How to choose a DME?

[brsett]

Hello

Just finished a sleep study, and the nurse gave me a form to choose my preferred DME (there were 11 on there I think). I wouldn't pick because I had no idea how to choose. Can anyone recommend a DME in Knxville, TN. Or at least tell me how to go about choosing an equipment provider?

Cheers

[GumbyCT]

Hello

Just finished a sleep study, and the nurse gave me a form to choose my preferred DME (there were 11 on there I think). I wouldn't pick because I had no idea how to choose. Can anyone recommend a DME in Knxville, TN. Or at least tell me how to go about choosing an equipment provider?

Cheers

Choosing a DME, mask, and sleep doc are the three hardest things in cpap therapy. I don't have a TN recommendation but would say to read & educate yourself here.

Get a copy of your prescription and sleep study, in hand. Keep a notebook of questions and things to try.

AVOID any DME directly connected to any doctor, period. They will NOT have your best interest in mind.

After reading here you will learn some common DME tricks/lies. IF/when your DME lies to you, find another. Once they've lied to you, it will happen over & over again.

Following diagnosis we are at our lowest and do NOT process cognitively very well at all. Get a notebook and use it.

Then Read & Learn more here.

Good Luck

[robysue]

Can't make any specific recommendations since I'm in Buffalo, NY.

But I can tell you how I found my excellent DME here.

Make phone calls and ask questions. And remember that YOU will be their customer. Make them earn your business.

Start by contacting your insurance company. You want to make sure you understand exactly how they do the billing. Do they bill by code? And you also want to know exactly what the insurance company will be paying for and what you will be paying for. In particular, you want to know if they pay for the machine by code number since all CPAP/APAP machines fall under the same code number. And you want to know what your copay will be.

Then start making phone calls. For each DME on the list, ask the same basic list of questions:

"I've recently been diagnosed with sleep apnea and I am in the process of finding a DME to supply my CPAP machine and supplies. I would like to know the following information about the services you provide your OSA customers.

• My prescription will be for a CPAP machine running at ** cm of pressure. Will you provide me with a CPAP/APAP machine with full efficacy data capabilities such as the Resmed S9 AutoSet or Elite, the PR System One Auto or Pro, the F&P Icon Auto or Premo? [See note below.]
  
  What is your mask return policy? How long do I have to make a decision about whether a particular mask is or is not working out for me? Is there a limit to the number of masks I can try while I am adjusting to CPAP therapy?
  
  Do you have an RT on staff? What are his/her hours? Are other members of your staff familiar with CPAP equipment?
  
  If I have trouble using the equipment, how much help can your staff provide in trouble shooting issues such as dealing with leaks, problems with cleaning, disassembling or reassembling equipment, rainout, etc.?

Thank you for your time."

Write the answers you get down for each place so you remember the information accurately.

NOTE about the first question: If you KNOW what your prescription will be, then use your exact prescription when you contact the DMEs. But if you don't know exactly what the doctor is going to write down on that prescription sheet that will be faxed to the DME, you should assume the worst: Assume the prescription will simply read, "CPAP at <fixed> pressure" which, unfortunately will allow the DME to issue you a bottom of the barrel compliance only CPAP machine that gathers no efficacy data. The purpose of that first question is to ELIMINATE the DMEs that intend to do just that from your list right away.

Also look in the phone book and browse the web: Do a search for CPAP equipment suppliers Knoxville TN and see what turns up. As long as your INSURANCE company works with the DME, it doesn't matter whether the DME is on that list that the lab that did the sleep study provided to you.

I found my excellent DME that way. It's a small, locally owned chain that specializes in CPAP equipment. The whole staff uses xPAPs. I found them through a web search after calling a bunch of DMEs on the list provided by my insurance company as ones they worked with. CPAPXpress was not actually on that list, but after visiting the store several times, I finally asked if they took my insurance and they did. The price was exactly the same as the DMEs on the list the insurance company had provided to me---and unlike all the other DMEs on that list, CPAPXpress sets all their customers up with full data machines.

Good luck

[KatieW]

http://maskarrayed.wordpress.com/what-y ... me-part-i/

[Janknitz]

There's some homework you should do BEFORE you call your first DME.

1. Know exactly what your insurance will cover and HOW it will be covered. See "What you need to know before you meet your DME" in my signature for what you need to know and how to find it out.

2. You should have some idea of what you want before you call your DME. This is really hard because you probably have NO idea what you want/need at this point, but if you go to a DME with no idea, you will be at the mercy of the DME and what's best for the DME's pocket, not necessarily what's best for YOU. To start learning, click on the lightbulb above and look particularly at machine types and features.

3. At the very least, make absolutely certain that you know what machines are data capable (efficacy data, not just compliance data) and INSIST that you get a data capable machine. Beware that DME's play a bait and switch game sometimes--they consider "compliance only" machines data capable, but you NEED efficacy data, or they claim that there is no such thing as patient accessible efficacy data.

4. Make sure you have a copy of your prescription in your hand, so you know what it says and you can go anywhere you choose.

5. Armed with that information, NOW you can start calling around to DME's. Tell them what you want and let them tell you how they will fulfill your request. You can get a sense about whether they will work respectfully with you to find the best set up for YOUR needs and wishes or treat you like an idiot while they try to protect their bottom line over your needs. Make sure any DME you work with has a liberal mask return policy. They should be very open to having you trade out masks for at LEAST the first 30 days to ensure that you find the most comfortable mask for you--the mask is the key to success in CPAP therapy.

6. Don't let a DME charge you a higher rate for one CPAP or APAP machine over another. Be sure you read "Don't pay that upcharge" in my signature if a DME tells you that there is an extra charge for one machine over another.

It's a bit of a jungle out there, but if you are a careful consumer, you can get the best equipment and mask for you to ensure your CPAP success.

Good luck, sleep well.

[jbn3boys]

While all of the previous suggestions are great, I just plain old didn't have the energy/brain power do do all that. I didn't do a lot of homework, I did not have my prescription in hand yet, but here's what I did.

First and foremost, make sure you pick a DME that will work with your insurance company. I just went to my insurance company's website and found the information I needed.

I made a list of the approved DMEs in my area, with phone numbers. I called each one and asked if they carried the S9 (since this forum had convinced me that was THE machine to get). It's amazing how much you can tell from a company by asking a simple question!

When I found a DME that actually took time to TALK with me, instead of a short yes/no answer, I was hooked. AND, I did NOT get the S9 I was looking for. I have a PR System One, and I could not be happier!

I think the best part about the DME that I use, and it seems to be a common thread among the few, good DME's, is that they are locally owned, Mom-and-Pop type store. I really believe their customer comes first.

You can make this process long and detailed, or short and sweet. For me, with the lack of concentration that I had from the sleep apnea, I had to do short and sweet. (Well, it wasn't short in time frame--that probably took me three days to do that little bit.)

[HoseCrusher]

I didn't choose a DME. I hired a Respiratory Therapist as an adviser on my medical team.

My RT happens to work for a DME.

My RT started out as a Fire Fighter, then moved over to a Paramedic. He is a Registered Nurse with a specialty in respiratory problems. He has access and uses almost all the different machines, hoses, and masks. When I have problems, he is an effective advocate with both the doctor and the equipment manufacturer. While I don't agree with all of his ideas, I have great respect for his experience and knowledge. He is a valuable asset to my team.

[avi123]

Hi, I would follow a similar approach as HoseCruser posted above, but with a few variants. Let’s face it that the central figure in the team is the Sleep Doctor, preferably the one who diagnosed my Sleep Study and hopefully one is knowledgeable about sleep disorders and ACCREDITED as such. It’s OK if another Doc or a Physician- PA shares the info.

So I would arrange an appointment with this physician and ask him/her to explain to me the results of the test and why the specified CPAP is just a CPAP or APAP, or BiPAP, etc. Same question about a specified mask. Also, if I should get an Oximeter and how often to use it. My last question from the Doc would be to recommend two or three DMEs that the Doc is satisfied with, and preferably those who focus on respiration equipment. IMO, all the issues of hardware and prices are SECONDARY in importance. The merchandise offered is almost identical and it does not pay to hassle much with anyone.

If you don’t have access to a Sleep Doc I would use this list to locate a SLEEP DISORDER PHYSICAN in my area:

Use the CPAP Community- Service Locator, at the bottom of CPAP.com, the owner of this website.

But here is one problem that I am presently annoyed with: I get my stuff from a local DME under a Medicare rental and am happy with them. When I asked CPAP.COM if I could send them a copy of my Sleep Study and buy with cash a mask from them their reply was:

Greetings,

Thank you for contacting CPAP.com for your CPAP equipment needs. A
prescription is required to purchase a machine, humidifier or mask.

Unfortunately, we are unable to accept a sleep study report as a
prescription. The prescription must be an order for the equipment
signed by the doctor.

Why do they need to contact, and bother, my sleep Doc to appove a mask?

[bap40]

As another poster said be careful in using a DME connected to the sleep doc. I found that out the hard way. Received more than one lie from them and finally ended up handing my machine in and getting all their paperwork and going elsewhere. This was hard for me to do as I do not like conflict BUT it is MY treatment and I was not going to take being told that the one particular machine was the one that would work for me. I knew better...... I ran fast and never looked back. By the way that place, sleep doc and all disappeared about a year after that.

[rested gal]

Why do they need to contact, and bother, my sleep Doc to appove a mask?

Silly though it might sound... it's because it's the law. Federal law.


Why CPAP.com Requires Prescriptions - topic started by johnnygoodman - Dec. 2009
viewtopic.php?p=429546#p429546
Johnny Goodman is the owner of cpap.com and the cpaptalk.com forum.

Prescriptions to buy mask on cpapaution - topic started by dogbone - Jan. 2010
viewtopic.php?p=444332

If you have a cpap machine Rx on file with cpap.com, I think that covers having a "mask" prescription on file, even if the "cpap" Rx didn't specifically mention the word "mask." I think a "cpap" Rx covers the accessories used with cpap therapy. Not sure about that.

But anyway, once you place a prescription on file with cpap.com, the prescription is good "for life" with them.

[rested gal]

Welcome to the forum, brsett!

I used to live in Knoxville. I have no experience with the DMEs there, though.

Please check your Private Messages. Just now sent you one.

[avi123]

Why do they need to contact, and bother, my sleep Doc to appove a mask?

Silly though it might sound... it's because it's the law. Federal law.


Why CPAP.com Requires Prescriptions - topic started by johnnygoodman - Dec. 2009
viewtopic.php?p=429546#p429546
Johnny Goodman is the owner of cpap.com and the cpaptalk.com forum.

Prescriptions to buy mask on cpapaution - topic started by dogbone - Jan. 2010
viewtopic.php?p=444332

If you have a cpap machine Rx on file with cpap.com, I think that covers having a "mask" prescription on file, even if the "cpap" Rx didn't specifically mention the word "mask." I think a "cpap" Rx covers the accessories used with cpap therapy. Not sure about that.

But anyway, once you place a prescription on file with cpap.com, the prescription is good "for life" with them.

RG, your last line seems to me be against the Fed Law. This is b/c the Sleep Study Rx, signed by a physician, needs to specify when and after what conditions the patient needs to repeat the test.

p.s. when are you going to depart from the beautiful Cardinal and give it back to a state that adopted it?

[Janknitz]

Avi may live in a perfect world, but many of us do not.

So I would arrange an appointment with this physician and ask him/her to explain to me the results of the test and why the specified CPAP is just a CPAP or APAP, or BiPAP, etc.

In an ideal world, this would be a great suggestion, but often people never even SEE a "sleep doctor". Their PCP orders the sleep test, a technician runs it, a sleep doctor who may never even lay eyes or hands on you "interprets" the test, and sends a report back to your PCP with a treatment recommendation (CPAP or APAP at X pressure). The reality is that sleep physicians make their money on the test and interpretation, NOT on taking time to explain all of the above to the patient, and some of them just plain will NOT do it.

Same question about a specified mask.

Hopefully your doctor will write the prescription for "mask of patient's choice." The mask is the single most important factor in CPAP success or failure. If YOU cannot sleep comfortably in a mask YOU are not going to use it. What your doctor wants you to have (if he has ANY opinion at all, most do NOT) is only a guideline for a place to start--if that mask doesn't work for you, then YOU need to find one that does. Your doctor will not care one bit, I guarantee that.

My last question from the Doc would be to recommend two or three DMEs that the Doc is satisfied with, and preferably those who focus on respiration equipment

.
Some doctors know the local DME's and whose best for patients to work with, but many either don't pay attention or they want to steer you in a particular direction because of some benefit to themselves (which could be as simple as "X DME doesn't call and bug me with questions all the time"). Your doctor cannot be expected to keep track of which DME's your insurance works with or who goes to bat to make sure the patient is doing well with CPAP.