Is the DME lying?

[scoobiedu]

Make sure you know which A10 you are getting because there is a low end model that does not have many reporting features.

He got an A10, I didn't know there was a low end APAP, how do I check to see if it is the low end model?

[scoobiedu]

Update, just got back from DME. Hubby was given an Airsense 10 Autoset APAP. The billing seemed a little too good to be true so now I'm worried about that especially after player's comment. DME lady knows our insurance does not rent as she stated such so all of the prices, we assumed were for purchase price. Total for the APAP, headed hose, heated humidifier, and mask came to $530. DME told us that is what they submit to insurance and that we would have to pay our percentage of that which would be 20%. Is this price too good to be true? Probably...

[me50]

I buy supplies on line because the DME tends to screw up my orders and overcharge for the privilege.

OpalRose,

Do you get reimbursed for the supplies you buy online? or just out of pocket for tax deductions?

I have a Humana Medicare Advantage plan, and if I buy on line, as long as I submit the required paper work and follow the Medicare schedule, I am reimbursed at 80%. I admit it is more of a hassle to buy on line and submit it to insurance, and insurance takes a longer time to reimburse me.

If I buy from my DME, they usually pay 100% after yearly deductable is met. The crazy part is that my insurance ends up paying more to he DME than what they reimburse me.

My DME has taken as long as 3 to 4 weeks to send me a nasal pillow and fine white filters. At one time, I called to see where my order was, and they claimed I received it. I ask for proof or a tracking number which they couldn't give me.
Then they had the nerve to say that maby I forgot that I received it.
After me pestering them, they admitted that they never placed the order.

Sometimes it's easier to just buy online and avoid the DME and the stress they cause.

You should do some checking on your insurance payments. I suppose they can be different in each state, however, I would think the coverage would be the same (depending upon whether you are in a competitive bid area or not).

I have the same insurance, however, I may not have the same plan you do. Mine is a PPO and I don't have a deductible.

[DariaVader]

Update, just got back from DME. Hubby was given an Airsense 10 Autoset APAP. The billing seemed a little too good to be true so now I'm worried about that especially after player's comment. DME lady knows our insurance does not rent as she stated such so all of the prices, we assumed were for purchase price. Total for the APAP, headed hose, heated humidifier, and mask came to $530. DME told us that is what they submit to insurance and that we would have to pay our percentage of that which would be 20%. Is this price too good to be true? Probably...

$530 might be your 20%.... the A10 Auto Apap is ~ $900 from the cheapest online suppliers and generally ~ $2k from a DME. Then there is a $100 mask for $250, and extra charges for hose, filters, etc. My DME "estimated" my charges at somewhat over $400 assuming that I had to pay 20% (I didn't - my insurance covers at 100%) Make sure that they charge you 20% on the discounted insurance price and not 20% on their generous markup. That is illegal.

[Sleeprider]

The Resmed AirSense machines that are "bricks" are the Escape CPAP and Escape Auto. The Autoset is great, and $550 is an amazing price for the machine and masks. I don't know how it can be sold for that.

[scoobiedu]

Update, just got back from DME. Hubby was given an Airsense 10 Autoset APAP. The billing seemed a little too good to be true so now I'm worried about that especially after player's comment. DME lady knows our insurance does not rent as she stated such so all of the prices, we assumed were for purchase price. Total for the APAP, headed hose, heated humidifier, and mask came to $530. DME told us that is what they submit to insurance and that we would have to pay our percentage of that which would be 20%. Is this price too good to be true? Probably...

$530 might be your 20%.... the A10 Auto Apap is ~ $900 from the cheapest online suppliers and generally ~ $2k from a DME. Then there is a $100 mask for $250, and extra charges for hose, filters, etc. My DME "estimated" my charges at somewhat over $400 assuming that I had to pay 20% (I didn't - my insurance covers at 100%) Make sure that they charge you 20% on the discounted insurance price and not 20% on their generous markup. That is illegal.

That's what I was thinking, however the pink order slip they gave us with every item's description, had a price next to it. The price for the machine alone was 210, the humidifier, 45, heated hose, 77. The only stuff that looked really marked up was the mask, which was in two parts, the mask 125, and the headgear, 73.

Not sure why there was a separate charge for the humidifier since it's supposed to come with the machine? No?

Even if we walk out of there only paying the $530, that will be fine with me since we were ready to pay closer to a grand going online

[Adoniscmj]

I have to let you know that that is the initial bill going to your insurance company. They will reduce the price of everything and then you will recieve a bill for your portion. Most likely you will be billed your portion on a monthly basis until the machine is paid for. Most insurance company's use a rent to own basis. After the rental period the unit is your's . I have heard of some being as high as $150 per month. When I get my first bill, I will figure out whether it is cheaper to buy online out of pocket or keep the rental. If your bill is more than $80 dollars a month it would be cheaper to buy it online.

[AlanE]

I have to let you know that that is the initial bill going to your insurance company. They will reduce the price of everything and then you will recieve a bill for your portion. Most likely you will be billed your portion on a monthly basis until the machine is paid for. Most insurance company's use a rent to own basis. After the rental period the unit is your's . I have heard of some being as high as $150 per month. When I get my first bill, I will figure out whether it is cheaper to buy online out of pocket or keep the rental. If your bill is more than $80 dollars a month it would be cheaper to buy it online.

That's right. They'll adjust the bill and stick you with the some smaller charge. Like it would bankrupt them to pay the full charge, instead they stick you with a 1.50... but I digress..

[scoobiedu]

I have to let you know that that is the initial bill going to your insurance company. They will reduce the price of everything and then you will recieve a bill for your portion. Most likely you will be billed your portion on a monthly basis until the machine is paid for. Most insurance company's use a rent to own basis. After the rental period the unit is your's . I have heard of some being as high as $150 per month. When I get my first bill, I will figure out whether it is cheaper to buy online out of pocket or keep the rental. If your bill is more than $80 dollars a month it would be cheaper to buy it online.

It would have been nice of them to let us know it wasn't the total bill, but a rent to own. DME stated the only other future charges would be for new hose or mask supplies... hmmmm I'm sure you are right about the rental thing though. Just don't understand why she stated our insurance company doesn't do rentals and then stick us with a rental price.

[me50]

I haven't ever heard of an insurance company that didn't buy the humidifier outright. I can't imagine the humidifier being less than the hose. But it is Apria so who knows what they have done