Insurance stuff
Insurance stuff
For the past several months I have been having issues with my DME. They refuse to order the mask I want. Never have gotten a new humidifier, on and on. While visiting the sleep Dr, I let out my frustration about them and she said “let me send them an Rx for that particular mask and see what happens” Still refused and it seems to me I should not have make do with the masks they carry so I told them to flake off.
So today I called my insurance company and explained what was going on and they allowed that I can order from cpap.com and they will reimburse me. I need a claim form, the insurance billing codes, and the prices I paid, and my name on the receipt.
So now I need an idea of what supplies I can order and how often. I believe the former DME used the Medicare schedule. I wont need supplies that often but dont want to order something too soon.
I feel free
So today I called my insurance company and explained what was going on and they allowed that I can order from cpap.com and they will reimburse me. I need a claim form, the insurance billing codes, and the prices I paid, and my name on the receipt.
So now I need an idea of what supplies I can order and how often. I believe the former DME used the Medicare schedule. I wont need supplies that often but dont want to order something too soon.
I feel free
- ChicagoGranny
- Posts: 14619
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Re: Insurance stuff
Yes the DME is in network.
- ChicagoGranny
- Posts: 14619
- Joined: Sun Jan 29, 2012 1:43 pm
- Location: USA
Re: Insurance stuff
cpap.com use to send out, via email, a printable universal insurance claim form that you could use to file with your insurance company.
I don't know if they still do that or not....call them up and ask them.
If they do...it will pretty much have everything you need to file insurance already on it.
I don't know if they still do that or not....call them up and ask them.
If they do...it will pretty much have everything you need to file insurance already on it.
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Re: Insurance stuff
They should be reported to the state regulators. Refusing to fill a prescription for devices they are licensed to sell may be a violation.ChicagoGranny wrote: ↑Wed Jun 19, 2019 11:10 amThey should be reported to your insurance company for being unwilling to fill your prescription.
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Re: Insurance stuff
I told them alll about itChicagoGranny wrote: ↑Wed Jun 19, 2019 11:10 amThey should be reported to your insurance company for being unwilling to fill your prescription.
Re: Insurance stuff
The last 2 times I ordered from them, the receipt had everything I would need to file a claim. But I will attach that paper to my insurance claim form..just to be safe!Pugsy wrote: ↑Wed Jun 19, 2019 11:15 amcpap.com use to send out, via email, a printable universal insurance claim form that you could use to file with your insurance company.
I don't know if they still do that or not....call them up and ask them.
If they do...it will pretty much have everything you need to file insurance already on it.
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- Posts: 1766
- Joined: Mon Mar 27, 2017 5:45 pm
- Location: Central Virginia
Re: Insurance stuff
It looks like cpap.com has tried to make insurance easy. I have not tried this though.
https://www.cpap.com/cpap-insurance-claim-form
https://www.cpap.com/cpap-insurance-claim-form
_________________
Machine: AirSense 11 Autoset |
Mask: AirFit™ P10 Nasal Pillow CPAP Mask with Headgear |
Additional Comments: ClimateLineAir Heated Tube & Sleepyhead software |
Last edited by prodigyplace on Wed Jun 19, 2019 5:57 pm, edited 1 time in total.
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Re: Insurance stuff
Thank you! I had not noticed that page before!prodigyplace wrote: ↑Wed Jun 19, 2019 1:03 pmIt looks like cpap.com has tried to make insurance eay. I havenot tried this though.
https://www.cpap.com/cpap-insurance-claim-form
- chunkyfrog
- Posts: 34471
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Re: Insurance stuff
I tried it with BCBS.
It did NOT work.
Maybe it's just the company.
It did NOT work.
Maybe it's just the company.
_________________
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Re: Insurance stuff
I asked if I could turn a claim in quarterly instead of each time I ordered something. The answer I got was yes. We will see how it goes...chunkyfrog wrote: ↑Wed Jun 19, 2019 3:52 pmI tried it with BCBS.
It did NOT work.
Maybe it's just the company.
Re: Insurance stuff
You should file WRITTEN complaints with both the state regulators and your insurance company (verbal complaints do nothing). They are CONTRACTED to provide the DME your doctor prescribes to insured individuals, and they refused. And they refused to provide medically prescribed equipment they are licensed to provide.prodigyplace wrote: ↑Wed Jun 19, 2019 11:20 amThey should be reported to the state regulators. Refusing to fill a prescription for devices they are licensed to sell may be a violation.ChicagoGranny wrote: ↑Wed Jun 19, 2019 11:10 amThey should be reported to your insurance company for being unwilling to fill your prescription.
If you don't have it in writing from your insurer that they will reimburse you for purchases from cpap.com, it might be a little shaky. So don't go hog wild on purchases until you are assured they will honor what they told you.
You can order a copy of your "Evidence of Coverage" document by contacting the insurance company and requesting it. That's the contract the insurer has with you, even though you've never seen it. The document may be available on line, or they will have to send it to you. I print it out every year. If that document says they will reimburse you for out of network purchases, then you have backup if they deny it.
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Taming the Mirage Quattro http://tinyurl.com/2ft3lh8
Swift FX Fitting Guide http://tinyurl.com/22ur9ts
Don't Pay that Upcharge! http://tinyurl.com/2ck48rm
Re: Insurance stuff
Great idea. Thank you!Janknitz wrote: ↑Wed Jun 19, 2019 4:27 pmYou should file WRITTEN complaints with both the state regulators and your insurance company (verbal complaints do nothing). They are CONTRACTED to provide the DME your doctor prescribes to insured individuals, and they refused. And they refused to provide medically prescribed equipment they are licensed to provide.prodigyplace wrote: ↑Wed Jun 19, 2019 11:20 amThey should be reported to the state regulators. Refusing to fill a prescription for devices they are licensed to sell may be a violation.ChicagoGranny wrote: ↑Wed Jun 19, 2019 11:10 amThey should be reported to your insurance company for being unwilling to fill your prescription.
If you don't have it in writing from your insurer that they will reimburse you for purchases from cpap.com, it might be a little shaky. So don't go hog wild on purchases until you are assured they will honor what they told you.
You can order a copy of your "Evidence of Coverage" document by contacting the insurance company and requesting it. That's the contract the insurer has with you, even though you've never seen it. The document may be available on line, or they will have to send it to you. I print it out every year. If that document says they will reimburse you for out of network purchases, then you have backup if they deny it.
Re: Insurance stuff
well, i think i may be misunderstanding this part. do you mean how often you should order supplies or how often they will want you to order supplies?
if the later, dunno. if the former, i think you've been on board here long enough to know we don't blow through supplies all that often.
and just browse through cpap.com and see what they have on hand.
_________________
Machine: AirCurve™ 10 VAuto BiLevel Machine with HumidAir™ Heated Humidifier |
Mask: AirFit™ P10 Nasal Pillow CPAP Mask with Headgear |
people say i'm self absorbed.
but that's enough about them.
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Oscar-Mac
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but that's enough about them.
Oscar-Win
https://www.apneaboard.com/OSCAR/OSCAR-1.5.1-Win64.exe
Oscar-Mac
https://www.apneaboard.com/OSCAR/OSCAR-1.5.1.dmg