Sleep Apnea Support Group
Sleep apnea is a common sleep disorder characterized by brief interruptions of breathing during sleep. People with sleep apnea partially awaken as they struggle to breathe, but in the morning they may not be aware of sleep disturbances.
I was diagnosed in July of 2010 and was given a basic Resmed CPAP. It simply blows a steady stream of air at a pressure of 12. I got used to it fairly quickly and easily.
I never got a statement from my insurance company or the DME for the machine. I did get regular statements when I ordered new supplies and always owed nothing as my insurance covered it.
In Feb. of 2011 I got a statement from the DME telling me I was past due on paying the balance for my CPAP and they were threatening to send me to a collection agency. Well, I got on the phone immediately telling them I hadn't seen bill one for the CPAP yet so how could I pay? They sent me an itemized statement. The CPAP they were charging me for was a CPAP with C-flex. A slightly more expensive machine than the one I actually have. That started a LOOOONG spate of calls between the DME and myself trying to get things straight. Finally, the end of Dec. I got a letter from the DME stating that they felt their charges were correct and if I was still disputing it I needed to call the sleep center where I got the diagnosis and prescription.
So, I began calling the sleep center and it has taken a full 2 weeks of back and forth calls to them to find out today that I was basically ripped off and the sleep center made a little extra money!
Seems there is only one code the DME uses to charge for the lowest level CPAPs, and it's the charge for a C-flex. So, regardless of whether my CPAP cost less than the C-flex, I, and my insurance were charged for a C-flex. AND the sleep center was paid a set amount by the DME for the C-flex as well! So, they give me the base line machine but get payment for a more expensive model. Dirty pool if you ask me. Out right, dishonest thievery.
After getting off the phone I thought about it all and stewed and decided that if I was going to have to pay for a C-flex then the sleep center was certainly going to give me a C-flex! So I called the sleep center back and told them they owed me a C-flex. After speaking to my doctor they called me back and said they would have to take the issue to their Executive Director who wouldn't be in until Monday.
Any bets as to what they will tell me come Monday? I will fight this because it's just plain unfair and I'm in the right on this. Wish I had known to ask more questions back when I was first diagnosed.
I never got a statement from my insurance company or the DME for the machine. I did get regular statements when I ordered new supplies and always owed nothing as my insurance covered it.
In Feb. of 2011 I got a statement from the DME telling me I was past due on paying the balance for my CPAP and they were threatening to send me to a collection agency. Well, I got on the phone immediately telling them I hadn't seen bill one for the CPAP yet so how could I pay? They sent me an itemized statement. The CPAP they were charging me for was a CPAP with C-flex. A slightly more expensive machine than the one I actually have. That started a LOOOONG spate of calls between the DME and myself trying to get things straight. Finally, the end of Dec. I got a letter from the DME stating that they felt their charges were correct and if I was still disputing it I needed to call the sleep center where I got the diagnosis and prescription.
So, I began calling the sleep center and it has taken a full 2 weeks of back and forth calls to them to find out today that I was basically ripped off and the sleep center made a little extra money!
Seems there is only one code the DME uses to charge for the lowest level CPAPs, and it's the charge for a C-flex. So, regardless of whether my CPAP cost less than the C-flex, I, and my insurance were charged for a C-flex. AND the sleep center was paid a set amount by the DME for the C-flex as well! So, they give me the base line machine but get payment for a more expensive model. Dirty pool if you ask me. Out right, dishonest thievery.
After getting off the phone I thought about it all and stewed and decided that if I was going to have to pay for a C-flex then the sleep center was certainly going to give me a C-flex! So I called the sleep center back and told them they owed me a C-flex. After speaking to my doctor they called me back and said they would have to take the issue to their Executive Director who wouldn't be in until Monday.
Any bets as to what they will tell me come Monday? I will fight this because it's just plain unfair and I'm in the right on this. Wish I had known to ask more questions back when I was first diagnosed.
cflex makes it easier to breathe out and with your pressure, would be worth having
I am surprised your insurance company is not paying and taking care of this. Perhaps the bill went to the insurance company and they haven't paid yet? if they are supposed to pay, let them know that they are being charged for the more expensive machine.
rkc