everything cost. She did not know, that is handled by billing department In another state. I said no card until I knew how much they might charge, since my insurance was paying 100% anyway. She asked for the card about 15 more times before we were done. When I returned for supplies they asked for my CC again (a few times each visit). They know me now and have given up on the CC. They will NEVER get my credit card number.
If I ever owe them any money, I am even Leary of paying by check. I will probably pay cash only in spite of the sign that says no cash or checks accepted.

There is a saying around here. If it's midnight and a DME says its dark outside, go out and check yourself.
This applies to every word out of there mouth.

I would advise you to cancel the credit card they have on file for you, before they drain it. I am serious. Google Apria and Crapria if that is in fact your DME and you will begin to understand.
If it is Lincare I understand they are about equal, but I have been lucky enough to never have used them.

crapria did the same thing to me. I went to pick up my equipment. The first thing I did was ask what unit they were giving me (it was not set up when I got there). The girl said she thought it was the escape. I told her no way was I going to take that machine and to forget I ever walked in the door. So, she brought out the s9 auto, heated hose and humidifier. I asked her for the phone number to resmed and I called them with the serial number to make sure that what I was getting was not the escape (yea, I know what it says by the button but I wanted to make sure before I left). Then, after all of that, they asked for my cc and I said why and got the same answer you mentioned. I said, I am not giving you my cc because 1. Brandy didn't tell me it was your procedure to secure that and 2. my insurance pays 100%. I then pushed my equipment back to them and got up to leave. They stopped me and said that they would listen to the recording and make sure that Brandy didn't tell me the procedure and I said no, I am not wasting my time with this. I got my equipment and left with no cc info given to crapria. Good thing too because they billed my insurance company for supplies I didn't get and it has been almost 2 years and my insurance company still doesn't have their money back. I also turned in my equipment to crapria and went out of network and that DME only makes me pay what I would pay if they were in network. Then, my insurance company contacted crapria and gave them my contact info because they were in network. crapria tried to send me supplies and I called them and said I would never use them and to quit contacting me. I then called my insurance company and told them not to ever give my contact info to any doctors, suppliers, etc. and that if I needed help with that, I would contact them. Then, a few weeks later, crapria sent me a bill that they claimed I had not paid (remember my insurance paid 100%) and I said, geez, I am sure glad I didn't have to give a cc because I never would have gotten my money back! I told them I do not owe crapria any money so get it fixed!

I say do NOT use crapria if you have any other choice. Most DME's will be willing to charge you in network rates if you ask them. Now that there is competitive bidding, the company that wins that gets all the business and the other DME's need all the customers they can get and most are willing to charge in network copays. Rather than deal with crapria ever again, I would buy my supplies myself through an online vendor if it came down to that.
(This post was last modified: 09-12-2014 11:17 AM by me50.)
09-12-2014 11:13 AM
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Paralel Offline

Preferred Members

Posts: 68
Joined: Aug 2014

Machine: Respironics PR System One 60 Series REMstar Auto with A-flex
Mask Type: Full face mask
Mask Make & Model: ResMed Mirage Quattro
Humidifier: Respironics PR System One 60 Series Humidifier with Heated Tube
CPAP Pressure: 10-13
CPAP Software: SleepyHead EncoreBasic

Other Comments:

Sex: Male
Location: Mitten State, USA

Post: #10
RE: Dealing with a dishonest Healthcare provider
(09-12-2014 09:51 AM)Galactus Wrote:  ...My wife has the answer for this situation by the way, it is far easier than arguing, go to any store by a prepaid V/MC card for $25 spend $23 of it then keep it in your wallet. Any time someone wants a CC# and you don't want them to have one you give them that card. They stop annoying you, and they can never charge you, win/win.

I would be extremely careful with this. Many of these prepaid cards now charge an "insufficient funds" fee that will drop you into a negative balance (it's usually quite significant, $10-15) and you will get a notice about correcting the negative amount, and if you don't, they can and will attack your credit report
09-12-2014 01:15 PM
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