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Insurance question - Redswife - 04-30-2017

Hi,

I have a question. I am new to CPap. The supplier where I got my machine told me the difference between cash price and filing on insurance. Since the cash price was $400 cheaper, we paid cash. She DIDN'T tell me that masks and other parts are so expensive, when mine needs replacing. I asked her to refile on insurance but she won't. It hasn't even been 30 days yet. Is it possible to get a refund? 

Thanks,
Redswife

RE: Insurance question - OpalRose - 04-30-2017

Did you sign anything?  Read what it says about returns.  You should be able to return that machine within 30 days.

I have a feeling you probably paid more than buying online.  I would pack up machine, return it and demand a refund.  

When your dealing with DME's, the best advice is: check with your insurance first, don't take DME's word for anything.

Also, there's no rule that says you have to buy supplies from them.

RE: Insurance question - Sleeprider - 04-30-2017

Contact your insurance and identify options for in-network providers. Even if you bought the CPAP outright, you can file insurance claims for supplies and replenishment. Also carefully look at your options for online suppliers to cut costs. The Resmed Airsense 10 Autoset is $883 through Supplier #1, and lower prices are possible with shopping. Supplier #30 is very good about providing online prices and will invoice insurance. Depending on what mask you are using, Amazon can be a very inexpensive way to buy replacement masks frames, straps and cushions. It is even possible to buy mask parts and filters on Ebay.

You have already absorbed the most expensive part of the cost by buying the device through a DME. The cost of that is you had none of that price applied to deductibles, and you may not receive the longer warranty period and services that insurance requires the DME to provide. In spite of that, you got a very good machine that can meet your needs for years to come.

Be sure to download #Sleepyhead software. At least it's free and can help you to optimize your results. I see you're using ResScan, so the data is similar, but presented in a much more useful way. You may want to include your mask model and device settings in your profile. It will help us to resolve any questions that might arise.

RE: Insurance question - smiledog - 04-30-2017

Hey I just read the closed thread from this topic. I as many people start off clueless with DME. As was suggested to me when I was asking questions, was to learn your rights as a patient, learn what my machine can do, ask for records. This all started in February this year. I am not able to get the doctor on the phone, the DME has told me "IT'S A PRESCRIPTION YOU AREN'T ALLOWED TO CHANGE YOUR SETTING" They started me off on a Cpap then after the 2nd study changed it to a Bipap @ pressures I couldn't handle. I still don't know why. My point is after learning my rights as a patient and listening to some really good people on this forum on how to tweak my machine. It has worked beautifully since I made the changes. My next step is contacting my insurance company before Thursday to tell them what I'm being told and to be clear on there procedures . Thursday I go back to see the doctor. ( It sure is strange that the DME's front door is only 5ft from my doctor's door) I am going loaded full of questions and requesting my records.
The bipap I have now is the Resmed Aircurve 10 Vauto. Great machine if used correctly. The DME set it up in S mode, and from day 1 I was failing to get what I needed from the machine. I'm pretty sure when I go this week and they see it's working great, they will be disappointed. It's all about the numbers for them, and I'm not talking about pressure numbers, I'm talking about Benjamin's $$$$ I truly think something is very fishy and I don't do fishy.
So don't get discouraged. (I was when I started failing) Look Listen and Learn from this forum and do your own research. I've checked Amazon, Ebay ETC. You can find what you need at a lower price. 
Sleep-well

RE: Insurance question - Redswife - 04-30-2017

Hi, 

Thanks to all who replied. I read over my paperwork and it says they will replace or repair machine. No refunds. We were trying to save money but I found out Thursday that I have a deviated septum and need surgery. So we knew that paying cash that nothing would go towards the deductible. Now I need the surgery so we are STILL going to have pay a high deductible. The ENT said that was why I was having so much trouble with the machine cause my nose is always stopped up.You think you are doing right by trying to save money but you cost yourself more in the long run. 

Thanks again
Jodi

RE: Insurance question - trish6hundred - 04-30-2017

Hi Redswife,
WELCOME! to the forum.!
I hope your surgery gose well and also, good luck to you with your CPAP therapy.

RE: Insurance question - smiledog - 05-01-2017

Redswife, I've had that surgery. It's not pleasant. Good luck. Our thoughts will be with you.

RE: Insurance question - Redswife - 05-01-2017

Thanks so much trish6hundred.

Smiledog- did the surgery help with the stuffiess?

RE: Insurance question - xxyzx - 05-01-2017

(04-30-2017, 02:08 PM)smiledog Wrote: Hey I just read the closed thread from this topic. I as many people start off clueless with DME. As was suggested to me when I was asking questions, was to learn your rights as a patient, learn what my machine can do, ask for records. This all started in February this year. I am not able to get the doctor on the phone, the DME has told me "IT'S A PRESCRIPTION YOU AREN'T ALLOWED TO CHANGE YOUR SETTING" They started me off on a Cpap then after the 2nd study changed it to a Bipap @ pressures I couldn't handle. I still don't know why. My point is after learning my rights as a patient and listening to some really good people on this forum on how to tweak my machine. It has worked beautifully since I made the changes. My next step is contacting my insurance company before Thursday to tell them what I'm being told and to be clear on there procedures . Thursday I go back to see the doctor. ( It sure is strange that the DME's front door is only 5ft from my doctor's door) I am going loaded full of questions and requesting my records.
The bipap I have now is the Resmed Aircurve 10 Vauto. Great machine if used correctly. The DME set it up in S mode, and from day 1 I was failing to get what I needed from the machine. I'm pretty sure when I go this week and they see it's working great, they will be disappointed. It's all about the numbers for them, and I'm not talking about pressure numbers, I'm talking about Benjamin's $$$$ I truly think something is very fishy and I don't do fishy.
So don't get discouraged. (I was when I started failing) Look Listen and Learn from this forum and do your own research. I've checked Amazon, Ebay ETC. You can find what you need at a lower price. 
Sleep-well


my experience with my DME is that they lie and dont care about you or your treatment but only getting the maximum amount of money possible 

my device did not work for me and I asked them to change it.
they said do another sleep test.
3 month wait and too much $$$$$

now i saw the sleep doctor and he said the machine was a fail
and prescribed an ASV instead
now the DME is trying to talk my insurance into ignoring the Rx and adjusting my old machine
seems like when their revenue is on the line they can do anything

they also said when it still failed
that they would have to give me an S/T instead of an ASV
since when do they get to override an RX ??

DMEs are pure evil from my experience

RE: Insurance question - xxyzx - 05-01-2017

(04-30-2017, 03:10 PM)Redswife Wrote: Hi, 

Thanks to all who replied. I read over my paperwork and it says they will replace or repair machine. No refunds. We were trying to save money but I found out Thursday that I have a deviated septum and need surgery. So we knew that paying cash that nothing would go towards the deductible. Now I need the surgery so we are STILL going to have pay a high deductible. The ENT said that was why I was having so much trouble with the machine cause my nose is always stopped up.You think you are doing right by trying to save money but you cost yourself more in the long run. 

Thanks again
Jodi

maybe 
maybe not
  
a lot of surgery for deviated septums is for cosmetic reasons not breathing problems

i dont trust plastic surgeons any more than DMEs