Post Reply 
[Equipment] Ripped Off by Medical Industry
Author Message
Sleepster Offline
Wiki Editor
Moderators

Posts: 4,995
Joined: Feb 2012

Machine: ResMed AirCurve10 VAuto
Mask Type: Full face mask
Mask Make & Model: F&P Simplus
Humidifier: HumidAir and SlimLine Hose
CPAP Pressure: MaxI 13.6 | MinE 5.2 | PS 4.4
CPAP Software: ResScan SleepyHead

Other Comments: Diagnosed Nov 2011. Conquered aerophagia.

Sex: Male
Location: Houston, Texas

Post: #1
Ripped Off by Medical Industry
The amount of money paid by insurance companies to medical equipment suppliers is outrageous, and these costs are passed on to us, the consumer, in the form of co-payments, insurance premiums, and deductibles.

Here's an example. My CPAP machine is the ResMed AirCurve VAuto. Supplier #1 charges $1726 US dollars for this machine and the humidifier.

My insurance company paid my equipment supplier $3984.
I paid my equipment supplier $779.

That's a total of $4673 for something that costs $1726.

This is a system in need of reform!

And on top of this, the equipment supplier is now telling me that I owe another $270 for this machine.

Sleepster
Apnea Board Moderator
www.ApneaBoard.com


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.
05-23-2016 02:36 PM
Find all posts by this user Post Reply Quote this message in a reply

Donate to Apnea Board
Sleeprider Online
Wiki Editor
Advisory Members

Posts: 3,369
Joined: Dec 2014

Machine: Resmed Aircurve 10 Vauto
Mask Type: Nasal pillows
Mask Make & Model: Resmed Airfit P10
Humidifier: Resmed Climateline
CPAP Pressure: Auto Bilevel 18/9, PS 3
CPAP Software: ResScan SleepyHead EncoreBasic

Other Comments:

Sex: Male
Location: Where they make Respironics

Post: #2
RE: Ripped Off by Medical Industry
Most insurance companies pay a significant discount on the invoiced price. Are you sure that was the final settlement? With your costs over $1000, I'm pretty sure I would have found a different source. Maybe call your insurance and ask why they allow this much when the advertised price is so much less nearly everywhere. They pay a premium for monitoring, service and warranty. but it's hard to believe they are paying over twice the price.

______________________________________________
Organize your SleepyHead Data
Post your SleepyHead Data from Imgur
Robysue's Beginner's Guide to Sleepyhead
05-23-2016 02:43 PM
Find all posts by this user Post Reply Quote this message in a reply
Sleepster Offline
Wiki Editor
Moderators

Posts: 4,995
Joined: Feb 2012

Machine: ResMed AirCurve10 VAuto
Mask Type: Full face mask
Mask Make & Model: F&P Simplus
Humidifier: HumidAir and SlimLine Hose
CPAP Pressure: MaxI 13.6 | MinE 5.2 | PS 4.4
CPAP Software: ResScan SleepyHead

Other Comments: Diagnosed Nov 2011. Conquered aerophagia.

Sex: Male
Location: Houston, Texas

Post: #3
RE: Ripped Off by Medical Industry
(05-23-2016 02:43 PM)Sleeprider Wrote:  Most insurance companies pay a significant discount on the invoiced price. Are you sure that was the final settlement?

Yes.

Quote:With your costs over $1000, I'm pretty sure I would have found a different source.

Time travel?!

Quote:Maybe call your insurance and ask why they allow this much when the advertised price is so much less nearly everywhere. They pay a premium for monitoring, service and warranty. but it's hard to believe they are paying over twice the price.

Yes, it is hard to believe. Which is why I chose to post this information.

Sleepster
Apnea Board Moderator
www.ApneaBoard.com


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.
05-23-2016 02:50 PM
Find all posts by this user Post Reply Quote this message in a reply

Donate to Apnea Board
green wings Offline

Advisory Members

Posts: 547
Joined: Feb 2016

Machine: Respironics System One RemStar Pro (460)
Mask Type: Nasal pillows
Mask Make & Model: AirFit P10
Humidifier: integrated humidifier
CPAP Pressure: 13.0 cm
CPAP Software: SleepyHead

Other Comments: using CPAP since Jan. 2016

Sex: Undisclosed
Location: US

Post: #4
RE: Ripped Off by Medical Industry
I don't think it would matter what supplier Sleepster used, would it? His insurance has a fixed amount that they reimburse for that particular machine, so he's stuck paying his ~20% of the bill.

(05-23-2016 02:43 PM)Sleeprider Wrote:  Most insurance companies pay a significant discount on the invoiced price. Are you sure that was the final settlement? With your costs over $1000, I'm pretty sure I would have found a different source. Maybe call your insurance and ask why they allow this much when the advertised price is so much less nearly everywhere. They pay a premium for monitoring, service and warranty. but it's hard to believe they are paying over twice the price.
05-23-2016 04:33 PM
Find all posts by this user Post Reply Quote this message in a reply
justMongo Offline

Monitors

Posts: 3,853
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: #5
RE: Ripped Off by Medical Industry
Sleepster: You should take a look at your EOB. I'm sort of with Sleeprider here.
I frequently see where a provider bills for one price; but must settle for a lower contracted price.
Of which the patient co-pay is a % of the contracted price.

Let's name names -- who's the insurance carrier and who's the DME?
And that extra $270 -- sounds like a Crapria stunt.

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.
05-23-2016 05:12 PM
Find all posts by this user Post Reply Quote this message in a reply

Donate to Apnea Board
Sleepster Offline
Wiki Editor
Moderators

Posts: 4,995
Joined: Feb 2012

Machine: ResMed AirCurve10 VAuto
Mask Type: Full face mask
Mask Make & Model: F&P Simplus
Humidifier: HumidAir and SlimLine Hose
CPAP Pressure: MaxI 13.6 | MinE 5.2 | PS 4.4
CPAP Software: ResScan SleepyHead

Other Comments: Diagnosed Nov 2011. Conquered aerophagia.

Sex: Male
Location: Houston, Texas

Post: #6
RE: Ripped Off by Medical Industry
(05-23-2016 05:12 PM)justMongo Wrote:  Sleepster: You should take a look at your EOB.

Yes, I did that before posting. I, too, was in denial. But it's true. The EOB justifies the extra $270. The only "stunt" is that I was not informed of the actual cost before I agreed to the purchase. This American medical system is allowed to get away this preposterous scheme. That's the crime that we allow them to commit because of their highly successful lobbying efforts.

Sleepster
Apnea Board Moderator
www.ApneaBoard.com


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.
05-23-2016 06:45 PM
Find all posts by this user Post Reply Quote this message in a reply
justMongo Offline

Monitors

Posts: 3,853
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: #7
RE: Ripped Off by Medical Industry
Pay them in pennies.

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.
05-23-2016 07:03 PM
Find all posts by this user Post Reply Quote this message in a reply

Donate to Apnea Board
Homerec130 Offline

Advisory Members

Posts: 445
Joined: Mar 2012

Machine: Philips/Resperonics BiPAP auto SV Advanced System One (950P)
Mask Type: Full face mask
Mask Make & Model: ResMed Quatro FX
Humidifier: Philips Respironics System 1
CPAP Pressure: 6-16
CPAP Software: SleepyHead

Other Comments: But it is a dry heat.

Sex: Male
Location: Tucson, AZ

Post: #8
RE: Ripped Off by Medical Industry
My last set of replacement parts was as follows:

Insurance Billed: 603.93; Allowed 202.60; Paid 162.08. My cost - 40.52 (which was picked up by my supplement).

This was not as bad as when my wife had her back surgery - hospital billed $650,000 and change and the allowed amount was around $70,000. This was for the surgery and a week's stay. Our supplement picked up what was left (less than $200). Our insurance also has a catastrophic cap of $3000 for the family so we hit the cap on this one.

Homer
05-24-2016 03:32 PM
Find all posts by this user Post Reply Quote this message in a reply
Phill Offline

Preferred Members

Posts: 90
Joined: Nov 2015

Machine: ResMed S9 Auto Set
Mask Type: Full face mask
Mask Make & Model: ResMed AirFit F10
Humidifier: ResMed H5i, with heated hose
CPAP Pressure: unsure
CPAP Software: ResScan SleepyHead

Other Comments:

Sex: Male
Location: UK, sunny south coast.

Post: #9
RE: Ripped Off by Medical Industry
Goodness, what a system, it almost makes our setup look half reasonable, with the emphasis on ALMOST.

Best of luck Sleepster.
05-26-2016 10:33 AM
Find all posts by this user Post Reply Quote this message in a reply

Donate to Apnea Board
Cudos Offline

Members

Posts: 5
Joined: Apr 2016

Machine: resmed autoset
Mask Type: Full face mask
Mask Make & Model: f10
Humidifier: unsure
CPAP Pressure: unsure
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location:

Post: #10
RE: Ripped Off by Medical Industry
It is outrageous and quite the racket. Hows this for a dilemma. My DME, sleep center wanted to charge my insurance $2600.00 for a Resmed 10 Auto, $2,000 of which my insurance would pay leaving $600.00 to me.

I discovered a reputable company offering to me "2" Resmed 10's with all the gear for $2,000 total. Once they knew my insurance limit they were more than willing to sell me 2 billed as one unit. how's that for a pickle.

Should I have been honest and let the DME screw me and my insurance for 1 machine or get 2 for $600.00 less. Of course i doubt the insurance company would see my logic in getting 2 for the price of one.

It's a pickle.
05-26-2016 11:37 AM
Find all posts by this user Post Reply Quote this message in a reply
Post Reply 


Possibly Related Threads...
Thread: Author Replies: Views: Last Post
  CPAP and the Medical Industrial Complex asoundsleep 7 433 10-12-2016 05:54 PM
Last Post: surferdude2
  Ridiculous Cpap machine and industry jxyzobrien 7 762 08-31-2016 10:01 AM
Last Post: gmapes
  Looking for medical or dental air compressor ckingzzzs 10 909 05-26-2016 04:46 PM
Last Post: stanleydean
  Medical Supplier Follow Up Visit Zeeez 5 836 05-26-2016 10:35 AM
Last Post: AndyB
  Find a Good Medical Supplier Zeeez 4 617 02-27-2016 10:34 AM
Last Post: Mosquitobait
  Medical policy and standards sunshine 12 1,803 09-23-2015 10:14 AM
Last Post: sunshine
  List CPAP user on Medical ID Tag? Mosquitobait 5 986 09-05-2015 01:28 PM
Last Post: Mike1953

Forum Jump:

Who's Online (Complete List)