Are all medical equipment suppliers soulless vampires?

olesniperolesniper Senior MemberPosts: 3,553 Senior Member
edited July 12 in Clubhouse #1
Rant mode: ON

So.....a little over 3 months ago, my doctor gave me a prescription for a nebulizer, so I can take breathing treatments at home. I hit several medical suppliers before I find one that takes Aetna insurance, the provider my company switched to. I give them my insurance card and they bring out a sealed box, a Philips Respironics nebulizer. The woman taking care of me takes the box and goes in the back room and comes out a few minutes later, carrying the empty box, the compressor, and 2 nebulizer sets, one disposable and one reuseable. A nebulizer set has a medicine cup, mouth piece, and tubing. She starts to tell me how to use it and I tell her I got plenty of experience with them, when I was in the hospital, with pneumonia. I leave, with my new toy, the sun's shining, the birds are singing, and everything is right with the world.
Skip ahead a month, and I get a bill from the medical supply. Seems I haven't paid out my deductible on my insurance and they wouldn't pay for the nebulizer. The bill was for $206 and change. I was PO'ed and shocked at the price for what amounted to a glorified fish tank aerator.   I didn't have a spare $200 handy and, online,  the same nebulizer, from a certified Philips dealer, was $40 and shipping.






This irked me. Last week, I decided I needed to get it taken care of, so I checked the claim on my insurance account, to see if I could get it lowered. The itemized bill they had showed that they were charged:



Wait a minute.......I got the box the nebulizer came in and found the contents, printed on the box.



OK......they opened a sealed box, removed one of the enclosed items, and was charging for it. Is this even legal?

I started calling around, trying to find out if this was kosher or not. I ended up talking to a lady with Consumer Protection, at the Kentucky Attorney General's office. She told me she wasn't versed in the ways of medical equipment sales and the people who were, were out for the weekend. She was, also, shocked at the mark-up on the cost. She suggested that I print out all the info I had and go to the dealer, to see if they might negotiate a better deal. If we couldn't come up with a cost the we were both happy with, hold off paying, go to the AG's website and fill out a consumer complaint. She said her department would contact them and see how things went. So I headed to the supplier, locked and loaded.
I walked in the door and was met by a young black man, who was obviously the new guy, and he asked if he could help me. I told him I had a bill and I need to talk to somebody. Over his shoulder, a middle aged guy was walking our way and picked up the pace, when he heard what I said. He told the young guy he'd take care of me. We sat down at his desk and I showed him my bill and told him I'd found the same unit, online, for $40. He said that they dealt with Medicare and insurance companies, who had set prices for such things and they had to go by those guidelines. I then asked him about charging me for a nebulizer that came in the sealed box, with everything else........when I heard his answer, I was absolutely gobsmacked. He actually pegged the needle, on my BS meter.
"We pay Philips to put the reusable nebulizer in the box, so we will be sure to have one on hand, when someone comes in for a nebulizer kit."
OH.........MY.......GOD......, did I really hear him say that? Wish I'd worn my boots.

He seemed a little nervous. Guess he was just used to people blindly writing checks and sending them in and not showing up with a bunch of questions. He suggested he might be able to charge it as a equipment rental. instead of a purchase. That way I could pay a $25 monthly rental fee and turn the unit back in. I told him that I'd had it for 3 months. He checked his computer and said yeah, I'd just started my 4th month. He said he'd talk to his boss see what they could come up with, then disappeared into the back room. After about 10 minutes, he came out and said they wanted him to have me turn in the one I had and sell me one of their rental units, for $40. Then he said he didn't have any rental units on hand and I didn't have my unit with me, so he just sell me the one I had at home,  as used, for $40. Again......gobsmacked. I told him to right it up.
While he was filling out the bill, he kept telling me to not tell anyone about this, because it was a one-time deal and he wouldn't be able to do it for anybody, if they came up and asked for it. I told him that wasn't a problem, I wouldn't tell anyone. Yeah, right......like I'd tell my friends to do business with this bunch.
When I got home, I called the AG's office and talked to the young lady I'd dealt with, earlier. She was astounded. She thought it was really strange that they would settle for 20% of the bill. And I hadn't even mentioned the AG's office to the guy. She said she would turn everything I'd given her, over to the people who handle the medical equipment complaints. She said they might want to take a look at this place and would I mind talking to them, if they wanted to. I gave her my number.

Rant mode" OFF

Yea, though I walk through the valley of the shadow of death,
I will fear no evil: For I carry a .308 and not a .270

Replies

  • JermanatorJermanator Senior Member Posts: 14,044 Senior Member
    I didn't read all that, but the answer is yes. I needed a CPAP.... the same exact one they wanted to charge me $1500 for, cost less than $500 on Amazon.
  • earlyagainearlyagain Posts: 1,261 Senior Member

    Google government oversight of medical supply and make some calls. Tell everyone. Sing like a rooster under a bike tire.

    Hire a bulldozer.
    Jk😇
  • tennmiketennmike Senior Member Posts: 22,616 Senior Member
    You've got that company by the short and curlies. START YANKING HARD!
    If a Liberal throws a hand grenade at you, pick it up, pull the pin, and throw it back at them.



  • CHIRO1989CHIRO1989 Senior Member Posts: 9,691 Senior Member
    You cannot charge less than Medicare allows, for a Medicare patient, it is called "enticing". If you are not using Medicare, then the price should be negotiable, but, if you have a copy of Amazon/Ebay/Google search pricing that is that much lower, obviously do it yourself, if you don't have an HSA or FLEX acct., you should.

    I had a hernia fixed last year, my local hospital is considered a rural hospital compared to the St. Cloud MN hospital. Both hospitals are owned by the same company, the same doctor would have been doing my surgery at either hospital, it was $7000 LESS out of my pocket to have the surgery done in St. Cloud.
    Healthcare buyer beware, shop around and get quotes in writing.    
    I take no pleasure in the death of the wicked, but rather that they turn away from their ways and live. Eze 33:11
  • zorbazorba Senior Member Posts: 16,285 Senior Member
    DME costs are one of the major reasons healthcare prices are completely out of control in this country. Its a complete scam, and a disgraceful waste.
    -Zorba, "The Veiled Male"

    Carry a 25 if it makes you feel good, but do not ever load it. If you load it, you may shoot it. If you shoot it, you may hit somebody, and if you hit somebody – and he finds out about it – he may be very angry with you. --Jeff Cooper
  • knitepoetknitepoet Senior Member Posts: 17,292 Senior Member
    edited July 12 #7
    zorba said:
    DME costs are one of the major reasons healthcare prices are completely out of control in this country. Its a complete scam, and a disgraceful waste.
    Yep.

    When I had my knee replacement last year the "DME company" that supplied my CPM machine, was located at a "self storage" company... Made me feel WONDERFUL about the quality of cleaning they did on it after the last time it was rented, and wonder about what had been crawling across it since its last use

    Ole, to answer the question in your title... YOU BETTER BELIEVE IT :angry:
    Seven Habits of Highly Effective Pirates, Rule #37: There is no “overkill”. There is only “open fire” and “I need to reload”.


  • alphasigmookiealphasigmookie Senior Member Posts: 7,991 Senior Member
    Same reason they can charge you $25 for an aspirin at the hospital. Also the same reason why the industry pays hundreds of millions to an army of lobbyists to keep it that way!
    "Finding out that you have run out of toilet paper is a good example of lack of preparation, buying 10 years worth is silly"
    -DoctorWho
  • LinefinderLinefinder Moderator Posts: 4,120 Senior Member
    I work for a contract medical device manufacturer. We don't design them, we just build them. We have to follow FDA regs, (OSHA is a mere piker in that regard....case in point....if I sign a document as 6 Jul 2018, as I was taught in the military, I'll have no less than 4 supervisors come tell me that the proper format is July 6, 2018. And then all 4 supervisors have to note on the job sheet that the original date was an error on the part of the "Operator". It probably costs over a hundred bucks to "correct" the date format. We have a certain device that we build and sell (all materials and labor included) for $147 per unit, and I'm not sure we make over 10 cents per.....if that. But, it's gonna cost you, or your insurance company $3700 if you need one. Wonder who got the mark-up. Sure wasn't us.
    Decisions have consequences, not everything in life gets an automatic mulligan.
    KSU Firefighter
  • zorbazorba Senior Member Posts: 16,285 Senior Member
    That's good to know. Somebody's getting rich off of DME, must be the distributors...
    -Zorba, "The Veiled Male"

    Carry a 25 if it makes you feel good, but do not ever load it. If you load it, you may shoot it. If you shoot it, you may hit somebody, and if you hit somebody – and he finds out about it – he may be very angry with you. --Jeff Cooper
  • LinefinderLinefinder Moderator Posts: 4,120 Senior Member
    zorba said:
    That's good to know. Somebody's getting rich off of DME, must be the distributors...
    Well, yeah.....after us, the only folks who have "hands on" the product is the company that sterilizes and provides final packaging. Our client never even sees the finished product. They just direct to what distribution points the lot gets sent to. Somebody between us and the end user is is making a metric butt ton of money. Mike
    Decisions have consequences, not everything in life gets an automatic mulligan.
    KSU Firefighter
  • ArmoredmanArmoredman Member Posts: 317 Member
    I ran a medical supplies warehouse many years ago, and we took very good care of our rental DME. I never once opened any boxes to remove any items for stocking for sale elsewhere, ever - we took pride in our work and what we supplied.
  • Wambli SkaWambli Ska Moderator Posts: 26,262 Senior Member
    Let’s also remember that in many countries when you get medicine it’s a crapshoot whether what is in your pill or vaccine is even close to the required formulation.  Medical equipment is not calibrated to the parameters they are designed for and you’ll be lucky if the surgeon washes his hands before he puts them in you.  Heavy oversight is out of control in this country but the other end is just as bad.  There is a sweet spot in the middle but it would require a lot of people putting themselves out of a job and THAT is unlikely to happen.
    "Attack rapidly, ruthlessly, viciously, without rest, however tired and hungry you may be, the enemy will be more tired, more hungry. Keep punching." General George S. Patton
  • ilove22silove22s Senior Member Posts: 1,040 Senior Member
    sorry to hear that but the recommendation to chat first and if you dont feel you got a good answer then head to the AG is good.

    imo, anything dealing with the medical/education industry is a bunch of greedy SOBs.  

    i didnt realize it until someone made a comment, that those things will go up in price due to the fact that free money is waiting.  its not free, its the $$ we pay in taxes.

    one thing that would raise flags in my book would be when someone takes a product in the box in the back and brings a unsealed unit out.  ****?   


    The ears never lie.

    - Don Burt
  • zorbazorba Senior Member Posts: 16,285 Senior Member
    ilove22s said:
    imo, anything dealing with the medical/education industry is a bunch of greedy SOBs. 

    i didnt realize it until someone made a comment, that those things will go up in price due to the fact that free money is waiting.  its not free, its the $$ we pay in taxes.

    Yet the Liberals want to SUBSIDIZE this mess with socialized medicine and "single payer".
    -Zorba, "The Veiled Male"

    Carry a 25 if it makes you feel good, but do not ever load it. If you load it, you may shoot it. If you shoot it, you may hit somebody, and if you hit somebody – and he finds out about it – he may be very angry with you. --Jeff Cooper
  • JermanatorJermanator Senior Member Posts: 14,044 Senior Member
    We need up front pricing for procedures, medications, treatments, and equipment. A mechanic doesn't fix my car, then bill me after the fact at some rate that he negotiated with my insurance company-- they give me an estimate up front before I consent to any work. Obviously you can't do that in a medical emergency, but for the vast majority of medical issues you can.

    There is no free market in health care. That is where real reform is going to happen.
  • alphasigmookiealphasigmookie Senior Member Posts: 7,991 Senior Member
    zorba said:
    ilove22s said:
    imo, anything dealing with the medical/education industry is a bunch of greedy SOBs. 

    i didnt realize it until someone made a comment, that those things will go up in price due to the fact that free money is waiting.  its not free, its the $$ we pay in taxes.

    Yet the Liberals want to SUBSIDIZE this mess with socialized medicine and "single payer".
    and Republicans want to keep it so the government can't use it's power to negotiate prices for all the medical care, drugs, and medical devices it's paying for....
    "Finding out that you have run out of toilet paper is a good example of lack of preparation, buying 10 years worth is silly"
    -DoctorWho
  • zorbazorba Senior Member Posts: 16,285 Senior Member
    Of course. Big Pharma and their lapdogs, the FDA. Nobody seems willing to do anything about it, although Trump has made some noises.
    -Zorba, "The Veiled Male"

    Carry a 25 if it makes you feel good, but do not ever load it. If you load it, you may shoot it. If you shoot it, you may hit somebody, and if you hit somebody – and he finds out about it – he may be very angry with you. --Jeff Cooper
  • coolgunguycoolgunguy Senior Member Posts: 5,835 Senior Member
    zorba said:
    ilove22s said:
    imo, anything dealing with the medical/education industry is a bunch of greedy SOBs. 

    i didnt realize it until someone made a comment, that those things will go up in price due to the fact that free money is waiting.  its not free, its the $$ we pay in taxes.

    Yet the Liberals want to SUBSIDIZE this mess with socialized medicine and "single payer".
    and Republicans want to keep it so the government can't use it's power to negotiate prices for all the medical care, drugs, and medical devices it's paying for....
    Sounds like the government negotiated price point was the issue here... The private market sells the item @ $40, but Uncle's Medicaid pays the low, low price of five times that amount. 

    You'll forgive me an eyeroll here.  

    The problem isn't republicans, or democrats. The problem is the system... it has to be fed before ANYTHING else happens. Once the system is fed, THEN "healthcare" can happen.  Well, so long as the system approves...
    "Bipartisan" usually means that a bigger than normal deception is happening.
    George Carlin
  • CHIRO1989CHIRO1989 Senior Member Posts: 9,691 Senior Member
    zorba said:
    ilove22s said:
    imo, anything dealing with the medical/education industry is a bunch of greedy SOBs. 

    i didnt realize it until someone made a comment, that those things will go up in price due to the fact that free money is waiting.  its not free, its the $$ we pay in taxes.

    Yet the Liberals want to SUBSIDIZE this mess with socialized medicine and "single payer".
    and Republicans want to keep it so the government can't use it's power to negotiate prices for all the medical care, drugs, and medical devices it's paying for....
    Congress critters set fees, Democrats, Republicans, and Independents:
    https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/PhysicianFeeSched/
    and
    https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/DMEPOSFeeSched/DMEPOS-Fee-Schedule.html
    The govt. tells us what we will be paid, do not deviate or there will be penalties and jail time.
    I take no pleasure in the death of the wicked, but rather that they turn away from their ways and live. Eze 33:11
  • alphasigmookiealphasigmookie Senior Member Posts: 7,991 Senior Member
    CHIRO1989 said:
    zorba said:
    ilove22s said:
    imo, anything dealing with the medical/education industry is a bunch of greedy SOBs. 

    i didnt realize it until someone made a comment, that those things will go up in price due to the fact that free money is waiting.  its not free, its the $$ we pay in taxes.

    Yet the Liberals want to SUBSIDIZE this mess with socialized medicine and "single payer".
    and Republicans want to keep it so the government can't use it's power to negotiate prices for all the medical care, drugs, and medical devices it's paying for....
    Congress critters set fees, Democrats, Republicans, and Independents:
    https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/PhysicianFeeSched/
    and
    https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/DMEPOSFeeSched/DMEPOS-Fee-Schedule.html
    The govt. tells us what we will be paid, do not deviate or there will be penalties and jail time.
    And those fee structures are written by an army of lobbyists paid for by the companies that benefit from them and pay millions into the campaigns of those on both sides who vote to approve them. Nope, no corruption here. The supreme court said all this is just "free speech". Corporations are people too you know! 


    "Finding out that you have run out of toilet paper is a good example of lack of preparation, buying 10 years worth is silly"
    -DoctorWho
  • CHIRO1989CHIRO1989 Senior Member Posts: 9,691 Senior Member
    Just like every other bill passed, someone still had to introduce the bill, people have to be paid to introduce and support the bill. nothing to see here, move along.
    I take no pleasure in the death of the wicked, but rather that they turn away from their ways and live. Eze 33:11
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