The Big Lie

[Snoozin' Bluezzz]

However - why is it the Equipment Provider that is "evil" and not the insurance company?

The insurance company collects the premium

The insurance company decides what equipment you are allowed.

The insurance company decides how much they will pay for it.

All the equipment provider does is provide what they are instructed.

So to me, the problem is with the insurance company. Why do others see it differently?

Bingo

It seems that , in your opinion, the DME is just a pawn and is not a part of the problem at all?

Hmmmm!?

My insurance company will pay whatever their contracted rate is with the DME. I am prescribed an APAP (or CPAP with monitoring capability) with humidifier, the DME insists on giving me a dumb CPAP without humidifier because the insurance will not reimburse enough on the APAP with humidier. Now, question, who signed the contract between the insurance company and DME? Not me. Not the Doctor. Not the Sleep Clinic.

Darn! I'll be doggoned! The DME did. How did that happen?

David

[Bingo]

I can't wait to see the responses to THIS one......

Especially:

All the equipment provider does is provide what they are instructed.

Den

You know, when I wrote that I thought to myself "Someone is going to take that sentence completely out of its context and jump all over it."

I should have known better.

You know, I give up. It's just too difficult to try and have an open and objective conversation here.

I sincerely hope you all find what you are looking for, and I wish you the best. Honestly, I really do.

Bingo - giving up

[Offerocker]

BINGO:

Now, in the quote I've snagged above this again raises one of the same central questions I've asked a number of times but no one has responded to.

Please repeat the question...Thank you. I didn't see one in previous post.

Why the schism between the two entities? The same equipment - the same reimbursement. Yet one group (The Equipment Providers) are considered money-grubbing scum out to get rich, the other considered 'The beginning of a revolution!'.

W H Y ?

Bingo...I know you can read, and pretty well understand what you read; your responses are sometimes outstanding,.

The schism is a result of....SERVICE, COURTESY, SELECTION, EVEN PRICE!

Tell me now, wouldn't those features (of many others) influence you?

[NightHawkeye]

I TOTALLY AGREE WITH YOU!

However - why is it the Equipment Provider that is "evil" and not the insurance company?

The insurance company collects the premium

The insurance company decides what equipment you are allowed.

The insurance company decides how much they will pay for it.

All the equipment provider does is provide what they are instructed.

So to me, the problem is with the insurance company. Why do others see it differently?

I agree with you about insurance companies, Bingo. It's just that the DME is where things collide, or maybe I should say reach flash-point. The whole point of this thread is that as individuals we need to assume control of our own health care, and that includes dealing with the insurance companies as well.

I'll even relate one of my own horror stories dealing with Aetna insurance. Aetna errantly entered a $300 charge as a $3300 charge. As a result the hospital wanted to charge me more simply because their agreement with the insurance allowed them to do that. Aetna wouldn't correct their error (they didn't think it was a problem) and the hospital wouldn't drop the charge. This went on for about six months and numerous phone calls until one day, in a very determined moment, I finally spent hours on the phone discussing (OK, yelling!) at everybody trying to find out how to get the #@%*$ thing fixed. Finally. Aetna agreed to correct their end and that allowed the hospital to bill me properly.

Like lots of folks here have already said; "The system is broke."

Regards,
Bill

[Guest]

BINGO:

Now, in the quote I've snagged above this again raises one of the same central questions I've asked a number of times but no one has responded to.

Please repeat the question...Thank you. I didn't see one in previous post.

Sorry, I included it below that sentance in that post I thought I put it in the same paragraph. It's this question here:

"One of the regular points of contention in many posts around here has been the amounts being reimbursed by an insurance company for equipment. Cpap.com gets reimbursed the same amounts from the insurance companies, yet he is regularly considered a wonderful person/company here. Why the schism between the two entities? The same equipment - the same reimbursement. Yet one group (The Equipment Providers) are considered money-grubbing scum out to get rich, the other considered 'The beginning of a revolution!'. Understand, I have ZERO problem with that model, and both sides should be allowed to make whatever living they can in their chosen field. I just take issue with the double-standard. "

[Snoozin' Bluezzz]

BINGO:

Now, in the quote I've snagged above this again raises one of the same central questions I've asked a number of times but no one has responded to.

Please repeat the question...Thank you. I didn't see one in previous post.

"One of the regular points of contention in many posts around here has been the amounts being reimbursed by an insurance company for equipment. Cpap.com gets reimbursed the same amounts from the insurance companies, yet he is regularly considered a wonderful person/company here. Why the schism between the two entities? The same equipment - the same reimbursement. Yet one group (The Equipment Providers) are considered money-grubbing scum out to get rich, the other considered 'The beginning of a revolution!'. Understand, I have ZERO problem with that model, and both sides should be allowed to make whatever living they can in their chosen field. I just take issue with the double-standard. "

Why the schism between the two entities? The same equipment - the same reimbursement. Yet one group (The Equipment Providers) are considered money-grubbing scum out to get rich, the other considered 'The beginning of a revolution!'.

W H Y ?

Bingo...I know you can read, and pretty well understand what you read; your responses are sometimes outstanding,.

The schism is a result of....SERVICE, COURTESY, SELECTION, EVEN PRICE!

Tell me now, wouldn't those features (of many others) influence you?

It's been answered quite well although I wouldn't say "even price" I would say "and price". My experience with Apria was painful enough that I am willing to go out of pocket to get want I want from CPAP.COM and because of their pricing I can afford to do this. I think this says it all. I am fortunate, I can "sort of" afford to do this. Not all can and they suffer the poor service and selection from bricks and mortar DMEs (not all of them are bad, plenty of reports here about good ones but...)

David

[Snoozin' Bluezzz]

You know, when I wrote that I thought to myself "Someone is going to take that sentence completely out of its context and jump all over it."

I should have known better.

You know, I give up. It's just too difficult to try and have an open and objective conversation here.

I sincerely hope you all find what you are looking for, and I wish you the best. Honestly, I really do.

Bingo - giving up

I thought I replied to this one earlier so if it happens to show up twice forgive me.

Again, how on earth did we take that sentence out of context? We took it in the context offered, at least I did. As I see it you must be a part of the industry, even work as, or for, a DME and want to be justified. You have offered various opinions, statements and points of view each of which has been reasonably and (I hope) intelligently rebutted by various folks but it feels, to me, like you just pound the same drum - "it's not the DME's fault".

All of us, patient/client/customer, doctor, and DME's have a part in this mess. None are innocent. Patients can only correct or do their part as individuals. Some will all of the time, some will some of the time and some will none of the time. It serves no one for various members of a system that is clearly broken to say it is the other member who is at fault.

So, I am sorry if we were unable to accept your justification and I am sad to see you depart the field shaking your head and saying we all take things out of context and are unreasonable but...

David

[ufo13]

Goodbye Bingo! Why is it there was NO info in your profile-NO equipment - NOTHING?



Best to all,


Steve,
ufo13

[nosbig-nosbig]

Was wondering when or if the Doctors Union (AMA) would be mentioned. My understanding is that one of the first things the AMA did after the Civel War was to limit services (close hospitals and reduce the numbers of people admitted to medical school). The result was less medical care and higher prices.

It amazes me that our, (USA) brand of socialized medinine works as well as it does.

[snoregirl]

I have been wondering about Bingo and his motivations myself for a while now.

[Snoozin' Bluezzz]

Several times in this thread I have wanted to pose the question -

What good is a visit to the sleep doctor without monitoring stats?

I have gone three times in the past 6 months and the last 2 went something like:
---------

RT - Everything OK?

Me - I guess so, still a bit tired and sleepy, having some trouble with making the interface work well and leaks.

RT - OK (no advice, no help, no further questioning), let me download your card---Hmmmm! great compliance, we never see that! Let me call the doctor in.

Me - Ok

Doctor - Everything OK?

Me - I guess so, still a bit tired and sleepy, having some trouble with making the interface work well and leaks.

Doctor - Let me look at your compliance - Hmmmm! Great, we never see that. Come back in two months (which appointment was canceled and re-established Memorial Day Friday and finally moved to 7/14).

--------
Now, what else could he do or say? He had nothing to look at or talk about other than my subjective sense. It will be the same on 7/14 unless I spring for my APAP and get some stats before then. I will ask for a referral to get a mask replacement (Apria told me I need a referral to get a mask replacement).

Now, who made how much money on this waste of time?

Does anyone see a problem here?

_________________

CPAPopedia Keywords Contained In This Post (Click For Definition): APAP

[Offerocker]

Does anyone see a problem here?

Surely you jest!!

I see an all-too-familiar problem!

Hmmmmmmmm this sounds like good fodder for another "Not So Friendly DME" (politically correctness here)

[Wulfman]

Hmmmmmmmm this sounds like good fodder for another "Not So Friendly DME" (politically correctness here)

Oh, just call them what they are..... (the BAD ones)

Devious Money Extractors


Den

[neversleeps]

I've always been rather fond of the term "EVIL DME". It has been around almost since cpaptalk began and a quick search indicates chrisp is the one who coined the term (most often accompanied by the symbol---- or several symbols).

Posted: Thu Dec 30, 2004 10:55 am

Beware of some of the EVIL DMEs outthere. They are not all bad just beware. They will sell you the cheapest most profitable setup they have. And some of the sleep docs are in conspiracy with them .

The second time it was ever used was about a week later:

Yes beware of the evil DMEs

and it snowballed from there.

I'd hate to part with something so steeped in tradition. After all, it's use is so appropriate on so many occasions. Take Bingo, for instance. Please.


Have a good day!

Oh, and beware the Evil DME .

[jkeene]

I see it a bit differently. The annual premium on my family health coverage is over twelve thousand dollars.
...
Yes, I think there's some call for using the word "evil" in this situation.

See, this is a great example of exactly what I've been trying to say.

I TOTALLY AGREE WITH YOU!

However - why is it the Equipment Provider that is "evil" and not the insurance company?

The insurance company collects the premium

The insurance company decides what equipment you are allowed.

The insurance company decides how much they will pay for it.

All the equipment provider does is provide what they are instructed.

So to me, the problem is with the insurance company. Why do others see it differently?

Certainly the insurance company factors into the description, as they selected the DME as their designated agent for delivering on that part of their obligations of the insurance contract.

But if my doctor orders a complex blood test, the lab really will do it. If he orders some complex imaging, radiology will take care of it. If he refers for a less than common surgical procedure, the hospital and surgeon will get it done.

If he orders fancy xPAP equipment, delivery to the order is nowhere near the compliance or satisfaction levels of the other healthcare providers. Thus the DME gets liberally and justifiably plastered with the label "evil".