WHAT?!?

[ladybug]

OK, so I have it set up to have my new PARI-Ultra Proneb delivered tomorrow! YAY!!! I've had this one for 10+ years, so its time to get a newer version. lol!

I wanted to give a heads up for those considering a new compressor AND to anyone who has also experienced this, please share...

I guess the PARI compressors are coded the same as the "cheaper" compressors, so when it goes through insurance, they will only cover what the cheaper model (non-PARI) would cost at that code. This was told to the company by both BCBS AND Tricare Prime. So, I have to pick up the extra $50 "upgrade charge". BUMMER! Has anyone else experienced this? I will try to get a letter of necessity and send it in, but for now I will just pay it so I can get the new compressor. What a bummer.

PARI, why don't you code your compressors differently than a "generic" model???

I was told by doctor AND the medical supply store that the meds I'm on require a PARI ultra neb. So, I don't have a choice to downgrade to a "generic" version.

Anyway, just a heads up and comment for PARI.

 

[HairGirl]

I know I had to take mine in to get fixed, they couldn't fix it so they gave me a Pari Ultra Neb. I did pay the difference, can't remember but I think it was only $10 or so, might have been $50. It does stink to pay the difference.

 

[julie]

Sonia,

Tricare is your secondary, right? I know that after we submitted a letter of medical necessity stating that Mark HAD to use these meds with a Peri Ultra Neb, they did cover it. but since BCBS is your primary, they are going to have to authorize it first.

I'd like tohear what Pari says about the coding too though. I do recall a recnet post from them that they'd be gone for a week or two from the board. Maybe an email with the link to this post in it so they know to answer it when someone comes back on.

 

[becca23]

I just bought a pari trek for traveling and the company I went through charged the same as regular compressor. So I would talk to the DME company also.

 

[ladybug]

Thanks, PARI. I actually don't have a copay for DME and my deductibles have been met for this year, so it should be covered 100%. I find it odd that BOTH insurance companies would not cover the $50. They both apprently cited the same thing to the DME company (PARI compressors are considered an "upgrade" cause they're more expensive than a "regular" compressor). At that point, I had already waited a couple weeks to FIND a company and get things going, so I didn't want to have to get a preauthorization and letters of medical necessity, so I just paid it. Pretty sad when you have 2 insurance companies and have to pay for a nebulizer compressor that's required. Oh well.

Anyway, I may now try to get a letter of necessity and have them reimburse me (if possible)... to me, its more important to get the DME and start to use it than to wait another 3-4 weeks cause of "red tape". JMO though.

Thanks for the response, PARI. I do appreciate it!!! <img src="i/expressions/face-icon-small-smile.gif" border="0">