What does a DME actually do? MY story

I'm glad online works for you, cinco.

My prescription coverage has a $5 co-pay. Presumably, I would pay $5 whether I bought online or not. There is a CVS across the street from my primary care provider's office. On the rare occasions I am prescribed meds, I can have them in 10 mins or so and be on my way. I would spend the SAME 5 bucks online and wait a couple of days for the meds. (It's possible I'd have to pay up front and get reimbursed all but $5 later. Who knows? Never did it that way...see no reason to try.)

I like my way.

LinkC wrote:I'm glad online works for you, cinco.

My prescription coverage has a $5 co-pay. Presumably, I would pay $5 whether I bought online or not. There is a CVS across the street from my primary care provider's office. On the rare occasions I am prescribed meds, I can have them in 10 mins or so and be on my way. I would spend the SAME 5 bucks online and wait a couple of days for the meds. (It's possible I'd have to pay up front and get reimbursed all but $5 later. Who knows? Never did it that way...see no reason to try.)

I like my way.

I would like your way, too, if I only had to pay $5. I had to pay $50 for a 60ml bottle of cough medicine last week.

Scrappin, he's one of the lucky ones who has good insurance. For the folks who don't, they don't have his privileges. He gets it all handed it to him, and then begrudges people trying to save money, because they are under or not insured at all. Most folks who have OSA would be uninsurable due to "preexisting conditions" if their employer did not provide group coverage. I, too, have 5 dollar generic co-pays for my meds, but I would NEVER begrudge increased coverage for anyone who did not have the same coverage as do I. Of course he likes "his way" as it is virtually free.

Sorry auto, not playing your game. I have no idea what most of that diatribe was about.

I don't go to bars but I DO work with a fine bunch of sailors every day. Wouldn't trade places with them...I already did my part. But we have mutual respect and good rapport.

But "jet jockey", "wannabe", "right to affordable health care"???? No clue as to what that nonsense is about. But feel free to rave on...free speech isn't just for the sane.

Deleted--will not engage in Ad Hominems with Link

Autopapdude wrote:Scrappin, he's one of the lucky ones who has good insurance. For the folks who don't, they don't have his privileges. He gets it all handed it to him, and then begrudges people trying to save money,

It isn't thru luck. It isn't a privilege. I begrudge no one. I choose not to buy meds online. If others do, fine. I certainly wasn't suggesting cinco change his practices. He asked me what I do. I told him.

The fact that you--once again--didn't follow the gist of the conversation doesn't change any of that. Is English your second language, maybe?

This has been a really busy forum, lots of hot buttons pushed. I would like to clarify a couple of things for Julia from a few pages back.

The purpose of FAXing my RT in a month is to share my leak history for that month (although the AHI and summary data will be included so yes, the compliance confirmation will be there). I have Encore Pro and I have been monitoring my own data regularly. Before I established the current relationship with my RT I adjusted my pressure upward slightly and I am the one primarily responsible for the quality of life I am now experiencing--I did the right stuff. My ability to do that is directly because of this forum and I am forever grateful.

I am using a Swift LT for Her. As acknowledged by my RT my leak profile is not ideal. It's something this forum has jumped all over earlier. I've managed to take care of the large leaks the majority of the time, but the overall is not yet ideal and may never be with the nasal pillow. Almost certainly this is due to mouth leaks. At the same time my AHI is consistently below 5 now, and most importantly, I feel pretty darn good. On that basis we are both keeping an eye on the data. When it comes time to get another mask in a few months we're going to discuss whether that should be a full face (ideally with nasal pillow--trying to stay away from the bridge of my nose).

What's feeding our current decision to stay as is for now is the ease with which I sleep in the current mask and, again, the fact that I'm alert during the day with an AHI most recently running from 2-3. I am very satisfied not to change anything for now. I expect to check out a full face mask sometime in the future, but my current routine I can easily imagine going through life just like this, the rest of my life. Sleeping in my current equipment is a snap. That is nothing to scoff at, even if it turns out eventually to be the right thing for me to go to a FFM.

I am very interested in managing my own health. I'm learning all I can about my condition--and I have to say there is value coming both from this forum of users and from the medical professionals I deal with. I am well acquainted with the frustration that it took 6 months from the time I went to a doctor and said, you know, this is real a problem for me, to when I finally knew what was wrong with me and had a machine. I experienced the utter stupidity of a physician prescribing me acid reflux medication over the phone after finally seeing my sleep study (note: maybe I do really have that too, who knows) but not realizing I was already on CPAP for a week. However, I am not ready to throw everything that comes from the medical community out the window--I'm just not handling the whole shebang over to them and abdicating my brains, that's all.

This is what I mean by what I consider a collaborative relationship with my RT. I hoped this post clarified my personal position. Regarding software, at the time I filled that in my profile all I had was the smart card and the machine. I'll fix it.

As far as the RX discussion has been about whether a copy of an RX is valid or nor depends on the "class" of item or drug ordered. Sleep therapy supplies and equipment are class II and as such a copy is valid. This being said Medicare requires the DME to have the original for billing purposes. I have not in 25 years ran across an insurance that required the original. If I sent the original RX then what would I have as documentation? Now, if the RX is for a narcotic I am reasonably certain an original is required.

Thanks for the clarification, Scarlett.

And, Leejgbt, thanks for sticking w/us and keeping your cool!

leejgbt wrote:As far as the RX discussion has been about whether a copy of an RX is valid or nor depends on the "class" of item or drug ordered. Sleep therapy supplies and equipment are class II and as such a copy is valid. This being said Medicare requires the DME to have the original for billing purposes. I have not in 25 years ran across an insurance that required the original. If I sent the original RX then what would I have as documentation? Now, if the RX is for a narcotic I am reasonably certain an original is required.

My brick-and-mortar DME here in Florida requires either an original 'script or a fax directly from the Dr. office. They keep it on file for continuing supplies, of course. I also know that brick-and-mortar pharmacies here require originals (or faxed) for meds other than narcotics.

What you say may be Federal law (mixed with Montana?). I'm not a lawyer...and not even a spokesperson for "Ax Gary"! I just know my experience here. Various states impose more stringent requirements, apparently.

My DME company has just about totally demoralized me. Just like another member said above, they dropped off the machine and left. That is about the extent of their involvement with me. They have not provided me with any help adjusting to cpap therapy and, as a matter of fact, they have demonstrated unmentionable evidence of disassociating from me now that I have had the equipment for more than 30 days.

Purpleswan,

Change DME companies. It is not too late. Let your insurance know why. Let the new DME company know why. Hope you find a good one, they are out there.