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+--- Thread: DME (/Thread-DME)
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DME - Bladskinner - 01-12-2014
Can I get a new DME or am I stuck with the one from the sleep center I went to. I mean they gave my info to a place an hour away.
RE: DME - zonk - 01-12-2014
Hi Bladskinner
As far as I know, you can use any DME on your list of insurance approved DME if nothing changes since Obamacare
Hang on for someone in the know
RE: DME - robysue - 01-12-2014
Bladskinner,
As long as your health care is not paid by an HMO, you can choose whatever DME you want, although your insurance may have certain prefered "in network" DMEs. You need to check with your insurance company about coverage.
If your health care is through an HMO, the HMO may have some very strict restrictions on what DMEs you are allowed to use. You need to check with the HMO to find out what restrictions apply.
RE: DME - Bladskinner - 01-12-2014
Ok, I do have ppo insurance so I'll will be changing as my current guy sucks and is to far away so I have to mail the card to be read by him. My only concern is that the new DME would not have made the money off the sale of the Equipment.
Do they charge the insurance to read the card?
RE: DME - iheartsleep - 01-12-2014
I had a horrible experience with my local DME, everything from overbilling my insurance to them harassing me on the phone. So I switched to an online provider and I pay directly for my equipment and parts. No insurance billing and no hassle. I've also found that it's strangely much more cost effective. I'm not certain what they (DME provider) were charging me so much money for, but since I switched to getting it all on my own I have much lower out of pocket.
RE: DME - me50 - 01-12-2014
(01-12-2014, 01:46 PM)iheartsleep Wrote: I had a horrible experience with my local DME, everything from overbilling my insurance to them harassing me on the phone. So I switched to an online provider and I pay directly for my equipment and parts. No insurance billing and no hassle. I've also found that it's strangely much more cost effective. I'm not certain what they (DME provider) were charging me so much money for, but since I switched to getting it all on my own I have much lower out of pocket.
That is great you found out it is less expensive to buy online.
For me, it wouldn't be.
My cushion with insurance is about $9 monthly
Tubing about $8 every 3 months
Frame with cushion is $22 every 3 months
Filters are about $2 every month
Chamber is $4 every 6 months
Chin strap is $4 every 6 months
Head gear is $8 every 6 months
I have rounded the price up
RE: DME - Bladskinner - 01-12-2014
Yes the insurance was billed 3600 dollars for what anyone can get for 1000 bucks on the web. They only paid 1600 and I'm waiting for the bill. I'm sure I won't be happy when it comes.
RE: DME - me50 - 01-12-2014
(01-12-2014, 01:46 PM)iheartsleep Wrote: I had a horrible experience with my local DME, everything from overbilling my insurance to them harassing me on the phone. So I switched to an online provider and I pay directly for my equipment and parts. No insurance billing and no hassle. I've also found that it's strangely much more cost effective. I'm not certain what they (DME provider) were charging me so much money for, but since I switched to getting it all on my own I have much lower out of pocket.sounds like Apria. It would be scary if there were 2 different DME companies that were like this.
Some DME's charge for the download and some don't. I had one that wanted to charge $25 and we all know it takes but a minute to do it. Another one didn't charge but they half the time didn't do the download right. You can look at your data yourself though if you have sleepyhead or Rescan on your computer. If for compliance data, ask your new DME to provide a modem for you to put on your machine and then they can retrieve the data that way.
As far as a new DME goes, they will be providing your supplies won't they?
RE: DME - me50 - 01-13-2014
(01-12-2014, 09:03 PM)Bladskinner Wrote: Yes the insurance was billed 3600 dollars for what anyone can get for 1000 bucks on the web. They only paid 1600 and I'm waiting for the bill. I'm sure I won't be happy when it comes.
are you responsible for say, 20%? you should only have to pay whatever % you are responsible for but of the allowed amount only. It doesn't matter what the DME bills your insurance company because the in network DME's have a contracted price with the insurance company and that is all they will get whether it is paid in full by the insurance company or partially by the insurance company and you.
Did the $1600 include the humidifier?
RE: DME - PsychoMike - 01-13-2014
Yeah, most DMEs local to me are welcoming to new patients. Sure, they might not get the "big ticket" item of your CPAP machine, but masks, hoses, filters, liners, office visits for "check ups" and such add up in between when you might need a CPAP machine purchase.