Really PO'd now!

wading thru the muck! · Post by **wading thru the muck!** » Mon Feb 28, 2005 2:50 pm

Andy,

Great advice. Nice to see another convert to the best way to get treated for OSA.

It's great to be free of the DME/Insurance rat race.

imacpappro · Post by **imacpappro** » Mon Feb 28, 2005 3:55 pm

Hello Nenetx2004,

We hear the problem of not being able to get an Rx from time to time. I am not aware of any specific law in Texas that prohibits the release. Especially being that Cpap.com is based in Houston. Maybe this is just the wrong wording. You don't really need it released; you simply need a copy to either get a second opinion or to purchase a machine on your own. However, I guess the DME companies have thier own wording or terminology. Anyone is within their right to request a copy of their file. In your case, for a second opinion I would get a copy of the complete sleep study (polysomnography and titration) as well as a copy of the prescription.

Here’s a link to a page which addresses questions a patient might have about HIPAA. In the upper left side, it states the patient has the right (and the provider must comply) with their request to, “…see and get a copy of your health records”.

http://www.hhs.gov/ocr/hipaa/consumer_summary.pdf

Further, the HIPAA law itself states:

§ 164.524 Access of individuals to protected health information.
(a) Standard: access to protected health information.

(1) Right of access. Except as otherwise provided in paragraph (a)(2) or (a)(3) of this section, an individual has a right of access to inspect and obtain a copy of protected health information about the individual in a designated record set, for as long as the protected health information is maintained in the designated record set….

If there’s a law on the books which prohibits the release of a patient’s DME prescription, I’d like to see it.... I hope this helps.

Regards,
ICP

G00fy217 · Post by **G00fy217** » Mon Feb 28, 2005 4:12 pm

FL andy wrote:In Floriida I just give the DME a copy of the Rx and keep the original. I have to believe you will quidkly find another doctor to give you another CPAP prescription. Then have it filled thru cpap.com because when you compare cost of rental for two years to buying your equipment, you not only get the exact machine and mask you truly want, you don't spend a lot of extra money. Maybe some extra, but not a lot.

Ok... may I ask a real stupid question here? Will your insurance company pay for a 2nd machine? This might be something you might want to ask first to your insurance company before you go ahead and get a new prescription. They might not pay for a new machine. And, if you have a new machine anyways, doesn't it have C-Flex? Isn't C-Flex better than just straight Cpap? Sorry... I am still a newbie... just thought I would ask, just in case your insurance company doesn't pay for a 2nd machine, you might have to go with the out of pocket anyways.

Janelle · Post by **Janelle** » Mon Feb 28, 2005 7:56 pm

Nenetx, my Sleep Doctor in Austin is J. Douglas Hudson, MD. Addrerss 4200 Marathon Blvd, Ste 310 (near Seton Hospital), phone is 512-420-9900.
He prescribed a APAP for me right off the bat. He is very popular and you might have to wait to get an appointment. I saw his PA twice before I ever saw him. She is very nice, too. He is an older man but is very easy to deal with. Also has all kinds of masks and machines near the waiting room you can feel and look at.

The Office is called Sleep Medicine Consultants.

rock and roll · Post by **rock and roll** » Mon Feb 28, 2005 9:24 pm

I AM FROM TEXAS and it is true that the RX can't be given to another and one can't get a copy of it. This is Texas law. Not bull or anything else. Keep it civil, a fair question was asked and that is the reason for this forum. I don't live in Austin but do in Houston and know several doctors that will confer with yours and issue a new RX for you. A GP can give it. Just ask for it. Good luck and I would like to knoe how it works out. This is so much harder than it needs to be.

chrisp · Post by **chrisp** » Mon Feb 28, 2005 9:33 pm

Gee , I have bought 3 cpaps with the same Rx . I live in TX. Last I heard a FAX machine doesn't destroy the original and all copys when you press send..LOL

I think a more important question to ask your Doc is "What is your relationship to the DME and sleep lab". He is required to disclose this relationship or he is in violation of medicare rules. Even if your are not a medicare patient its a good thing to know.

Follow the money

Chris

Guest · Post by **Guest** » Mon Feb 28, 2005 9:43 pm

Well, Elvis feed his drug habit for years with his MD but that did not make it legal. In this day of litigation, a lot of doctors are to the letter of the law. But there are always exceptions. But he can have another doctor get his records and make another "RX" from that

rock and roll · Post by **rock and roll** » Mon Feb 28, 2005 9:44 pm

Well, Elvis feed his drug habit for years with his MD but that did not make it legal. In this day of litigation, a lot of doctors are to the letter of the law. But there are always exceptions. But he can have another doctor get his records and make another "RX" from that

chrisp · Post by **chrisp** » Mon Feb 28, 2005 9:57 pm

Well I don't know about Elvis and his drugs. I do know that I have 2 cpaps and 3 pair of glasses. All were bought with the original Rx. I have 1 next to my bed and 1 as a spare . Ready to travel at a moments notice. Same with my glasses.

Why wouldn't a cpap be the same as glasses. I can only use 1 at a time. Not like drugs . I can take them all at once .

Cheers,

Chris

gailzee · Post by **gailzee** » Mon Feb 28, 2005 10:21 pm

Keep us posted on your getting a copy of your scrip. Do you believe that the DME actually faxed me a copy, so then I asked the dr. and they said no "problem" nothing is every a ''problem'' for them. I'm still waiting for the
"original" copy of the scrip. haha.
Sign me: not waiting by my mail box in a foot of snow!!

Good Luck!

Nenetx2004 wrote:Thanks Wader. I'll try again but I've had two different sources tell me otherwise. I'll make another stab.

As far as Ionizer is concerned, I wish I had all the time in the world as he does to track everything that goes on in this forum. However, with a full time job plus a heavy teaching schedule at a karate school I don't have that luxury. I always think it's interesting that the people who are "direct" but "mean no harm" are the ones who are not registered members.

Gail, I'm familiar with all the HIPAA stuff. I'll keep trying until I get some answers.

Jeanne

G00fy217 · Post by **G00fy217** » Tue Mar 01, 2005 7:27 am

Crisp, Sorry to have to repeat myself.... but will your insurance company or anyone's in fact, really pay for a 2nd machine? My insurance company gave me such a hard time for the first machine that I can't imagine them oking a 2nd one.

Janelle · Post by **Janelle** » Tue Mar 01, 2005 8:00 am

Insurance companies vary, but will generally pay for a new machine every 5 years, and a new mask every 6 months. You have to have your original RX for this, so most DME's will give you a copy of it for that purpose only. Most will also admit that you can order online cheaper than going through them. it is your prescription and you should get a copy from the DME without a big fuss. Tell them you want it so you can order another mask as an alternative to what you got from them. They know the insurance won't pay for it, so it is no big deal to them. They don't know you don't need it to buy a mask online.

G00fy217 · Post by **G00fy217** » Tue Mar 01, 2005 8:12 am

Janelle,

Thanks for answering my question. I thought maybe it was just a stupid question and I was the only one with such a problem with my insurance company. You make a very valid point as well.... the DME's wouldn't know what we really want it for (we aren't suppose to know about these sites and this forum..... my DME looked at me like he was in shock that there was such a forum)..... However, not all DME's would do that, right?

Janelle · Post by **Janelle** » Tue Mar 01, 2005 6:26 pm

Both my Rts at the DME are CPAP users and neither one had any idea there was anything like this out there.

sgrol · Post by **sgrol** » Wed Mar 02, 2005 9:59 pm

I live in Houston and have been on CPAP for almost 5 years. I wanted to get a second unit for travel/backup. I called my dr., who I haven't seen since I was diagnosed, and asked for my prescription. They had to dig through archives to find it but faxed it, my sleep study and the dr comments right over. It is a pdf file so I can use it whenever I want and as often as I want. If it is against the law in Texas to resupply a prescription than my doctor is, thankfully, guilty.
P.S. The RX did have a new date if that makes any difference.

Really PO'd now!

everyone has a moment on the board..!