I'll list the steps. See if you can follow it to it's incompetent conclusion.
1) Sleep doctor sends a prescription for a battery backup to THAT DME.
2) DME calls my house and says it's not covered. "You have to pay $1,100."
3) I ask why. DME says to call Carecentrix, so I call.
4) Carecentrix doesn't have any record of this. Tells me to call Cigna, so I do.
5) Cigna says Carecentrix handles sleep claims and transfers me back to Carecentrix.
*Note: I have to explain the entire history to each new person.
6) Carecentrix says the DME never submitted a claim so she calls DME.
7) DME says yes they did call me and tell me it wasn't covered.
8) Carecentrix asks DME how they came to that conclusion. DME says she doesn't know.
9) Carecentrix tells DME to submit a claim like they should have in the first place.
10) I'm told I should hear from them in a few days. Doubtful.
BTW, Cigna says the battery backup IS covered. Go figure.
DME apparently did not want to be bothered with actually calling the insurance company. You need to find a more reliable, competent, DME. Or better yet, contact the insurance company and see which DMEs they would recommend.
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 OPINIONS ONLY AND NOT NECESSARILY STATEMENTS OF FACT.
John, sounds like you're getting the standard "Medical Mafia" run-around. I'd be willing to bet that the DME was trying to extort $$ from you claiming it wasn't covered, and they were hoping you would simply pay the full retail price and they'd get more profit than if they were to submit it to the insurance company whereupon they would receive the lower, insurance-adjusted price for the item. The back-peddling by the DME was just an attempt to cover their tracks.
Like Archangle's signature line goes...
"If it's midnight and a DME tells you it's dark outside, go and check for yourself."
Apnea Board Administrator
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.