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[How to] Conversation with DME
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Sleepster Offline
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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
Conversation with DME
I've been wondering why I've never gotten a bill from my DME. Turns out they never sent me a statement because I have a credit of over $150 with them. It took me a long time to figure all this out, and I just want to reconcile what the insurance company has paid them, what I've paid them, and what the balance is afterwards.

I don't think that's unreasonable.

Well, they won't send me a statement, but after failed attempts to figure this out by communicating with the employee at the DME who sends my supplies, I finally asked to speak with a supervisor.

It turns out the credit on my account was not due to me being overcharged for my CPAP machine. Oh no, we don't call it that. It's called an overpayment. Silly me. I thought that when they delivered my CPAP and told me I owed them $390, it was a charge. So I wrote a check. Wrote another for $260 two weeks later when they delivered my BiPAP and took back the CPAP.

So, at the end of the conversation I was told that I shouldn't stress out over this. I should just relax and try to sleep well and trust that they are charging me the correct amounts.

Yes, she really did say that!


Huhsign

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.
03-20-2013 11:14 PM
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PaulaO2 Offline
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Posts: 8,067
Joined: Feb 2012

Machine: S9 Autoset
Mask Type: Full face mask
Mask Make & Model: F&P Simplus
Humidifier: H5i
CPAP Pressure: 14-20
CPAP Software: SleepyHead

Other Comments: Ehlers-Danlos Syndrome, Hypermobility Type; chronic sarcasm

Sex: Undisclosed
Location: western NC, USA

Post: #2
RE: Conversation with DME
Mention "insurance fraud" just once. Maybe toss in "Better Business Bureau".

PaulaO2
Apnea Board Moderator
www.ApneaBoard.com


Breathe deeply and count to zen.

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.
03-20-2013 11:27 PM
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Shastzi Offline

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Posts: 1,174
Joined: Dec 2012

Machine: ResMed S9 Autoset
Mask Type: Full face mask
Mask Make & Model: FitLife Total face mask
Humidifier: F&P HC150 with Hybernite heated hose.
CPAP Pressure: 15cm-20cm H2O (auto)
CPAP Software: SleepyHead Other Software

Other Comments: CMS50-F wearable Oximeter; Software: SPO2 Assistant

Sex: Undisclosed
Location: Florida, USA.

Post: #3
RE: Conversation with DME
That's right Sleepster. Go home. Relax, have a few beers and await further instructions from the Borg Collective.

Yep. It's the old "lets pocket the overpayment and hope the customer and insurance company don't notice" ploy.

Mind you, the insurance company compensates for this in other ways, by ignoring claims from folks that need the payments.
In that case the insurance company is pocketing the premium and hoping no one notices...

"banks and insurance companies are always your financial *adversaries*"

I did not make that one up.
=^.^=

"With ordinary talent and extraordinary perseverance, all things are attainable." - Thomas Foxwell Buxton

Cool
03-21-2013 09:45 AM
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PaulaO2 Offline
Wiki Editor
Moderators

Posts: 8,067
Joined: Feb 2012

Machine: S9 Autoset
Mask Type: Full face mask
Mask Make & Model: F&P Simplus
Humidifier: H5i
CPAP Pressure: 14-20
CPAP Software: SleepyHead

Other Comments: Ehlers-Danlos Syndrome, Hypermobility Type; chronic sarcasm

Sex: Undisclosed
Location: western NC, USA

Post: #4
RE: Conversation with DME
I read the online story of a gaming friend who had cancer surgery and treatment. The same group did all of it and the bills came with the same group name. So she paid it off using one of the first bills. Then started getting collection warnings from some of the docs within the group.

She had inadvertantly been sending the money to the one account. Each doctor had different accounts for her. So one was overpaid by tens of thousands of dollars and they never said anything, just kept the money. They never called her and said "You paid us, did you mean for me to hand the money to the staff person sitting next to me?"

Now her credit rating is ruined while she waits 6 wks for them to cut her a check for the over payment so she can then pay the others. In the same office.

PaulaO2
Apnea Board Moderator
www.ApneaBoard.com


Breathe deeply and count to zen.

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.
03-21-2013 04:23 PM
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JJJ Offline

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Posts: 751
Joined: Apr 2012

Machine: ResMed S9 Autoset
Mask Type: Nasal mask
Mask Make & Model: Most recent: Wisp, Pilairo, Mirage Vista
Humidifier: ResMed S9 Autoset
CPAP Pressure: 17-20
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location: USA 97217

Post: #5
RE: Conversation with DME
(03-21-2013 04:23 PM)PaulaO2 Wrote:  Now her credit rating is ruined while she waits 6 wks for them to cut her a check for the over payment so she can then pay the others. In the same office.

Time for her to see a lawyer. A letter from the lawyer mentioning "Fair Credit Reporting
Act" should restore her credit rating, and I mean toot sweet. And if they balk, then they get to pay her statutory damages plus costs and attorney's fees. Assuming her story is correct, of course.
03-21-2013 07:15 PM
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PaulaO2 Offline
Wiki Editor
Moderators

Posts: 8,067
Joined: Feb 2012

Machine: S9 Autoset
Mask Type: Full face mask
Mask Make & Model: F&P Simplus
Humidifier: H5i
CPAP Pressure: 14-20
CPAP Software: SleepyHead

Other Comments: Ehlers-Danlos Syndrome, Hypermobility Type; chronic sarcasm

Sex: Undisclosed
Location: western NC, USA

Post: #6
RE: Conversation with DME
Yes, it is something she has already started. It is going to take a while, though. Meanwhile, she's still recovering.

PaulaO2
Apnea Board Moderator
www.ApneaBoard.com


Breathe deeply and count to zen.

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.
03-21-2013 08:15 PM
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cincysinner Offline

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Posts: 20
Joined: Feb 2013

Machine: Looking
Mask Type: Nasal pillows
Mask Make & Model: ResMed S9 VPAP Auto
Humidifier: H5i
CPAP Pressure: 13/8
CPAP Software: ResScan SleepyHead

Other Comments:

Sex: Male
Location:

Post: #7
RE: Conversation with DME
Funny, I had a very similar experience... seems like some funny stuff is going on with the insurance billing (fraud). My 1st clue was my DME wouldn't let me have a ResMed machine without an explicit machine written on the RX from the doctor. Their company policy is they only sell Phillips resporonics machines unless a specific machine is written on the Rx.

In any other industry this is racketeering, is healthcare it is simply the way business is done :-).

Got a similar answer, just relax we have the billing right.
03-21-2013 09:18 PM
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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: #8
RE: Conversation with DME
(03-20-2013 11:27 PM)PaulaO2 Wrote:  Mention "insurance fraud" just once. Maybe toss in "Better Business Bureau".

Well, they've offered to cut me a check for the credit on my account. If I tell them to do that then I'll have to start paying their bill every time they send me something.

Until I learned of that credit it was money spent.

Unfortunately, I think the only hope I have of getting statements from them is to have them cut me the check. Then when they send me my next shipment of supplies I'll get a bill for $21.45 or something stupid like that.

It's hopeless.

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.
03-21-2013 09:28 PM
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Shastzi Offline

Advisory Members

Posts: 1,174
Joined: Dec 2012

Machine: ResMed S9 Autoset
Mask Type: Full face mask
Mask Make & Model: FitLife Total face mask
Humidifier: F&P HC150 with Hybernite heated hose.
CPAP Pressure: 15cm-20cm H2O (auto)
CPAP Software: SleepyHead Other Software

Other Comments: CMS50-F wearable Oximeter; Software: SPO2 Assistant

Sex: Undisclosed
Location: Florida, USA.

Post: #9
RE: Conversation with DME
If you want to steal from someone, first you must cause confusion.

Time to call the biker gang to go in and bust up the place. Grr...

No, I would not really do that....
I'd like to but it's *against the law*.

*FUME*

"With ordinary talent and extraordinary perseverance, all things are attainable." - Thomas Foxwell Buxton

Cool
03-21-2013 09:36 PM
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PaulaO2 Offline
Wiki Editor
Moderators

Posts: 8,067
Joined: Feb 2012

Machine: S9 Autoset
Mask Type: Full face mask
Mask Make & Model: F&P Simplus
Humidifier: H5i
CPAP Pressure: 14-20
CPAP Software: SleepyHead

Other Comments: Ehlers-Danlos Syndrome, Hypermobility Type; chronic sarcasm

Sex: Undisclosed
Location: western NC, USA

Post: #10
RE: Conversation with DME
A friend of mine, years ago, had trouble with her car. She kept taking it in, paying for repairs, but it was never really fixed. Finally, she got her kid and several other kids and she and their parents gave them permission to be brats. No outright damaging of anything, but running around, being loud, was fine. So she took these five kids to the repair place. Told them she had a new job of babysitting these kids after school. And wasn't it a shame they had to come with her every time she needed repairs?

Wouldn't you know, not only was it finally fixed, but it was her lowest bill yet. And she didn't have to go back. The kids got some good ice cream on their way home!

PaulaO2
Apnea Board Moderator
www.ApneaBoard.com


Breathe deeply and count to zen.

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.
03-23-2013 02:27 PM
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