Ontario CPAP purchase experience

[newapapuser11]

I just wanted to share my experience going through diagnosis to purchase of an APAP machine in Toronto, Ontario. The system seems to be fraught with abuse and wanted to share my experience with others.

My first sleep study went great. Great facility, very friendly and knowledgeable technician. Follow-up appointment was with a Dr. in the sleep clinic. She diagnosed me with severe sleep apnea and recommended I get a trial APAP right away, then follow-up with another sleep study in 3 weeks. So far so good. Then it turns out the DME has an office right in the sleep clinic. Not in the same building as the sleep clinic... in the same practice, literally in the room next door. Seems a bit dodgy for a DME to be located in the Dr's practice. But I wasn't forced to use them (just highly suggested), so fair enough, I suppose.

The DME gave me a trial APAP machine. $400 deposit, 100% refundable if I purchase through them, otherwise a $150 charge. Sounds reasonable.

The DME gave me a pre-authorization letter to send to my insurance company. This letter listed the APAP machine at $1020, hose for $200, filters for $150, humidifier chamber for $225, SD card for $150. This seemed outrageous. Hose, filter and SD card comes with the machine, and even then, should cost no more than $40 combined (based on online pricing).

After the second sleep study I was given a prescription for an APAP machine. I went to the DME's main office to return the trial machine and buy I new one. Luckily I had done my research on this forum in advance. Thanks to everyone here. Under the Ontario Assistive Medical Devices (ADP) program, DME's are required to sell me an APAP system (from a list of approved makes/models) for $1020. The ADP program covers 75% of this cost and I am to pay the balance 25% directly to the DME. This should work out to $255. This should include an APAP machine, basic mask, hose, humidifier

However, I was told by the Respiratory Therapist that I had to purchase mandatory upgrades, such that the amount paid by me would be over $1000. This was not optional -it was mandatory. Even said so on the Therapist's pricing sheet. The upgrades were a hose, SD card, filter etc. - all of which comes with the APAP machine and is required by the ADP program to be included in the cost of the APAP. The only true upgrade was free servicing and downloads from the machine every 6 months. I said I just wanted the basic ADP package for $255. She said it was't possible and that nobody has walked out of the clinic with an APAP without paying less than $1000. I said the ADP program requires her to sell it to me for $255 and that I would hate to see the clinic lose their ADP license over this. This really pissed her off. She stormed out saying she needs to call management.

15 minutes later she comes back and says I can have the machine for $255. Great. I was kind and polite all along. She fitted me with a mask. Then presented me with an invoice for $255+$300 for the mask. I stated again that a basic mask needs to be included in the package. Happy to discuss an upgraded mask, but with the ADP package, they need to provide a basic mask. (I was planning on using this as a backup mask). This again seemed to frustrate her - but she reversed the $300 charge, such that I pay only $255. Now, I had given a $400 deposit on the trial, so I was told the balance would be sent by cheque in the mail in 2 weeks. Lets see if it actually shows up..

I don't know if the initial pricing of over $1000 (mandatory upgrades) was made out of ignorance of the government policy, just because the Therapist was following her employer's instructions, or as a means to deceive. Either way, I feel this is no excuse for a member of a professional College to conduct herself. (Respiratory Therapists are part of the College of Respiratory Therapists of Ontario). Furthermore, the policy of the DME clinic to have upgrades as mandatory is in clear violation of the ADP policy. Its troublesome to think of how many people pay over $1000, especially for people who would suffer significant financial hardship as a result.

I have lodged a complaint with the College of Respiratory Therapists of Ontario and have written to the Deputy Minister and Associate Deputy Minister of Health and Long Term Care as well as the Program Director for the ADP program. My suggestion is that the Ministry issue a brochure which it should require be made available at all DME's. In addition, the patient should have to sign a form explaining the ADP program and that all upgrades are voluntary, as part of the ADP reimbursement paperwork that needs to be submitted by the DME.

Thanks to all those on this forum who help educate others and prevent these kind of scams from happening. Its a shame to see that after tax payers are subsidizing important medical equipment for Ontarians, unscrupulous DME's are coming in and taking advantage of patients.

[Cheech5001]

IMHO the best place in Ontario to shop for CPAP related items is Shoppers Home Health Care. No upsells, super kind and knowledgeable staff. A great experience, after I had a similar experience to the OP at the DME suggested by my sleep clinic.

[Hose_Head]

A great post and educational for all Ontario cpapers! One more thing, though. Please post the names of the sleep lab and DME. That way anyone dealing with them can be forewarned.

I'm not sure I would have given them that $400 deposit up front. I suspect you are unlikely to see any refund from them and good luck getting it back through small-claims court. You might try to make that part of your complaint to ADP; a little leverage can't hurt.

And don't forget to get a written copy of your lab study and prescription!

[3dmark]

Yeah, I also went with Shoppers, great experience.