Question about costs for supplies

Don’t know if this will excite anyone, but I am trying to figure out what’s going on. I’ll be as brief as I can be.

I use consumable health supplies (catheters) – they are necessary for me. I can buy them outright for $1/per, so ~$90 a month. My insurance provider will cover them, but they require me to go through their approved supplies company, where they charge about 10x the price – I pay the same OOP as I would without insurance, but they bill in the 1000s of dollars for the same quantity. I get that insurance companies do that – I guess they like to pad the CEO’s pockets.

Then the place where I could buy them myself started a separate company where they would bill insurance. They bill my insurance company at about the same markup ($900 a month for $90 worth of supplies), but do not pass on any costs to me, although my EOB mentions that they do. It worked fine like this for a few months, but now every month the insurance company is reviewing the charges, and have even declined a few.

I spoke with the supplier and he said not to worry, they’d figure it all out, and I won’t be stuck with any bills. Also, they text every month to confirm delivery, almost as if they need it in writing that I want them rather than just sending them.

What is going on? I’ve asked the supplier why they’ve been declined, and they just mentioned “billing specifics.” Why are they not passing any cost on to me? Are they just making such a great profit off insurance that they don’t bill me the remainder to keep me coming back to them?

I don’t want to complain, because this is good for me – “free” necessary medical supplies. But I worry that it’s too good, and might come crashing down.

submitted by /u/Illustrious-Joke2921
[link] [comments]Don’t know if this will excite anyone, but I am trying to figure out what’s going on. I’ll be as brief as I can be. I use consumable health supplies (catheters) – they are necessary for me. I can buy them outright for $1/per, so ~$90 a month. My insurance provider will cover them, but they require me to go through their approved supplies company, where they charge about 10x the price – I pay the same OOP as I would without insurance, but they bill in the 1000s of dollars for the same quantity. I get that insurance companies do that – I guess they like to pad the CEO’s pockets. Then the place where I could buy them myself started a separate company where they would bill insurance. They bill my insurance company at about the same markup ($900 a month for $90 worth of supplies), but do not pass on any costs to me, although my EOB mentions that they do. It worked fine like this for a few months, but now every month the insurance company is reviewing the charges, and have even declined a few. I spoke with the supplier and he said not to worry, they’d figure it all out, and I won’t be stuck with any bills. Also, they text every month to confirm delivery, almost as if they need it in writing that I want them rather than just sending them. What is going on? I’ve asked the supplier why they’ve been declined, and they just mentioned “billing specifics.” Why are they not passing any cost on to me? Are they just making such a great profit off insurance that they don’t bill me the remainder to keep me coming back to them? I don’t want to complain, because this is good for me – “free” necessary medical supplies. But I worry that it’s too good, and might come crashing down. submitted by /u/Illustrious-Joke2921 [link] [comments]Read Morer/HealthInsurance

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