cpap.com

Ok, so I finally took a look at the equipment and prices on cpap.com. I can honestly say I don't blame any of you for buying off that website. In some cases they are selling masks cheaper than we can buy them from the manufacturer. Which is actually a little disturbing to me. For patients like most of you in this forum I think it is a great resource but it would probably not be good for those patients who need a lot of follow up and are reluctant to use their cpap in the first place.

It is a definite eye opener. Thanks

MelMel

MelMel,

Glad to see you are now "informed" on what kind of pricing is available. I think you guys (the good ones) offer a great service. I would just like to see you get paid for the service you provide and not bury it in inflated equipment prices. I understand that that's how the business works, but I don't have to like it.

Now you can see why there is such a loyal following with the cpap.com folks (not to mention, they are also great people).

I guess the question is how can even a good dme compete with that pricing?

You can by offering an itemised price list of goods and services. Let them choose what services they want. Most DMEs sell a $300 cpap for $3000 and wonder why they get trashed on this site.

Melmel is a good DME

Cheers

Chris

MelMel wrote:I guess the question is how can even a good dme compete with that pricing?

By providing good service. That's what your value is to the patient, not the equipment you give them.

Howdy MelMel,

Keep something things in mind.

1. High volume allows us to keep prices low.

2. We sell to a niche inside a niche. We sell to informed, with it, online CPAP users.

You are concerned about the quality of care given to patients who may be starting out and don't know much or may just throw the CPAP in the closet. So are we! We started this board, we have instructional cpap videos, a 9am-10pm toll free number, all types of product feature and compare info, and soon some other stuff I have to keep under wraps for the time being.

A patient who has gotten themselves online is most likely quite advanced and freethinking. Does that kind of patient need to be told by a human what he already read online? We let the patient answer that. If they think they need that support, they can drive to the DME. If they think an 800 number and videos will do, they can order from us.

On a side note, I know the DMEs get blasted around here. I don't share the views of many on this board in that I've billed insurance and know what kind of expense it brings to the picture.

cpap.com is growing because people vote with their money and their actions. However, people have also voted with their money and actions by signing up for insurance and using it for every little medical problem. Insurance could not survive because of the load people were putting on it and had to raise rates and also decided to bully providers by making it difficult or impossible to get paid for legit services rendered. In the face of this chain of poor choices, the DMEs have no real choice: they have to pay their bills (which are large because of the amount of personal care each patient receives) so they are forced to raise prices as well. I see "the masses" as the cause and the DME and insurance companies as the inevitable effect.

Many people believe that each patient should have personal care and attention. I think that is a beautiful ideal and I have respect for anyone who strives for it. When we designed our business model, however, took a look at the landscape and said "If people want to opt out of paying large sums of money for personal care - can we give them an option where they get excellent remote care for 1/3 the price"?

A lot of people have decided to opt out. I believe they should have that freedom.

Johnny

MelMel, regardless of what kind of prices you have to charge to stay in business, the single best thing you could do to provide your "walk-ins" a valuable service is let them take masks home on a trial basis. That "rental stash" of try-out masks I spoke of in another topic. I'm not talking about renting them forever - I'm talking about a one week (or three nights..whatever...) try-out.

The vast majority of new cpap users will go to a local home health care store for their first equipment. That's where you can shine. But only if you stock the best masks and let the people try various masks out AT HOME, in real sleeping conditions.

Mask, mask, mask, mask - the biggest stumbling block of all for the helpless new users who will never find their way to message boards. And probably the biggest reason of all for drop-outs.

Work to educate the doctors in your area about prescribing autopaps instead of plain cpaps.

When patients are prescribed bi-level machines, work to convince the doctors to prescribe autopap with C-Flex instead.

I know you want to do right, but you are constrained by the economics of what insurance and Medicare will reimburse. Maybe you can figure out ways to stay in business yet still get people the kinds of machines and masks they should have right from the beginning. Forget the "Comfort Classics" and "Profile Lites". Good luck. You are really trying and I wish you success.

I agree with Rested Gal. You are very interested in all our comments, and as one of the smart breed of DME'ers, I imagine you will have to lead the DME charge to auto versus (dare I say) straight CPaps, etc.
Also, encouraging the patient/customer to get their scrips and sleep study reports, so they know where they stand.

If they do have questions, this board is invaluable, but, and a big BUT for sure, is most patients are unaware of CHOICES.

Good luck educating your customers and listening to mftrs who complain to you and other DME's who want to dump their old stuff on you to give ''out'' . You're in a difficult spot.

I can offer this story and I'll keep it short. A good 20+ yrs ago a mammogram was not the ''norm'' as it it today, or a PSA prostate blood test for me. Today it's the SOP by most docs/patients for their yearly checkups.

So the autopap can be the ''start'' of newer technologies and beneficial to patients. Time for the walls and big reluctance to end.

rested gal wrote:MelMel, regardless of what kind of prices you have to charge to stay in business, the single best thing you could do to provide your "walk-ins" a valuable service is let them take masks home on a trial basis. That "rental stash" of try-out masks I spoke of in another topic. I'm not talking about renting them forever - I'm talking about a one week (or three nights..whatever...) try-out.

The vast majority of new cpap users will go to a local home health care store for their first equipment. That's where you can shine. But only if you stock the best masks and let the people try various masks out AT HOME, in real sleeping conditions.

Mask, mask, mask, mask - the biggest stumbling block of all for the helpless new users who will never find their way to message boards. And probably the biggest reason of all for drop-outs.

Work to educate the doctors in your area about prescribing autopaps instead of plain cpaps.

When patients are prescribed bi-level machines, work to convince the doctors to prescribe autopap with C-Flex instead.

I know you want to do right, but you are constrained by the economics of what insurance and Medicare will reimburse. Maybe you can figure out ways to stay in business yet still get people the kinds of machines and masks they should have right from the beginning. Forget the "Comfort Classics" and "Profile Lites". Good luck. You are really trying and I wish you success.

MelMel,
What a DME supplier CAN do to get the business is offer SERVICE. I was perfectly willing to go the DME route, until I called my DME and got told they had ONE machine only, which DID NOT work on 12 volt ( I already knew I would need this for camping, from a friend on cpap). They only had ONE style mask - choice small, medium, large. They were only open 8:30 to 4:30, which would mean taking time off from work, and since I normally work 8-5, it would mean a lot of time - at least half an hour plus the time to get to the DME (or to my office) plus the time spent at the DME. And I was told that they couldn't POSSIBLY schedule me for nearly a month as the person who handled cpap only worked part time!. That's when I knew there HAD to be a better way, and found out about buying cpaps on line.

So, if you really want to SERVE the patient:
1. Have multiple machines and masks in stock. It might be difficult to keep everything, but at least a sampling of the differnt sizes and styles of masks, pictures if you don't have the actual masks, brochures on the different masks and machines - somthing more than one VERY old, basic machine and one style mask.
2. If possible, try to be available evenings or weekends. Maybe go in later one or two days a week and then stay later, or work an occassional Sat. morning and take time off during the week. I know its a bit tougher on you, but your customers will really appreciate not having to take time off from work. Especially if they've already missed a lot of time from the sleepiness/tiredness/ doctor's visits/sleep studies, etc.
3. Try to set up appointments quickly. People are tired of being tired. They've found something that might work, and they want it NOW, not next month.
People are more than willing to pay a higher price for something, as long as they get a higher service with it. It's the idea of paying more WITHOUT getting the service that people hate.

Debbie

MelMel, you said you can't buy from the manufacturer at prices to meet Cpap.com's. Is it written in blood you HAVE to buy from the manufacturer. Seems to me, depending on where you are located of course, that you could stock less and probably buy direct from cpap.com and get the equipment sooner than from the manufacturer. you wouldn't have to worry about backorders (like on the Swift) because they are always in stock. I was told by my RT that they were still waiting on their first Swifts to arrive.

Make sure your RTs are THOROUGHLY familiar with ALL kinds of CPAPs and masks, not just a few and knowledgeable enough to know what kind of machine and mask a person might need for their face type and lifestyle and sleepstyle, for that matter. No one should be forced to buy the first mask they try out and then have to buy one themselves if it doeesn't work out or wait 6 months for the insurance to buy them a new one. This is where you get a lot of non-compliance.

I agree with Rested Gal. Dispense Autopaps. Convince the doctors this is a better choice not only for the patient but for the compliance level of the patient. Too much pressure blasting at a person all night long is not going to result in a great deal of compliance, especially combined with an uncomfortable, leaky mask.

Why the pricing of hoses and headgear separately from the mask and machine? These are sold together, so why are they priced separately. I was even charged a separate price for the filter on the machine?~~!!!
A dr. should be able to write the script for xPAP machine, heated humidifier and mask "package". Of course I suppose one reason might be the insurance companies require codes for each of these, but why can't they come up with a new code for a package for xPAP?

My insurance was charged #181.91 for one months rental of my APAP, $51.28 for the hose, $6.73 for the filter. The headgear (BOUGHT) was $147.02 (A Breeze Nasal Pillow) and the headgear for that was charged at $49.69. That's a total of nearly $200 for a mask you can buy for about $90. Heated Humidifier was $468 (FP 150).

I haven't received an EOB from my insurance so I'm not sure what their allowable is, but I think on the machine it is $1100. Someone listed the amounts BC/BS figures for each for their allowable contracted price.

For this the service I received the first month was only so-so. And I had to go in for each thing. Answering machines queries were unanswered or if returned was "I'll try and find out" and then nothing. I had to keep harassing them to get answers. Into the second months with some major (it seemed to me) problems with my APAP unit and runaway problems, I got the same runaround. I finally had to call the DME HQ to get any kind of response and respect. Now I am assigned to the head RT who is quite knowledgeable. I was assured I would get great care because both RTs were CPAP users themselves. Obviously one was not very informed. The head RT was not familiar with the newer mask interfaces that were available, but very willing to learn. But it took me two months to receive the care and respect I felt I deserved. And I never did get an answer to the runaway pressures but I did notice that the IFL was reset to 0 when I got my machine back after complaining about it. From this forum I had already reset it, then set it back when I took the machine back. If I hadn't known how to reset it, I would have had another 3 weeks of runaway pressures, possibly severe central apneas and possible medical problems as a result.

The patient should be the DME's primary responsibility, not how much profit they can make from the equipment. An unhappy patient is not going to comply, is not going to come back, and is not going to recommend the DME to their friends. As any business knows, satisfied customers and word of mouth are the best means of advertising.

MelMel,

As you can see, the LONG stories are seemingly endless regarding the overcharging and bad service from local DMEs. This should be a que to you about where your market is. The smart folks at cpap.com have figuired it out.