A great place to start Disorder information source Rated and Reviewed Sleep Links Entrance to all monitored Sleep Forums Search all of Sleepnet.com


Sleep Apnea
Forum130 Posting


Archived Apnea Forum130 viewing only. To post go to the Apnea Forum Homepage.

Re: Sleep centers and ethics

Posted by XSnorer on April 03, 2006 at 12:26:02:

In Reply to: Sleep centers and ethics posted by Poodle on March 31, 2006 at 10:48:56:

I found the same to be true. Here is how the process seems to work - Insurance companies have a set amount that they will pay for each DME supply item. This figure is quite a bit more than the equipement can be purchases for in the open competitive market. The DME provider knows this and bills the insurance company a rather large amount for the device.. I recall that my DME billed about 5 to 10 times what the device could be purchased for in the open (internet) market. The insurance company receives the bill and pays whatever the allowable is on the device. Your portion of the bill is per your insurance contract.

In my case, I have a $250 yearly deductable after which I pay 10% of the total bill. The 10% charge is less than the open market price. Based on this I will TRY to wait until reaching my deductable before purchasing supplies. I also will close out the year by purchasing backup items that I expect to need in the near future... filters, masks, etc. This year I did not anticipate losing my filter cap. So I'm having a problem because I do not want to pay more than the $10 internet filter cap rate because I have not reached my $250 deductible.

In any case the "ethics problem" is not on the backs of the DME. They are only playing the game. The problem is the allowable limits set by the insurance companies.. And we wonder why health care coverage continues to rise so rapidly.


Follow Ups:


Archived Apnea Forum130 viewing only. To post a new topic go to the Apnea Forum Homepage

  • IMPORTANT : Information not intended as medical advice. If you suspect that you have a sleep disorder you should seek care from a qualified professional. Read Terms of Use.
  • The Sleep Forums are not to be used for commercial purposes.
  • Commercial products and services are not endorsed by Sleepnet.com.
  • Sleep Deprivation due to Sleep Apnea and insufficient sleep are common and can present as insomnia, narcolepsy, or idiopathic hypersomnia. In infants and children sleep problems commonly present themselves as ADD or ADHD.


Copyright ©1995-2006 Sleepnet.com., All rights reserved