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Lincare: You signed it, so we can charge you whatever you owe..
#11
(02-11-2015, 11:52 AM)Sleeprider Wrote: The Airsense 10 humidifier is integral to the autoset blower. How are you being charged separately for a humidifier? It's all one machine! There is no component cost here. What a ripoff!

I repeat, you are being double billed for something that comes with your machine. You cannot buy a separate Airsense 10 humidifier.

Maybe because it's a heated humidifier?


Thanks for all your replies. I filed a complaint with the BBB and the Ohio Attorney General Consumer Protection Division, I am going to look into the Insurance Commission as well. I gave Lincare until noon to call me back because suprisingly all of the upper management were out of the office yesterday, I left voicemails, still no call back. So after noon came and went I started filing complaints.
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#12
The heated humidifier is integrated with the Airsense 10 Autoset. You cannot buy it separately. You can buy an optional Climateline hose for $40. You were charged for a product that doesn't exist.
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#13
(02-11-2015, 12:44 PM)Sleeprider Wrote: The heated humidifier is integrated with the Airsense 10 Autoset. You cannot buy it separately. You can buy an optional Climateline hose for $40. You were charged for a product that doesn't exist.

Well isn't that interesting!

I will call my insurance company right now.
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#14
What happened was, Medicare and insurance both have allowable schedules for CPAPs and Humidifiers. In order to maximize profits, Lincare has separated out the allowable cost for a humidifier and billed you, and will continue to rent the XPAP machine. So although there is not a separate humidifier available. These are billing codes normally used by the DME to charge insurance. Even though the product is integrated on the Airsense 10, they are billing insurance, and you the maximum allowed cost for every item you see below that you consume. It's not very ethical, but it is the way medical billing works, and it's the reason I don't use DMEs. It ends up costing me more to buy through a Lincare or Apria, than to just buy the product online, and be reimbursed at out of network rates.

A7034 is CPAP Nasal mask
A7032 is CPAP Nasal mask cushion
A7033 is CPAP Nasal pillows
A7030 is CPAP Full Face mask
A7031 is CPAP Full Face mask cushion
A7044 is CPAP Oral Interface
A7027 is CPAP Hybrid mask
A7028 is CPAP Hybrid mask cushion
A7029 is CPAP Hybrid mask nasal pillow
A7046 is CPAP Humidifier Chamber
A7037 is CPAP tubing, long and short hoses
A4604 is CPAP Heated tubing
A7038 is CPAP disposable filter
A7039 is CPAP gross particle (foam) filter
A7035 is CPAP headgear
A7036 is CPAP chinstrap
E0561 NU is CPAP Passover Humidifier
E0562 NU is CPAP Heated Humidifier
E0470 RR is BiPAP rental
E0470 NU is BiPAP purchase
E0471 RR is BiPAP-ST rental
E0471 NU is BiPAP-ST purchase
EO601 RR is CPAP rental
E0601 NU is CPAP purchase

As you can see, there is not rental reimbursement for a humidifier, so it was billed as a purchase. The problem is, it was billed to you and it should be an insured cost. You are probably eligible for reimbursement from your insurance if your deductible and copay has been met. Lincare will continue to bill the allowable cost of your Autoset under code EO601, for whatever the term is up to the allowed cost.
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#15
Sleeprider, you are correct. I just got off the phone with Anthem, they said they don't allow the humidifier to be billed as a rental. I'm basically out of luck. I was lied to by Lincare, bombarded with a charge I wasn't expecting. Not really sure what my next step is. I could ask them to come pick the machine up but I don't want to go through the hassle of meeting with a new DME, and I'm sure Lincare would probably try and screw me somehow.
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#16
(02-11-2015, 01:19 PM)heyheyrayray Wrote: Sleeprider, you are correct. I just got off the phone with Anthem, they said they don't allow the humidifier to be billed as a rental. I'm basically out of luck. I was lied to by Lincare, bombarded with a charge I wasn't expecting. Not really sure what my next step is. I could ask them to come pick the machine up but I don't want to go through the hassle of meeting with a new DME, and I'm sure Lincare would probably try and screw me somehow.

Here is what I did, and I have Anthem. I purchased out of pocket my own machine off Craigslist for $200, and wrote it off. I got a PR System One 60 Series Auto with heated humidifier with only 116 hours on the clock.

If you look at Supplier #1 on the forum supplier list, you can buy a complete Resmed Airsense 10 with heated humidifier for $883. No other costs. With Anthem BS/BC you can fill out a reimbursement form so that your deductible is 40%, rather than the normal 20%. The supplier I pointed to gives you all the forms needed to bill your insurance. Your total cost to own that machine new is $353 under that scenario, or just about $100 more than the humidifier you just bought. Now your copay for the rental you have now will easily exceed that cost.

You will probably have to pull some savings or credit to get the machine, but your total costs may make that worthwhile. Alternatively, I can help direct you to some used deals on Craigslist and from other people I know that can get you the machine for less, but probably no insurance reimbursement. As you can see, the whole insurance game is stacked against you, but by simply buying the machine, you gain independence. No more followup compliance and other B.S.
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#17
(02-11-2015, 01:46 PM)Sleeprider Wrote: Here is what I did, and I have Anthem. I purchased out of pocket my own machine off Craigslist for $200, and wrote it off. I got a PR System One 60 Series Auto with heated humidifier with only 116 hours on the clock.

If you look at Supplier #1 on the forum supplier list, you can buy a complete Resmed Airsense 10 with heated humidifier for $883. No other costs. With Anthem BS/BC you can fill out a reimbursement form so that your deductible is 40%, rather than the normal 20%. The supplier I pointed to gives you all the forms needed to bill your insurance. Your total cost to own that machine new is $353 under that scenario, or just about $100 more than the humidifier you just bought. Now your copay for the rental you have now will easily exceed that cost.

You will probably have to pull some savings or credit to get the machine, but your total costs may make that worthwhile. Alternatively, I can help direct you to some used deals on Craigslist and from other people I know that can get you the machine for less, but probably no insurance reimbursement. As you can see, the whole insurance game is stacked against you, but by simply buying the machine, you gain independence. No more followup compliance and other B.S.

Thank you for the advice. I agree that it is better to ditch the DME all together. I've bought several masks since first meeting with Lincare through an online DME, because Lincare wouldn't order the mask I wanted.

If I have Lincare pick up my machine do i get to keep my humidifier since I paid for it? Smile

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#18
I just talked to lincare, told them to come pick up their machine. What a pain and a waste of money! LESSON LEARNED!
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#19
I had Lincare for a grand total of 24 hrs when I started to get my Cpap machine. I already had an O2 concentrator from them here because my cardiologist freaked out at the O2 apnea desats of 62% and ordered it thru them until I could get the pap machine.

Long story short, I wanted a PRS1 Auto aflex. They wanted to give me a S9 auto set. And wouldnt get a PRS1. Said they werent allowed too by their national office. I called National office they said they never heard of any such thing and admitted they have a bunch of trouble with their local offices.

One lie and Im gone so I dropped Lincare like a hot potato. Got the PRS1 from a DME closeer to home that would get anything I wanted in that insurance code coverage.

As far a them picking up the machine I wouldnt hold my breath. Took me two weeks to get them to pick up the 02 concentrator. Even after I told them I had cpap machine and didnt need it. And I wouldnt pay them a single dime for it after that day. They wanted a DR prescription to pick it up. Got one they still wouldnt come get it.
Called insurance to stop them from billing for something I wasnt supposed to have. They still wouldnt come. Wanted another DR prescription. Dr said baloney they didnt need the first one make a flower pot out of it.

They finally came and got it when I told them I was moving it onto my home pistol shooting range as a target stand.
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#20
(02-11-2015, 03:31 PM)heyheyrayray Wrote: I just talked to lincare, told them to come pick up their machine. What a pain and a waste of money! LESSON LEARNED!

I don't think the humidifier can be removed from the machine you have can it? Either way, they should reimburse you for the humidifier they are taking back. IF you don't have copies of all the paperwork from Lincare, get it from them. Every piece of paper they made you sign, your prescription, your sleep study if they have it....everything.

This is why I don't like all in ones. Worse than that, I cannot stand unethical practices and I cannot stand a company (or anyone) that lies. If they lie, they will do anything IMHO.
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