CPAP Basics - 8 - Dealing With Difficult DME's

grayghost4 wrote:After reading these posts .... I check the machine that the DME delivered to my wife 5 weeks ago, and discovered that it has 35 extra hours on it beyond the use time my wife used it. It was supplied under medicare and billed to them ... is it legal to supply a used machine and bill as new ... without informing us?

What brand of machine? The ResMed machines run in cool down mode after you turn it off and this time in cool down mode will count towards the total run hours. So therapy hours and run hours can be different on the S9 machines and the machine was brand new when dispensed.

And yes...it is legal to dispense a used machine. Medicare really doesn't care. Nothing in the wording states implicitly that a machine must be brand new zero hour. They've done nothing illegal...now yeah, it stinks but not illegal.

it is a Philips PR 560 . do they also run a cool down ?

Blower hrs are 176 total machine time 211 hrs.

grayghost4 wrote:it is a Philips PR 560 . do they also run a cool down ?

No, they do not run a cool down period.
There might be one possible explanation for the difference between therapy hours and blower hours and that would be if the machine either didn't sense a live person on the other end (like big leak or the machine was ran for a bit of time without a person attached).
35 hours would be a lot of big leak or running just to be running a machine though.
Most likely the machine had been used in the past. It still isn't much use though and while I know it annoys the heck out of people to find that out...no laws were broken. The time to raise a stink about it would have been the very first day though...not a month later and even then with technically no laws being broken there isn't much recourse if a DME digs in their heels.

Yeah, it stinks when we pay new prices for used equipment because our insurance pays by HCPCS code and not brand or "new".
Ethically it stinks but it's legal.

35 hours isn't many hours though...that's roughly 4 days/nights of use. Now if it had been 3500 hour...different story.

grayghost4 wrote:it is a Philips PR 560 . do they also run a cool down ?

Blower hrs are 176 total machine time 211 hrs.

There's also "wiggle room" in the new/used categories with regard to hours on the meters. It's been discussed here a number of times in the past.

Could be it had some (or extra) "bench testing" before it left the factory.......and they zeroed out the user hours.

Heck, my "brand new" Pro 2 had a little over 20 blower hours on it when I got it (with zero user hours) in 2005.

Not at all uncommon or anything to worry about with the difference being that small.


Den

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I work for a company that has DMEs and my wife teaches Respiratory Therapy.

1. Ask your DME if they have a RT (Respiratory Therapist), if they don't try another DME. If you can't find a DME with a RT, use your doctor as a resource. Going to a DME doesn't guaranty you will be dealing with someone that has ANY knowledge about CPAPs.
2. RT's are mainly trained for hospitals, they have little training for other jobs like working for a DME. A RT that has been at a DME for a while is usually better than a newer person. Most of the time it is a learn as you go job.
3. Times are really getting down right crazy for the DMEs due to insurance issues and competitive bidding, your company that you are dealing with may be in a very grey area for a while. Some of their new rules and paperwork are making it really tuff for them. Try to get all your ducks in a roll the best as you can with the DME so hopefully things can work smoothly with you. (ask many questions and see if they have a work email that you can communicate with them)
4. Make appointments. Talking to RTs at our DME's they are way busier than ever. Companies are dropping employees to save money. Schedule a time to talk; walk-in's and quality time is becoming a thing of the past.

Last. Life is stupid: I work were I could get my machine and supplies, but no I have to go to a rival company down the street to spend my and my insurance money.

WRX03 wrote:2. RT's are mainly trained for hospitals, they have little training for other jobs like working for a DME. A RT that has been at a DME for a while is usually better than a newer person. Most of the time it is a learn as you go job.

True words. Which is why I, a DME RT, come to this forum... to learn from the people that use the equipment I'm putting out every day and therefore be best able to help the hundreds of new pap users I see each year.

WRX03 wrote:4. Make appointments. Talking to RTs at our DME's they are way busier than ever. Companies are dropping employees to save money. Schedule a time to talk; walk-in's and quality time is becoming a thing of the past.

In our DME, the RT's still make house calls daily. One stays in office once weekly for those patients that prefer not to be visited at home but daily work loads are excessive and appointments are definitely necessary. Just walking in and expecting to receive proper clinical help is futile. Call your DME anytime during office hours but don't expect to immediately talk to the person with the clinical knowledge you seek. Our RT's generally return phone calls when they return from their home visits... at the end of the business day.