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

[Sleeprider]

I wonder it the DMEs can claim some kind of loss on taxes for the difference between wht they bill and what they are paid?

Losses are based on actual costs vs income.  No credit for what you "hoped" for.  It's not even a legal unpaid debt.

[justMongo]

No. The IRS would be all over that. It's not a loss, they paid less than the $80 allowed by Medicare to get the product.
Using an inflated basis to claim a loss is tax fraud.

The gotcha is: If insurance or Medicare doesn't pay for some reason; like perhaps it was too early to send new supplies, then you are on the hook for the $333 not what Medicare would have paid.

[SuperSleeper]

https://www.cms.gov/Regulations-and-Guid...y23_r2.pdf

Thanks Sleeprider.  I removed the dash in the URL so it should work now.

[AlanE]

Of course the difference between what they bill the insurance company and what the insurance company actually pays is typically passed on to the patient.

[Sleeprider]

Of course the difference between what they bill the insurance company and what the insurance company actually pays is typically passed on to the patient.

That is called "double billing" and is illegal under Medicare and all insurance policies I am aware of.  If you are billed the difference between the DME invoice and the approved reimbursement amount, lawyer up.  You will be making some money.

[OMyMyOHellYes]

Not on Medicare - but I had a decent DME here for several years and then they started to charge me for delivery of supplies. So what did I do? I quit ordering supplies.... So the nice little monthly billing they were getting paid dried up to nothing... Since I was having to pay down deductible anyway, I just went to online suppliers. Well, I will. I don't really use supplie and that DME had me pretty well stocked up. See, I don't change my hose hardly ever, and the mask seals last me 6-12 months, and headgear I just keep using, and the actual mask frame last lasted me like 2 years. Filters, I won't accept the ones that the DMEs supply in any case. I insist on factory original OEM and none of them seem to carry those. They don't really cost more, but when I used the S-9 I always found dust trails around the non-OEM filters and into the machine intake. So I switched to OEM.

OMMOHY

[AlanE]

Of course the difference between what they bill the insurance company and what the insurance company actually pays is typically passed on to the patient.

That is called "double billing" and is illegal under Medicare and all insurance policies I am aware of.  If you are billed the difference between the DME invoice and the approved reimbursement amount, lawyer up.  You will be making some money.

Quest Diagnostics have been doing this for at least 10 years. They bill insurance $100, insurance pays $60, quest nails you for $40. They have you sign this agreement when you get blood work so you are on the hook for it.

[Sleeprider]

I use Quest, and have seen insurance invoice for several hundred dollars that are literally paid pennies on the dollar by insurance. No balance billing to me.

Don't pay the balance billing, it is illegal. Contact your insurance and inform them of the practice. https://www.complaintsboard.com/complain...61469.html

Know your rights!

[AlanE]

Easy for you to say. I don't have the money to hire a lawyer and no lawyer is going to take the case for a few hundred bucks of over charge.

[AlanE]

I did some closer inspection. I was charges these amounts because I didn't meet my deductible:

Provider Name: QUEST DIAGNOSTICS CLINICAL LABORATORIES
Total Billed: $1,891.22
Member Discount: -$1,723.20
Florida Blue Paid: $0.00
Member Responsibility $156.55

So no balance billing it seems. My bad...

Edit: The explanation which didn't get c&p'd was "Deductible: $156.55"
I'm at 100% met on my individual deductible for the year but still $25.35 out on my family deductible so my blood test coming up will be at least that. They'll find a way to screw you no matter what.