Auto Delivery of Supplies?

[jgolomb]

My DME provider was just bought out by another company and I am planning for (OK expecting) the worst.

My phylosophy is to stockpile what I can while I have insurance coverage in case something changes in the future. I would also like to have a ready supply of replacements in case something breaks or starts to leak. I have been using the same tubing, filter and humidifier water chamber for almost a year now and my DME provider has only let on that I am entitled to a new mask every 6 months. According to what I have been reading in other topics posted on cpaptalk I should be entitled to much more frequent replacements of all the staples.

Poking around the Internet I have found some DME companies that appear to work similar to the mail order pharmacies. I would like to get an e-mail reminding me that it is time to order a replacement part with a link to their web-site and they handle the insurance etc.

I would like to hear from anyone who has experience with any of these companies? Good or bad...

Thanks - Jeff

[Slinky]

I have Medicare and a secondary. I was totally disgusted w/my local DME supplier but was too far into the capped rental of my CPAP to get off the hook w/them. HOWEVER, I WAS able to get my supplies from another local DME supplier who also took Medicare and my secondary insurance w/no hassle. Of course, some local suppliers might not WANT to "interfere" w/another's business.

I don't know about Respironics, but Resmed has a site where you can register your Resmed xPAP and if you list when you got your various supplies and the interval you are eligible for replacements they will send you a reminder, PLUS at least the fully data capable Resmeds have reminder notices in the internal software that can be set and a reminder message will appear on your LCD screen - mask replacement to filter changes.

With Medicare there is a site w/their replacement intervals and many insurances also have them posted at their websites. Once you have your xPAP and know which mask is most successful for you I would think one of these mail order places might be a good way to go to get your supplies via insurance.

But it does make you wonder what the "catch" is that billmyinsurance and cpapforseniors had to go out of existence if these TV advertised companies can survive or even flourish!!!! THAT is what WOULD make me leery!! At least cpapforseniors and billmyinsurance were affiliated w/cpap.com and you could have CONFIDENCE in them and their service just as we can cpap.com!!!

[krousseau]

About every 6 1/2 months I get a call from Apria letting me know they it is time for a new mask-and whatever else they can send-tubing humidifier chamber. Medicare and my secondary pay and I owe Apria nothing. They replace the whole mask and headgear. That is all they will bill for. If Medicare has a schedule allowing more frequent replacement of any part, like nasal pillows--does not matter--it is probably not cost effective for Apria to bill more frequently. And Medicare only allows them to send a month's worth of things like pillows and filters--Apria (and other DME's are not permitted to send a six month supply and bill for it. So I have not found ANY supplier who wants to deal with the monthly stuff. Don't know why-I get a 90 day supply of drugs and diabetics can get their supplies.

[jgolomb]

krousseau - Thanks I'll keep that information in mind.

slinky - I went to the two sites you said were out of business and both web sites were active. I'm not a senior (yet) so that one is out, but the billmyinsurance looked interesting. Do you know if they were bought out?

Has any one had any dealings with billmyinsurance?

[Slinky]

I just asssumed .... there was post after post that they could no longer selll in that persons's state ..... my apologies!! They used to be linked from this forum and I don't seem them mentioned any more .... crawling back in my hole!!!

[jgolomb]

Not a problem. Appreciate the response.

[OldLincoln]

I deal with SleepQuest now, and love em so far. They sent me a reminder and I told them send everything I'm entitled to. 3 days later I got a new hose, mask/headgear, 3 cushions & 6 white filters delivered. They said insurance will report early billing on the cushions and not to worry about it. They send supplies via their headquarters location and have people dedicated to that. You might check out their web site http://www.sleepquest.com.

Of general interest is a letter the SleepQuest president wrote that defines their position on OSA treatment. You can read it here: http://sleepapneacommunity.com/blog/?p=33.

[krousseau]

OldLincoln
SleepQuest is the outfit Dement is "affiliated" with in some way-consultant or something-there are some legalalities about how physicians can be part of DME suppliers.
Does Medicare pay for your supplies?
My insurance would pay its share AFTER Medicare is billed-even if Medicare denies a claim-but if the DME will not bill Medicare-insurance won't deal with it.
I don't know if SleepQuest deals with Medicare-I think they are a provider that sets up contracts with individual insurers. Unless the regs have changed recently......as long as they don't bill Medicare they are free to set up any payment schedule they can with insurers (and it can be different for different insurers). Once they start billing Medicare and get reimbursed by Medicare they have to follow Medicare rules and cannot (by law) charge anyone less than they charge Medicare or provide any "advantages" to other insurers.

[jgolomb]

Thanks for the info. I'm surprised there isn't more feedback on this - good or bad places to deal with.

[OldLincoln]

Yes they do bill Medicare although I haven't seen the first bill actually processed yet (too soon). I also have the Medicare first, private insurance second. SleepQuest is in California and have 3 or 4 stores in the state.

I don't must have forgotten but I don't recall Dement. I know the issue in the article (for which I gave the link) is the relationships of doctor, lab and the DME. My thought from it is that we have medical labs and clinics everywhere with medical doctors as owners. They simply have a sign in their office stating they have a ownership stake in it and you are free to go to other labs if you choose. Seems if it works for one it ought to work for the other.