Can DME "Reuse" xPAP Machine?

Does anybody know the truth (or not) to this... Once a supplier provides the user with a CPAP machine on a monthly basis (and bills their insurance on a monthly basis), and lets say it comes back to them after a month or so for whatever reason, the DME cannot reuse that machine. I.E. they cannot give it to another user for their use on a monthly basis? I'm not talking about hoses, mask, any other accessories. Just the machine and humidifier.

Here's the back story:

In August '08 I aquired my first CPAP machine (ResMed Compact). I was having alot of difficulty with compliance and needed to get going because I had to be compliant and tolerant to regain my medical clearance for my job. I struggled with the machine for the first month and coordinated with that supplier (who coincidentally happens to be a combo lab/DME in which my Doctor has an interest) to return the machine and be billed only for the first month. They said turn it in when I could. I turned the machine in one week past my second month billing date as I was coordinating with a different (and independent DME) for a Respironics Auto BiPap (after much arm wrestling with my doctor and his lab rats). That's the machine I'm compliant with and tolerate today, though with the typical issues many on this site struggle with.

So now, it turns out the first supplier billed the second month anyway and BS/BC just sent me the check for that month. I've called them on it saying they agreed to bill only the first month as the insurance coverage for the new machine by the second DME will conflict with their billing. Their answer was that I had the machine past the end of the first month (I did by one week) and that the doctor has $500.00 in the purchase of that machine and now can't use it for anybody else (inspite of the fact that they agreed to bill only the first month.)

What gives here? Machines are not reused if the DME gets them back for upgrade, incompatibility, etc.??? I don't think the sleep lab uses a new machine for every patient they titrate. There must be some industry standard that suppliers use to make machines fit to reuse.

Bottom line... I think my doc and/or his lab is trying to pull the wool over my eyes. I'm sorry the basic cheap no frill CPAP machine didn't work for me and I needed something better that they couldn't or wouldn't provide and so I had to go elsewhere to get it (again after arm wrestling my doc and getting the necessary BiPAP Rx from him). That's why I'm going month to month right? That's why an insurance company won't just pay outright for a purchase until compliance is demonstrated right? Suppose I just didn't want to continue treatment no matter what the reason and just dropped off the machine unanounced? Then what, provider? You going to charge me for the cost of the machine because you can't use it anymore, when all parties knew it was on a month to month basis???

All that being said, I otherwise like my doc. We go back a long way. But I'm not too impressed with the sleep industry though and his efforts or lack thereof in it.

So.. anyone in the know out there? Can a provider reuse an xPAP machine or not? That's the basis question in all of this.

Thanks in advance... Joe

Machines are routinely reconditioned (whatever that means - cleaning, fixing, etc) and re-used, though whether or not someone can tell you you're getting a brand new machine when it isn't, is another story of course.

My first Rx was for an Auto PAP on a trial basis. My DME gave me a machine that he said was used. He used it for rental when he knew it was only on a trial basis and not intended to be a permanent machine. So yes, DMEs can reuse the machine. He told me that when I got my permanent Rx, I would get a new machine.

I would also think that machines that are returned may be used as temporary loaners if a client brings in a machine because it's not working right and it has to be sent back to the manufacturer. I don't believe that they can't be used again.

Sure they can...and do.

It's just clean (hopefully filtered) air going thru it. And maybe distilled water.

When I took my two-week old "Plus" back to swap for an "Auto", she told me they would "autoclave" it. (I doubt that. I can't think of a better way to abuse electronics than a pressure cooker...) But the implication was clearly that they would eventually give it to someone else.

Link -- I sure would like to see that cpap after they autoclaved it!!!

Like you I can't imagine anything harder on it than that.

My first CPAP machine many moons ago was rented by my insurance company from Apria, it was a Remstar Plus (the old beige model, anyone remember those?), and had plenty of hours on the meter when they started me on it.

(After demonstrating compliance, my insurance decided to buy me a machine, and Apria actually tried to stick me with the used machine I'd been renting until I raised a big stink about it)

LinkC wrote:I doubt that. I can't think of a better way to abuse electronics than a pressure cooker..

I can. Long ago I used to work in a service depot. We received a unit for repair that had been placed in a microwave to "dry it out". Total loss, but it was interesting to see how it was damaged.

My DME supposedly has several. They are used as loaners if yours is damaged or stops working and has to be sent in. I was told that the loaners they have are standard cpap and auto pap but no bipap so if your on bipap your out of luck if yours breaks.

rocketdork wrote:We received a unit for repair that had been placed in a microwave to "dry it out". Total loss, but it was interesting to see how it was damaged.

The unit or the microwave???

It really depends on if it is a rental or a purchase. My company always puts out new CPAP and BiPAP machines. I save all the used machines to put out as loaners, or to use as rental machines for facilities. Machines that are on rental do not have to be new machines.

KansasRT wrote:It really depends on if it is a rental or a purchase. My company always puts out new CPAP and BiPAP machines. I save all the used machines to put out as loaners, or to use as rental machines for facilities. Machines that are on rental do not have to be new machines.

Couple of questions.
Is there any kind of "rule of thumb" as to a percentage of spare machines that are kept for backups in relationship to the number of users being serviced by a DME shop?

Also, what happens to the ones that are considered "antiques" (well, OLDER, anyway)? (do they go to DSM's museum?)

Den

There is not a rule, I try to have a back up for every BiPAP type machine I have, and I have at least 20 CPAP's for back up. I don't know off the top pf my head what percentage that is, but I figure I can get CPAP's overnight from the company and the chances of more that 20 going bad in one day is pretty slim. I have an old machine graveyard in the basement. Sometimes I will give them away to people with no insurance. ( I have a hard time throwing things away.)

KansasRT wrote:There is not a rule, I try to have a back up for every BiPAP type machine I have, and I have at least 20 CPAP's for back up. I don't know off the top pf my head what percentage that is, but I figure I can get CPAP's overnight from the company and the chances of more that 20 going bad in one day is pretty slim. I have an old machine graveyard in the basement. Sometimes I will give them away to people with no insurance. ( I have a hard time throwing things away.)

Thank you for the info.
Yeah, I have that problem, too.......which can be verified by my wife.

Den

Thanks everyone, for this input. On the machine in question, my DME was the lab, which i believe is owned by my internist/pulminologist/now sleep doc apparently, or at least he has a big interest in it.

I suppose he's a small operation as sleep centers go so probably doesn't want to be taking stuff back, even though I'm clearly on a month to month basis, and he clearly knew I was under pressure to get my medical clearance back for work, i.e. needed to get compliant fast. He should know too that BC/BS and likely most insurances, will not purchase a machine anyway until compliance is proven. What someone in the thread here said makes sense... Should be giving used machines to renters anyway, until they are going to purchase at least. And, make it known up front what the situation is with the machine. I know this is alot of communication and info that the sleep industry is apparently loathe to provide (generalizing overall, I know there are a minority of exceptions out there).

Anyway, I will not let them think that they are correct in thinking they cannot use the machine for anyone else. They need to change their practices as far as I can tell.

Oh, and I am eventually going to an independent sleep doc, even though I otherwise like my doctor. But I'm going to do some interviewing and find out how open they are to their patients being proactive in managing their own care. Is it appropriate to ask if anyone has any recommendations in Orange County, CA? Feel free to PM me.

Thanks to all

Joe

insurance comps generally will not allow us to bill used machines (esp Medicare). Used machines are generally sold or rented to cash patients.