Hacker News Board Hacker News, browsed like a classic message board
Live data from Hacker News

How to Replace Your CPAP in Only 666 Days

aphyr.com

Post reply on HN
Print view View original

211–220 of 273 posts

Re: How to Replace Your CPAP in Only 666 Days

#211

Post by spondylosaurus »

gorbachev wrote: post #118
LegitShady wrote: post #6

'don't buy anthem products, period, for any reason"

These days I am screening potential employers with who they use for their medical insurance plan. There's absolutely no way I'm ever going with United Healthcare Group ever again.

LOL, I had a phone screener three days ago and did the exact same thing. Asked which health plan they offered with the explicit purpose of filtering out UHC. They're the lowest of the low and even doctors hate them. (At least one of mine audibly groaned when I mentioned being on a UHC plan and then he said "Guess there's no point in trying ."

Re: How to Replace Your CPAP in Only 666 Days

#212

Post by patja »

pas wrote: post #157
tylervigen wrote: post #143

I've worked on the claims management process flow for payer like Anthem before. It's probably obvious, but this story hints at some serious deficiencies in the backend processes. One way to look at it is that this Byzantine process helps Anthem by trapping valid claims in a black hole of bureaucracy. That way they don't need to pay, right? It's not quite that simple. It's true that incentives are not usually aligned,…

> They may be the third-party administrator charging back to an employer, can you please elaborate on this? does this mean that some companies (employers) directly see and pay their employees medical stuff on their books? > Ultimately for Anthem, this claim cost them a lot more to handle than if they had just paid out in the first place ... well, of course, but the whole middleman game costs the US many many many ser…

This is how a lot of big companies work. They self-insure. They set the rules, pay all the bills, and the insurance company just administers things.

If you work for a company that does this, be aware that the things you dislike about your insurance coverage may well have been designed that way by your employer, not the insurance company. Don't curse the insurance company when you don't like the benefits. Ask your manager and HR department why your employer chose that rule or limit.

Re: How to Replace Your CPAP in Only 666 Days

#213

Post by dmvdoug »

londons_explore wrote: post #33

Please folks remember that it isn't compulsory to use a companies byzantine process. Instead, check your insurance policy wording that you are covered, spend the money on a new machine, send a single letter to the insurer asking to be reimbursed, and when they don't reimburse within 30 days file in small claims court. They'll pay. They don't want to physically show up in court or have you send bailiffs to their HQ ov…

However, your policy might also contain (more likely) an arbitration clause, requiring you to submit any dispute to arbitration or (sometimes) a form selection clause, requiring you to submit a dispute in a particular legal forum other than arbitration.

Note: some states do not allow forum selection clauses in insurance contracts, by statute or by case law. However, that will not stop a company from boilerplating it in. so, just because the policy might have the clause does not mean it’s necessarily enforceable.

On the other hand, I get the point that they may just pay the money rather than send it to legal to handle. YMMV.

Re: How to Replace Your CPAP in Only 666 Days

#214

Post by quickthrower2 »

hn_throwaway_99 wrote: post #121
RecycledEle wrote: post #31

Earlier quoted context omitted.

Bingo! As someone with multiple "pre-existing conditions" who cares for a stroke survivor (my wife) and a stage 4 chronic kidney disease patient (my mother-in-law,) I suggest we do the following: 1. make private health insurance illegal 2. pass a Constitutional amendment allowing every human the unlimited and absolute right to buy, make, modify, and sell medical things including importing and exporting those items. I…

> pass a Constitutional amendment allowing every human the unlimited and absolute right to buy, make, modify, and sell medical things including importing and exporting those items. The ironically terrifying evidence about what a horrible idea this is is that it was just in the news that the FDA said that recalled CPAP machines made by Philips killed 561 people: https://www.cbsnews.com/news/fda-sleep-apnea-philips-rec…

They went too extreme. Maybe let people buy the device but it still needs to be manufactured to regulations.

However I don’t know enough about CPAP to judge whether you should need a doctors cert or some kind of training cert on the device. Can a CPAP harm you if you incorrectly use it / use incorrect settings?

Re: How to Replace Your CPAP in Only 666 Days

#215

Post by globallyunique »

For those who are looking for a cpap now in the US (maybe for other countries - haven’t tried) - https://cpapx.com/collections/resmed/products/airsense-10-au...

You can order one for 450 before taxes there.

You will have to email your prescription though before they process the order.

Ordering a backup one (or more) is very useful to leave in your travel suitcase etc

Re: How to Replace Your CPAP in Only 666 Days

#216

Post by patja »

seattle_spring wrote: post #180
dmazzoni wrote: post #170

I use Kaiser Permanente as my health care provider. For those who aren't aware, it's one of the few "integrated care" providers in the U.S., meaning they act as both the health insurance and health care provider. Now, Kaiser is FAR from perfect - they have their share of problems. But....this sort of nightmare is not one of them. With Kaiser, doctors are free to prescribe whatever they think is medically necessary, a…

I'm a Kaiser member and have to get CPAP supplies through a company called Apria. It has been the absolute most godawful experience I've ever had dealing with a company. Worst than a thousand Comcasts. I genuinely don't understand how you could be a CPAP patient with Kaiser without dealing with Apria?

I have Kaiser and when I need a new CPAP or supplies I just order from CPAPMan or whoever, and pay out of my HSA account. Not all plans allow HSAs though.

Re: How to Replace Your CPAP in Only 666 Days

#217

Post by jevoten »

jawngee wrote: post #39

Yeah try importing a CPAP from the states into Vietnam if you want a real adventure. A $650 cpap machine costs well over $2K here. So I thought I'd import one. Apparently you need a prescription in the states? Ok, get a "prescription" from an online service that basically just asks you if you snore over a video call. Amazing. Buy machine and have it sent to a freight forwarding service. They fuck up the paperwork. It…

> Next week you can't have it because they think I'm importing to resell it.

With all the "free trade" agreements Vietnam is party to [1], you'd think this would be perfectly fine. Funny how that works, isn't it?

[1] https://en.wikipedia.org/wiki/Free_trade_agreements_of_Vietn...

Re: How to Replace Your CPAP in Only 666 Days

#218

Post by mcculley »

samstave wrote: post #210
mcculley wrote: post #209

Earlier quoted context omitted.

Other common terms are “broker” or “agent”. I pay the agent. He deals with the local bureaucracy. He knows what things should cost.

AKA; ...'eeeeyyyyy, IgottaGuy..."

In my experience, they are more professional. I engage with a firm who offers "customs brokerage" and "agent" services. They take care of any local payments necessary. I get a proper invoice that I pay with a wire transfer.

Re: How to Replace Your CPAP in Only 666 Days

#219

Post by dendrite9 »

mikigraf wrote: post #10

It’s surprising to me that not only in my home country is the process of having a CPAP machine covered by insurance a long and complicated one. In my case, it took almost 12 months to receive my first CPAP machine, which then turned out to be refurbished. Initially, I had to visit a doctor, who had an available appointment in two months. He then referred me to a sleep laboratory (another two-month wait). After my sle…

Just in case you missed the news about the recall and issues with Philips CPAP machines. You might want to check if there is anything that you can or need to do. The disintegrating foam seems like an unpleasant flaw in production.

https://www.fda.gov/medical-devices/safety-communications/up...

Re: How to Replace Your CPAP in Only 666 Days

#220

Post by FireBeyond »

seattle_spring wrote: post #180
dmazzoni wrote: post #170

I use Kaiser Permanente as my health care provider. For those who aren't aware, it's one of the few "integrated care" providers in the U.S., meaning they act as both the health insurance and health care provider. Now, Kaiser is FAR from perfect - they have their share of problems. But....this sort of nightmare is not one of them. With Kaiser, doctors are free to prescribe whatever they think is medically necessary, a…

I'm a Kaiser member and have to get CPAP supplies through a company called Apria. It has been the absolute most godawful experience I've ever had dealing with a company. Worst than a thousand Comcasts. I genuinely don't understand how you could be a CPAP patient with Kaiser without dealing with Apria?

My girlfriend had the same experience literally this week. The whole thing was Kafkaesque.

She got sent an at home sleep study kit. Set it up, did it. Waited, nothing. Had a run around between the sleep center and her physician. Eventually got a hold of someone. "Well, of course you don't have results, you need to send it back to us. And if you don't they'll charge you $1200 for it". "Uhh, the kit gave me a PIN and specifically said I could dispose of it afterwards" (she hadn't, yet, in case she needed to redo the test). "Oh, well, no-one told us that!" (How is this surprising to you?)

In any case, someone reviews her study, diagnoses her with sleep apnea, writes a script for a CPAP.

She surmises this, because she never spoke to anyone, or got any messages in her portal. She realizes when Apria calls her to verify and confirm details for the CPAP machine (I think she pays $170, then $19/month for 3 months to rent it while they establish compliance, and then if she is using it, Kaiser will pay for it).

She confirms everything and waits. And after a while, sees it's still in "label created" tracking status. Calls them. "Oh, we're waiting for this form from you", that until now she's never been told about. She gets it emailed to her, signs, scans, sends. Asks questions about mask options. "Your provider will discuss that with you."

Uhh, you're about to ship this now. She hasn't spoken to any provider, and the sleep center and the physician are debating over who should talk to her, I suppose?

So she looks over them with me. I'm not a doctor, though I'm a paramedic. I'm experienced with ventilators and occasionally giving acute patients CPAP treatments. So I can talk with just enough knowledge to be dangerous. So we pick out a mask, and finalize.

CPAP arrived on Friday. No-one's spoken to her about it, so she's like "I guess I just start wearing and using it". I had to adjust a few settings for her around pressure and ramp and EPR (expiratory pressure relief) to help someone new to therapy acclimate to how it works.

So, ironically, though not good by any definition, Apria ended up being the best part of the process.

Post reply on HN