Apria in Portland, Or. was always reliable and responsive to our needs. Maybe it has something to do with the health insurance company, but they always delivered and picked up equipment within hours of all requests.
Oregon Native
Retired w/
2000 31' SurfSide
Class A
w6pea wrote: I called my insurance, they called APRIA...they got nowhere with them either.
This afternoon I recived a call from my doctors office. Apria is now requesting a new sleep study saying Medicare is requiring it. I talked to my insurance BC/BS FEHB. They called APRIA, the lady said APRIA was very rude and saying they needed a letter of Medical Nesecity from my doctor. So I wil call her tomorrow and see if she will send them clowns one of those. The next thing they will want is our first born...geez.
* This post was
edited 11/11/09 11:38pm by w6pea *
Remember "Without Truckers America Stops" It's too late to save your shoes..so roll up your pant legs "When all else fails..Amateur Radio" I need some more Coffee&Old Bushmills Semper Fi
Yesterday my doctor faxed a copy of my sleep study and a letter of Medical Necessity to Apria.
I talked to Apria this afternoon at 1645 hrs. they said that they were waiting for Medicare to approve the new machine what a joke.
I will wait a see what these clowns do next. I am sure glad I bought another machine out of my own pocket. I could die having to wait for Medicare and Apria to get me a new machine.
Just wait until the new Govt.Health Care plan takes affect.
The only problem I have with Apria is that now I have to go pick up the machine where with the first machine they delivered it to me. My wife need a sheelchair and the Dr ordered a wide chair and the didn't have one in stock but we needed it is a hurry so they lent us a std size chair and then three or four weeks later delivered a wide chair. They didn't have orders to pick up the std width chair so we ended up with two chairs. Finally they picked up the wide chair and we kept the std one.
Just sifting through some older topics and came across this one. I'm glad to see you found cpap.com. They're great to deal with. If you're paying out of pocket, you should also look at another site they manage: cpapauction.com. Cpap.com manages the prescription records for you so you can order from the auction site.
If you're worried about having trouble ordering new equipment when the time comes, start talking with your doctor NOW about getting a copy of your prescription in hand. Most doctors don't get it at first, but explain to him/her that it's a safety issue for you in case you need to replace the machine, mask, or other supplies while you're travelling.
Then you'll have the freedom to shop wherever you want. I found that I could buy the equipment out of pocket at the auction site and still spend way less than my copay going through my insurance. This also allowed me to get a "data capable" machine, which my equipment provider (Super{don't}Care) wouldn't approve for me. Now I can view the data from the machine and monitor the effectiveness of the treatment and get my numbers where they belong. I wouldn't have known that my mask was leaking so much if I didn't have access to this data at home.
dedmiston wrote: Just sifting through some older topics and came across this one. I'm glad to see you found cpap.com. They're great to deal with. If you're paying out of pocket, you should also look at another site they manage: cpapauction.com. Cpap.com manages the prescription records for you so you can order from the auction site.
If you're worried about having trouble ordering new equipment when the time comes, start talking with your doctor NOW about getting a copy of your prescription in hand. Most doctors don't get it at first, but explain to him/her that it's a safety issue for you in case you need to replace the machine, mask, or other supplies while you're travelling.
Then you'll have the freedom to shop wherever you want. I found that I could buy the equipment out of pocket at the auction site and still spend way less than my copay going through my insurance. This also allowed me to get a "data capable" machine, which my equipment provider (Super{don't}Care) wouldn't approve for me. Now I can view the data from the machine and monitor the effectiveness of the treatment and get my numbers where they belong. I wouldn't have known that my mask was leaking so much if I didn't have access to this data at home.
Yes Cpap.com is great. I still haven't got a machine from APRIA Ripoff, I now have an appointment with a new sleep doctor. He also faxed a letter of medical necessity and a new prescrition. Apria will still not supply the machine he is ordering. A Bi-Pap Auto.
Go figure how in the *&%& does Apria stay in business?
w6pea wrote: Apria will still not supply the machine he is ordering. A Bi-Pap Auto.
Go figure how in the *&%& does Apria stay in business?
Here's the dirty secret: Durable Medical Equipment providers (DMEs) like yours bill healthcare providers based on preset Medicare codes. These rates are based on the MSRP for the top of the line device. So when they provide you with an entry level CPAP machine, they turn around and bill your insurance with the appropriate code and are reimbursed for the top of the line model. If you're curious, do the math with your co-pay amount & percentage and calculate the amount they're charging. Divide your co-pay amount by your co-pay percentage to get the full cost. For example, if your co-pay is %20 and you're paying $50/month for ten months (a total of $500), then the full amount is $2500 (500/.20 = 2500).
So if they provide you with the device your doctor is requesting, they'll lose thousands of dollars of margin compared to what they reap when they sell you the entry level device.
As you've already figured out, you can spend less if you buy a competitively priced CPAP and pay out of pocket compared to your co-pay with a DME charging the Medicare rates. In most cases you can even buy a better machine and still pay less.
The flaw is that they have the discretion to provide ANY of the devices covered under that code and still charge the same rate.
Makes you wonder about our future reforms.
Talk to your doctor about finding a different DME. Explain the cost to your doctor and remind him/her that this is how we can all contribute to reining in the costs.
Once you have the device you want at a price you can tolerate, contact Apria and share your experience with them. Remind them that they also lost your business for biannual mask replacement, host replacements, etc.
Aside from this, how is your treatment going? Do you use software to monitor your nightly progress and stabilize your AHI and leaks?
You've probably already figured out that your doctor is busy (and maybe not 100% informed) and that the DME is not necessarily on your side. Your progress is all up to you.
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