My DME says they're starting to charge a $10 (US) fee per package for shipping

[Sleeprider]

What is amazing is that the allowed charges are only 10% of the billed amount. If you didn't have the insurance discount, it's nothing short of theft.

Anyway, in the event of balance billing, you would make back all your money and more if you challenged it, and the case would be taken on contingency...you won't owe anything. The best bet is to look at any invoice and ask your insurance about the charges. That's free. Everyone should understand that today, all service providers are contracted to accept a discounted (unknown) compensation for every item billed. It is flatly illegal to balance bill the difference. Even your copay and deductibles are subject to the contracted discount. This does not apply when you go out of network. Beware.

[green wings]

Interesting. I'd think the DME I use must know they can't charge Medicare clients shipping charges, then. They specifically mentioned Medicare patients when they were explaining how it's "just costing them too much money" in shipping costs, though. 

I wouldn't bet money that they were being strictly truthful with me. Not sure exactly what they're up to, though.

[SuperSleeper]

Thread has been moved into the Main Forum.

[SarcasticDave94]

Interesting info. Once my DME wakes up and actually supplies something, after the ASV I'm still waiting on that is, I'll take care to make sure the billing is correct. I'm curious to see how accurate they're gonna be, as they are my new DME, Apria. And this evening, I found that the 3rd accepted DME by my insurance is nearby as well, giving me Apria, Lincare, and Rotech offices within 30 minutes of the house.

he don't do CUPS of coffee no more...

[Shift Worker]

I will get to pick up my new ResMed Aircurve 10 ASV in the morning, finally! Before going in to Apria I called my insurance co. to find out exactly what my responsibility for this would be, the nice insurance lady told me that Apria should be given no money, if my deductible has not been met for the year, the insurance would bill me. My current Durable Medical Equipment coverage will cover everything on the prescription, including replacement parts.
I guess I have good coverage, but I do work for the hospital the coverage is through.
I have learned much through this forum, and am grateful fro the people here who take the time to help so many, A true gift! 

Once I am set up with my machine and have a few good nights of information I will start a new thread to get some further help.
Shift Worker

[SarcasticDave94]

Best to ya on the new ASV machine. And certainly keep us posted on progress. Ones just like you and me are on the same ASV path. That is what I should be in possession of already; Apria said that from the day the script was turned in, it would be about 5 days, which was 8 days ago. So I've got my big mallet out already and it's before 8 AM. I'm calling insurance first to be certain it's been pre-authorized even though I'm sure it has been done. Second, I call Apria to request it get done TODAY or I go to Lincare or Rotech. I am stating to Apria my other DME choices BTW; its past time to get a fire lit under someone.

BTW yesterday's calls, yes plural, to Apria gave me info on this line "your local office will call you within 2 hours to setup delivery" at 1:05 PM Eastern time. At 3:45 no call. I called back..."well it looks like we need more historical info from your pulmonary doctor..."   For some reason, I do not believe this line for a second. I went from delivery being set up to needing more proof in 2 hours. Really?

So today Apria gets the demanded deadline. If they cannot take definitive action today, I go elsewhere to Lincare or Rotech; yes I'm aware that starts me over, but I'm fed up with running in circles like some dog chasing his tail.

Where's my ASV?!

[Shift Worker]

Sarcastic Dave,
I sort of had that same runaround with Apria, I finally told the young lady at Apria that since this journey had taken so long I have researched this machine and treatment enough that I felt better qualified about it then most people, including their own, I will of course be asking many questions of the knowledge base at this forum! This was yesterday at 10:00 local time, she then put me on hold for about three minutes, came back and told me I could pick up the machine with out needing to take a "Class" on it. I told her that she should inform my local office (ten minute drive away from home) that I would be in this morning to pick it up, I will then sign up for their class because I wonder what BS they will feed me. Also i will need to be "Fitted" for the mask that is on the prescription, mainly for the re-supplies.
Good luck on your journey, I started this journey November last year when I went into AFib that kept me in the hospital for 6 day's, The doctors treating me said that non-compliance with cpap was a likely cause. 

Shift Worker

[SarcasticDave94]

Sarcastic Dave,
I sort of had that same runaround with Apria, I finally told the young lady at Apria that since this journey had taken so long I have researched this machine and treatment enough that I felt better qualified about it then most people, including their own, I will of course be asking many questions of the knowledge base at this forum! This was yesterday at 10:00 local time, she then put me on hold for about three minutes, came back and told me I could pick up the machine with out needing to take a "Class" on it. I told her that she should inform my local office (ten minute drive away from home) that I would be in this morning to pick it up, I will then sign up for their class because I wonder what BS they will feed me. Also i will need to be "Fitted" for the mask that is on the prescription, mainly for the re-supplies.
Good luck on your journey, I started this journey November last year when I went into AFib that kept me in the hospital for 6 day's, The doctors treating me said that non-compliance with cpap was a likely cause. 

Shift Worker

First, a sincere Best to ya. I was just on the phone with:

Insurance; no pre-authorization sent in as yet, expected from doc office.

Apria; they expect face-to-face notes from pulmonary doc.

Dr. office; we just hand info to Apria rep and it gets taken care of, who is supposed to do pre-auth?, we don't do that...

Me; to Apria and doc office, action today or I go elsewhere and do not promise within 5 days I'd have a machine if you can't do it.

Ironically, I think insurance is innocent in this case. Slacker doc & Apria regional rep are taking the heat from me on this. I stated if action and real progress was not accomplished today, I shop elsewhere.

Provided by Dave to educate poor handling process by specific doctor, DME regional rep. If you're interested in specifics due to a similar physical location of Greencastle, PA or Hagerstown, MD areas, PM me and I would state to stay away from at the least doc so and so. Just saying, this is not how the process ought to be. Unfortunately for us patients, this seems to be more the norm than it needs to be.

Despite the negative, hope we each have a great Friday and weekend. And I apologize for jumping over the topic fence.

PS with all the negatives thus far with Apria, I will look at the bills with a magnifying glass. No funny biz allowed on the bill. I am just looking for an excuse to dope slap or mallet smash someone......

OK and are on me today! virtual deliveries until 5 PM

[Sleeprider]

Shift Worker and Dave, note that Apria may ask for a credit card number which they will charge in a heartbeat if they feel they are owed something. Since your insurance bills you directly for any deductible and copay, I would try to avoid giving free use of a valid credit card to Apria, and explain that if any sum is due, to submit an invoice which you will first verify with insurance prior to payment. No provider should hold your credit card hostage in anticipation of non-payment or for unspecified and unaccrued future charges.

[SarcasticDave94]

Thanks Sleeprider for the heads up. I will be ready as advised. WOW this Duck/DME/Insurance dancing circus is incredibly broken. I am renting out a worn mallet for any that need it BTW. Seriously, neither this nor the prior DME got credit/debit card info from me; I'll just keep it that way.