“They acted like they had to do it that way. “
They do! MEDICARE determines how billing is done and what codes to use. Unbundling (that is what you are describing) is illegal.
The rental fees don’t tell the whole story. Equipment has to be SERVICED and maintained. There’s a heck of a lot of overhead involved in maintaining and servicing home equipment. There’s a heck of lot of EXPENSE involved in meeting MEDICARE, OHSA, AHA, state and other regulations to qualify as a MEDICARE provider.
If MEDICARE buys the equipment outright (many private insurance companies do.) who maintains it? Oxygen is critical for dependent patients. Who do they call when the equipment breaks in the middle of night?
I was in DME for 12 years. Believe me, it is a tough business requiring a 24/7 commitment.
My daughter is covered by private insurance, not Medicare, but they still billed it that way.