Angry at my doctor and DME supplier - they tried to spy on me

[mileena]

When I first started using my CPAP machine in December, I complained to be doctor that it felt like the mask was suffocating me until I fell asleep. The nurse said they would call me back, but they never did. So I am angry; they just want my money. I did not feel the doctor had a caring bedside manner.

I am also angry at my DME supplier, SuperCare:

1. They never did a proper fitting with me lying on a bed. They did not tell me how to put it on or adjust it. They used a small-size full face mask that the sleep study recommended even though I am tall, big, and obese. All my clothes are like 4x or 5x. I am not petite, so I need a large size face mask.

2. They inserted a wireless modem in my CPAP machine to secretly monitor me. That is outrageous. My insurance (Medicare) won't pay otherwise, but they do not need to spy on me. I removed the modem before the first use. They should simply rely on my word that I am using it.

3. I tried to adjust the pressure myself, but it would not let me. I am furious. I don't need them to treat me like a baby. I do not need their permission to adjust it.

4. I got angry at the phone rep since the fitter did not due a proper fitting, but she would not authorize a new fitting. So I asked to speak to her supervisor. She said she would call me back, but she never did.

This supplier is the only one in California which takes my insurance (Medicare and Medicaid). I do not know what to do. And the doctor is the only doctor in the Bay Area (San Francisco) that take my insurance.

I have refused to re-order free supplies from them, like the filters, face mask cushion, tubing, etc. I have been using the same mask and filters for 3 months now. I refused to let this evil company profit off me. I am trying to find another doctor and supplier. If necessary, I will report the supplier to Medicare to say that I never received the machine so the new supplier is able to give me one. You are allowed only one machine every 3-5 years.

Oh, the DME supplier has to have the media card or report from the doctor or modem report to comply with Medicare requirements that I am using the machine, or they will not get reimbursement. But they do not, and I won't report to them. Yet Medicare is still paying them. So they must have falsified their report.

Can anyone help me?

[palerider]

Well, apparently, I was suckered...

nothing to see here... :looks around innocently:

[MrsRinPDX]

Whoa there. You are joking, right?

Wireless modems are used to save you a trip into the doctor's office with the SD card data. It's not spying on you. They use the data to determine how the machine is working for you. It is to your benefit. I happily paid $25 for mine.

Using the same mask and filters for three months isn't the best idea. The fit of your mask is probably worse and the filters keep your machine from getting dirt and dust in it, prolonging its life.

You are lucky all of the supplies are free. This stuff is expensive.

[Mikebear]

Wait until she finds out about the camera, LOL.

[booksfan]

I am only going to address your issues about mask size.

I am also large (to put a polite spin on it ). I started on CPAP mid-Jan, with a very patient DME who fitted me with the multiple (10-12) masks I tried over the first 4 weeks. I will admit, fitting was sitting not lying down. Almost every single mask I tried, I needed a small size. For several, I also needed a small headgear. Palerider is right--there is no correlation between your body type/size and your mask size.

Good luck and welcome to the forum--there are a lot of helpful folks here!

[JimW159]

Are you certain your DME is the ONLY one that accepts Medicare and Medicaid in California? If so, I find it incredibly strange that it is true in the most populous state in the country. For example, I go to https://www.medicare.gov/supplierdirectory/search.html and input a zip code of 95035 (random zip in the general Bay area) and a distance of 100 miles. I get 27 DMEs within the competitive bidding category for CPAP and 34 within the non-competitive category for CPAP. What I suspect is that you don't actually have straight Medicare and Medicaid but rather one of the many advantage plans with very restrictive DME contracts. In which case you need to direct your ire toward your insurance carrier, not some nebulous "big brother" peering into your bedroom at night.

[chartle]

2. They inserted a wireless modem in my CPAP machine to secretly monitor me. That is outrageous. My insurance (Medicare) won't pay otherwise, but they do not need to spy on me. I removed the modem before the first use. They should simply rely on my word that I am using it.

Oh, the DME supplier has to have the media card or report from the doctor or modem report to comply with Medicare requirements that I am using the machine, or they will not get reimbursement. But they do not, and I won't report to them. Yet Medicare is still paying them. So they must have falsified their report.

I've been on a cpap for 5 weeks and have come to the conclusion that 95% or more of treatment is compliance. The first few weeks I would get pep talks from Resmed. The myAir website kept telling me how good I'm doing and gave me Medals of Achievement mirroring how certain games work like Pokemon GO. I even got "Keep it Up" robocalls.

As for your the DME reporting, I was given 3 months to comply by wearing the mask for 30 days at least 4 hours a day (already met that) and that I had to have a DR appt after 30 days but before 90 days (already scheduled even before I picked up the machine). During these 3 months my insurance would cover the rental and then after that finish paying it off over 9 more months and then I "owned" it.

I'm horrible with date math but you maybe hitting that 90 day soon or already passed it but if you are not compliant by proving it, through the modem or SD card, Medicare is probably going to stop paying and your DME is going to go after you to get their stuff back.

As for "spying", yes there is a Sleep Coordinator LPN thats monitoring not just my usage but my results. She noticed I've been hitting my max pressure a few times and told me she would consult with the Dr to see if she needed to boost my settings. If she did this she would call me and would do it remotely.

If you were paying for this 100% i would say do whatever you want but since its being paid for, all or partially, by someone else they are well within their rights to make sure you use the machine and its not being stored in a closet or worse. They also have to see if the machine they gave you is really helping.

As my wife and I talk to people about about having machines, maybe 2 or 3 out of the 10 we have talked to used their machine once and then threw it in a closet.

[loggerhead12]

My doctor knocked me out and took a video of my colon. Bastard.

[Mikebear]

My doctor knocked me out and took a video of my colon. Bastard.

I'd let him do that every night, if I could get sleep like that Propofol they use gives a person, LOL

[Pugsy]

Hey guys...I might be wrong here but I smell a "fly by".
You all can keep responding if you wish but I would wait to see if this person even comes back wanting help or see if they just want to stir up crap.

[Mikebear]

Hey guys...I might be wrong here but I smell a "fly by".
You all can keep responding if you wish but I would wait to see if this person even comes back wanting help or see if they just want to stir up crap.

I'm not so sure. Even with the ranting, she filled out her profile, so perhaps she's just venting a little because she has no clue as to how this all works, didn't realize most of what she posted is normal for getting setup by her doc, but really wants some help.

[Pugsy]

I'm not so sure. Even with the ranting, she filled out her profile, so perhaps she's just venting a little because she has no clue as to how this all works, didn't realize most of what she posted is normal for getting setup by her doc, but really wants some help.

Maybe it's just my general feelings given the recent spam stuff but you might be surprised what people put in the equipment section.
I don't trust anyone at the moment. I get spammers filling in all sorts of equipment and then sneaking in spam links in signatures.
You guys rarely see that stuff but I do. They don't anymore use the equipment than my dog does. They just play the game.

Like I said...I might be wrong but I have seen this kind of stuff before and all the person wanted to do was stir up crap.
They didn't really want to resolve any issues.

And like I said...you guys can keep on responding if you wish. I will help...if the person comes back and shows they really want help.
I don't help with pity parties or rants though.

[hobbs]

Translated to English; I am a victim!

[chunkyfrog]

Joined the forum right after 1 am cdt, posted a few minutes after.
A pan of brownies says she/he/it will be back around Pugsy's bedtime.
Pugsy smells a rat, I smell a dung beetle--nope, sorry, not on my menu.

[zonker]

My doctor knocked me out and took a video of my colon. Bastard.

i don't think that's exactly the standard way to treat sleep apnea!