Hello Guest, Welcome to Apnea Board !
As a guest, you are limited to certain areas of the board and there are some features you can't use.
To post a message, you must create a free account using a valid email address.

or Create an Account


New Posts   Today's Posts

[Equipment] Does your provider unbundle your mask kit?
#11
My DME (Providence) gives me the whole mask with all the different pillows need them or not. However, like parkerdt, I also have Cigna... 2016 maybe interesting!
هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه
Tongue Suck Technique for prevention of mouth breathing:
  • Place your tongue behind your front teeth on the roof of your mouth
  • let your tongue fill the space between the upper molars
  • gently suck to form a light vacuum
Practising during the day can help you to keep it at night

هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه
Post Reply Post Reply
#12
(09-08-2015, 01:47 PM)vpescado Wrote: So something that I noticed when I re-upped my supplies for my CPAP:

My mask comes as a kit with a small, medium, and large nose-pillow. My insurance allows me 6 nose pillows per 3 months, so I get another five along with it.

I realize that my supplier is removing the small and large pillows from the kit (obviously so they can sell them to someone else).

But this seems wrong as:
1) When I got my kit the first time, they gave me all three in the kit as well as the 5 extras .
2) They are invoicing my insurance company (and me) for the full kit based on the manufacturer's item number.

Like I said, this seems wrong to me (and possibly fraudulent).

When I asked my sales rep, she claims that they are required to remove the small and large pillows as otherwise I would be getting 8 pillows and my insurance wouldn't allowed that (but again, they left them in the first time, and they are still invoicing for the full kit).

Is this a standard practice? Should I switch providers? Should I contact my insurer?

Get a new supplier, as the package should be sealed for sterility and they come with three sizes. The DME is making money off of selling them to someone else. Not cool in my opinion. When I bought my latest mask it came with the mask , headgear, and S, M, L nasal pillows. When I buy replacements they come in a sealed bag labeled from the manufacturer. I would insist they give you the complete kit or I would take my business else where.
Post Reply Post Reply
#13
I have a Quattro FFM mask and my provider sends me a new one every three months complete with headgear. It is in a factory sealed container and if I listen carefully, I can hear the rush of air when I open it. Hardest part of the next mask is refitting it as the headgear hasn't stretched over my fat head. My filters, though, do come in a small plastic bag that is tied off. Everything matches the paperwork.

If you really have questions, check your shipping paperwork and get a copy of your EOB (Explanation of Benefits) to see what the billed to the insurance company.

Homer

Post Reply Post Reply


#14
I wonder if the suppliers that are giving you the pillows in your size only are reselling them individually. For me to buy a whole package of the nasal pillows I am currently using, the Swift FX it costs me around $200 or more from the DME. I was looking at our Canadian Amazon site to see what replacement nasal pillows for my Swift FX would be and here is a link to the cheapest ones: [link removed]

I think if all the extra nasal pillows get sold separately like this the vendor's can make a lot of money. However,I wonder who has been handling these prior to reaching the end user? And how sanitary can they be??


-----
Moderator Action: Link Removed
To maintain our status as an educational organization, the only commercial links allowed in this forum are to CPAP-related manufacturer websites. This is stated in the Apnea Board Rules with details given in the Commercial Links Policy section.
-----
Post Reply Post Reply
#15
I just found out my new DME is trying to bill me on top of what they receive from my insurance agreed rate (Aetna 80/20). I pay 20% of the "agreed" rate, not what they bill. I also have an incentive account with money in it to cover my 20% should I choose not to pay out of pocket. On DR. visits, I just pay the co-pay, on DME and such, I just let it come out of the incentive account. I just got an invoice for 9.00 and some change after they received payment, and co-pay from account from Aetna. (Got that invoice from Aetna in the mail also. I DON"T DO PAPERLESS JUST FOR THESE PURPOSES. Scan, e-mail and wham, problem solved.

Aetna will be receiving a call from me in the morning.!Dielaughing
Post Reply Post Reply
#16
Interesting stuff. My last mask with the single XL cusion was definitely factory sealed, and labeled appropriately. Thus my belief that the manufacturers packages can vary depending on if it is time for a Full Mask or just a Frame and Headgear. I'll know at 6 months. In any case no extra wrong-sized cushions for me, at least not so far.

Dave
Post Reply Post Reply




Possibly Related Threads...
Thread Author Replies Views Last Post
  Does dreamstation need a provider for dreamapper data to sync? Axxel6307 5 417 02-02-2017, 08:19 PM
Last Post: Jimsp1
  [Equipment] Best DME Provider In Seattle jdana24 8 482 12-27-2016, 08:38 PM
Last Post: WSHenry
  Can home care provider make our machine unusable? LPN2012 10 628 12-01-2016, 05:22 AM
Last Post: LPN2012
  [CPAP] Local Provider vs. Online CPAP BigDaddySnooze 15 1,230 07-10-2016, 05:06 AM
Last Post: kwhenrykerr
  Problems Getting Into Provider Settings [DreamStation] Hopefullady 5 1,452 12-16-2015, 09:31 AM
Last Post: Hopefullady
  Dealing with a dishonest Healthcare provider kfujioka 39 6,981 06-11-2015, 11:56 AM
Last Post: Adoniscmj
  Provider manual for philips respironics BiPAP autoSV Advanced System One racprops 0 2,681 10-30-2014, 04:05 PM
Last Post: racprops

Forum Jump:

New Posts   Today's Posts




About Apnea Board

Apnea Board is an educational web site designed to empower Sleep Apnea patients.

For any more information, please use our contact form.