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[Equipment] I'm having a go round with the DME and the insurance company. Buncha scammers!
#1
Angry 
First of all, thanks for all your help. I have been very informed about my rights and this process thanks to many of you.Thanks Immediately after my prescription was given to me I was on the cell with my insurance company checking my benefits. I was told that my company provided me with 85% of DME and I was responsible for 15%. Ok... What about deductible? Well, your deductible has been met for the year. Hurrah!
We dropped off my script at the DME later in the day on Tuesday and I waited. Yesterday I called and gave them my request for a specific machine. (Resmed airsense 10 autoset for her) they didn't know anything about their ability to provide that specific machine. I told them they can order it from the Internet and I'll wait until they get it. I've been prescribed this for life and I'm going to be provided the machine I want. Unsure she said she would make a note in my chart.
She then told me that I would owe $24.95 for the first 2 months and $120.00 for the next 3 that "my insurance company was REQUIRING me to rent the machine for 5 months. I hung up and called the insurance company back. The insurance company said they would provide for the rental until the purchase price is met OR straight out purchase. I told her great and hung up. I called back the DME and informed them that INDEED my insurance company did not require a rental and they said the DME should just get the machine I want and submit a claim. So if it all works out I should not have to pay over $400 for the apap. Just the 15% which is what my benefit provides. Laugh-a-lot I'm prepared to put my foot down more if I have to. After all, these people work for me...not the other way around. By the way, I was super nice the whole time.Grin
Hopefully the autoset will take care of my open airway events 12% and I don't have to do this
over for an ASV! Dancing

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#2
SpeedyD,

Good on ya. Let us know what happens.

Cheers,
otrpu
Love your family, treat your friend(s) well, and don't waste your time. Everything else is just so much BS. Sleep-well
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#3
Good for you for checking. They may not be a bunch of scammers though. That could be the requirement for some of the insurance company contracts with your insurance company. My brother and I both had Blue Cross of MN, but my contract (individual policy) covered more than his (work policy).
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#4
Hi SpeedyD,
Good job on standing up for yourself; you’re right, they do work for you.
Keep up the good work.
trish6hundred
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#5
In the "bunch scammers" department, we have a 10% sales tax in Washington. First time I bought a machine the DME told me that the insurance did not cover sales tax. So I was responsible for my 15% co-pay plus another 10% sales tax, for a total of 25%. This was, of course, total bull. Their scam was to bill the insurance company for the sales tax (which is of course covered) then pocket the extra 10% from me. This scam didn't work since I was on to them, but I had to wonder how many hundreds of other customers got scammed who weren't quick enough to recognize the rip-off.

One thing I'll say for CPAP therapy, ya gotta stay on yer toes! Dancing
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#6
(11-21-2015, 01:54 PM)Tacoma Droner Wrote: One thing I'll say for CPAP therapy, ya gotta stay on yer toes! Dancing

Is it just CPAP or is the whole DME industry like this?
DeepBreathing
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#7
(11-21-2015, 05:06 PM)DeepBreathing Wrote:
(11-21-2015, 01:54 PM)Tacoma Droner Wrote: One thing I'll say for CPAP therapy, ya gotta stay on yer toes! Dancing

Is it just CPAP or is the whole DME industry like this?

Pretty much the whole DME industry.
Cpap is just easier to fool people with than say oxygen concentrater or diabetic supplies etc.:

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