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Question about billing/insurance
#1
I got an Airsense 10 Autoset back on 2/2. When I was at the DME office, no mention of charges or payment was made. Today I get a bill from the DME saying insurance paid nothing and they have billed me for a "6 month rent to own" for the machine. Is this a normal set up? It is 6 payments of $130. I just wanted to see if this sounded like the norm for the rest of you.

However, there is another charge that seems totally bogus to me. I was charged $260 for the humidifier and tubing. On the resmed website, it says the machine includes tubing and the humidifier is integrated.

What do you think? Are they trying to scam?
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#2
Well, I would be upset, that sounds a lot like the car dealer giving you the keys and a week later saying they couldn't get the financing.

As for price - going price for a ResMed Airsense 10 Autoset online is about $880 to $900 - that includes the tank and hose and stuff.

You are being charged $1040 for your system in a rental agreement/plan. Most rentals I have heard of are for 10 months and run about 300% interest - meaning you would pay about $2400 for the machine.

So, from one perspective, you could have possibly saved about $150 if you had purchased it outright. But, I don't know what taxes would be in your area (assuming none). $150 premium does not sound like a rip off to me. I would have prefer to have been told that was a possibility up front, but it could be a lot worse.
I am not a Medical professional and I don't play one on the internet.
Started CPAP Therapy April 5, 2016
I'd Rather Be Sleeping
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#3
FrankNichols assessment is correct.
It is common for brick and mortar DMEs to bill seperately for the integrated humidifier.
It is also common for the rental period to run 10 or 13 months.
I recommend you contact your insurance company directly and get a written explanation from them of what they will or will not pay for XPAP and why.
It is not uncommon for DME to neglect to bill the insurance company and then tell you the insurance refused to pay.
Under NO circumstances would I give my credit card information to a DME. It would be the same as signing a book of blank checks and handing it to them.

And never forget, "if it is midnight and a DME tells you it's dark outside, go out and check yourself ".
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#4
On my system (I am still waiting after 9 days - grrr) I made sure they were getting preauthorization prior to delivery. On pick up I will confirm both with them and with my insurance company.

BTW, I don't know what insurance you have, but Medicare requires a 3 month compliance test followed by a 10 month rental. or they won't pay.

I also agree with bwexler, and I would contact my health insurance and see why they refused to pay. If they did not, then return the machine and walk away or file a complaint with the insurance company about the DME.
I am not a Medical professional and I don't play one on the internet.
Started CPAP Therapy April 5, 2016
I'd Rather Be Sleeping
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#5
(03-30-2016, 02:45 PM)Deej Wrote: I got an Airsense 10 Autoset back on 2/2. When I was at the DME office, no mention of charges or payment was made. Today I get a bill from the DME saying insurance paid nothing and they have billed me for a "6 month rent to own" for the machine. Is this a normal set up? It is 6 payments of $130. I just wanted to see if this sounded like the norm for the rest of you.

However, there is another charge that seems totally bogus to me. I was charged $260 for the humidifier and tubing. On the resmed website, it says the machine includes tubing and the humidifier is integrated.

What do you think? Are they trying to scam?
To give you a comparison
I got the same machine on 12/27 My insurance negotiated $1200 for the month and set up and $170 each month for three months once they had proof of compliance each that month. That's a total $1740 smackaroos. Humidifier headgear tubing and mask with two replacement cushions was included.
2004-Bon Jovi
it'll take more than a doctor to prescribe a remedy

Observations and recommendations communicated here are the perceptions of the writer and should not be misconstrued as medical advice.
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#6
(03-30-2016, 03:59 PM)0rangebear Wrote:
(03-30-2016, 02:45 PM)Deej Wrote: I got an Airsense 10 Autoset back on 2/2. When I was at the DME office, no mention of charges or payment was made. Today I get a bill from the DME saying insurance paid nothing and they have billed me for a "6 month rent to own" for the machine. Is this a normal set up? It is 6 payments of $130. I just wanted to see if this sounded like the norm for the rest of you.

However, there is another charge that seems totally bogus to me. I was charged $260 for the humidifier and tubing. On the resmed website, it says the machine includes tubing and the humidifier is integrated.

What do you think? Are they trying to scam?
To give you a comparison
I got the same machine on 12/27 My insurance negotiated $1200 for the month and set up and $170 each month for three months once they had proof of compliance each that month. That's a total $1740 smackaroos. Humidifier headgear tubing and mask with two replacement cushions was included.

Thats bad too, I have heard worse still.

My intention is to get all the numbers up front when I go in and if the total is over $600 out of my pocket, (I pay 20% of the cost my insurance pays 80% and no deductible) I plan to simply walk away and pay cash for one online. I do not want to deal with crooks. $300 more than buying it through my insurance is my pain threshold - meaning $900 online vs $600 via my insurance/DME.

They are now a week late calling me to arrange for me to come in and get the machine (I was told 3 to 5 days). I called 2 days ago and they said I would be called within 48 hours to schedule the meeting. This morning was 48 hours. They are treading on thin ice. Another week and I cancel and send a letter to the insurance company and medicare about my dissatisfaction with Humana's ONLY DME Aprea.
I am not a Medical professional and I don't play one on the internet.
Started CPAP Therapy April 5, 2016
I'd Rather Be Sleeping
Post Reply Post Reply


#7
(03-30-2016, 04:38 PM)FrankNichols Wrote:
(03-30-2016, 03:59 PM)0rangebear Wrote:
(03-30-2016, 02:45 PM)Deej Wrote: I got an Airsense 10 Autoset back on 2/2. When I was at the DME office, no mention of charges or payment was made. Today I get a bill from the DME saying insurance paid nothing and they have billed me for a "6 month rent to own" for the machine. Is this a normal set up? It is 6 payments of $130. I just wanted to see if this sounded like the norm for the rest of you.

However, there is another charge that seems totally bogus to me. I was charged $260 for the humidifier and tubing. On the resmed website, it says the machine includes tubing and the humidifier is integrated.

What do you think? Are they trying to scam?
To give you a comparison
I got the same machine on 12/27 My insurance negotiated $1200 for the month and set up and $170 each month for three months once they had proof of compliance each that month. That's a total $1740 smackaroos. Humidifier headgear tubing and mask with two replacement cushions was included.

Thats bad too, I have heard worse still.

My intention is to get all the numbers up front when I go in and if the total is over $600 out of my pocket, (I pay 20% of the cost my insurance pays 80% and no deductible) I plan to simply walk away and pay cash for one online. I do not want to deal with crooks. $300 more than buying it through my insurance is my pain threshold - meaning $900 online vs $600 via my insurance/DME.

They are now a week late calling me to arrange for me to come in and get the machine (I was told 3 to 5 days). I called 2 days ago and they said I would be called within 48 hours to schedule the meeting. This morning was 48 hours. They are treading on thin ice. Another week and I cancel and send a letter to the insurance company and medicare about my dissatisfaction with Humana's ONLY DME Aprea.

The part I found most frustrating was the three months the office manager in my doctors office, the insurance company, and the DME argued over what machine, mask, hose, and cushions I needed without even consulting me. I spoke to all three of them on the phone multiple times until I got blank forms and filled them out myself. I put the same machine and mask I wanted on all the forms and had my doctor sign them. It took another 30 days to get the equipment.

I have a annual max copay that is the same for the year no matter what the insurance ends up paying.

Quote
There's no way you can get involved in a racket and not someway be filthied by it.
- Steve Albini
2004-Bon Jovi
it'll take more than a doctor to prescribe a remedy

Observations and recommendations communicated here are the perceptions of the writer and should not be misconstrued as medical advice.
Post Reply Post Reply
#8
(03-30-2016, 05:07 PM)0rangebear Wrote:
(03-30-2016, 04:38 PM)FrankNichols Wrote:
(03-30-2016, 03:59 PM)0rangebear Wrote: To give you a comparison
I got the same machine on 12/27 My insurance negotiated $1200 for the month and set up and $170 each month for three months once they had proof of compliance each that month. That's a total $1740 smackaroos. Humidifier headgear tubing and mask with two replacement cushions was included.

Thats bad too, I have heard worse still.

My intention is to get all the numbers up front when I go in and if the total is over $600 out of my pocket, (I pay 20% of the cost my insurance pays 80% and no deductible) I plan to simply walk away and pay cash for one online. I do not want to deal with crooks. $300 more than buying it through my insurance is my pain threshold - meaning $900 online vs $600 via my insurance/DME.

They are now a week late calling me to arrange for me to come in and get the machine (I was told 3 to 5 days). I called 2 days ago and they said I would be called within 48 hours to schedule the meeting. This morning was 48 hours. They are treading on thin ice. Another week and I cancel and send a letter to the insurance company and medicare about my dissatisfaction with Humana's ONLY DME Aprea.

The part I found most frustrating was the three months the office manager in my doctors office, the insurance company, and the DME argued over what machine, mask, hose, and cushions needed without even consulting me. I spoke to all three of them on the phone multiples time until I got blank forms filled them out myself put the same machine and mask I wanted on all the forms and had my doctor sign them. It took another 30 day to get the equipment.

I have a annual max copay that is the same for the year no matter what the insurance ends up paying.

Quote
There's no way you can get involved in a racket and not someway be filthied by it.
- Steve Albini

Bottom line is this is what you get with our healthcare.
I am not a Medical professional and I don't play one on the internet.
Started CPAP Therapy April 5, 2016
I'd Rather Be Sleeping
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#9
If you think it is expensive now just wait until it is freely provided by your government.Dielaughing
2004-Bon Jovi
it'll take more than a doctor to prescribe a remedy

Observations and recommendations communicated here are the perceptions of the writer and should not be misconstrued as medical advice.
Post Reply Post Reply


#10
(03-30-2016, 05:16 PM)0rangebear Wrote: If you think it is expensive now just wait until it is freely provided by your government.Dielaughing

I edited my post because I originally said "for profit" instead of our. The reason I edited it, was that there are enough sites where we can go to discuss politics, and I prefer to keep this site about Apnea. Sorry, I started this.
I am not a Medical professional and I don't play one on the internet.
Started CPAP Therapy April 5, 2016
I'd Rather Be Sleeping
Post Reply Post Reply


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