DME Question

Hi Everyone,

I've been on CPAP for a few months now and the only time I've heard from my DME is when they needed me to send in the SD card at 1 and 3 months for compliance. After reading several posts about DMEs here, I'd like to know exactly what role should my DME be playing in my course of therapy. Is it up to me to keep in touch with them by letting them know what I need, or should they be keeping in touch with me asking if I need anything? This may be a stupid question I've seen my doctor a few times (and he's OK with me playing with my machine!) but he doesn't want to see me again until April 2011. He also told me not to let them jerk me around (or words to that sort)! So, should they be calling me to see if I'm happy with my equipment? Also, I never got any kind of report on the 3 month card reading from doc or DME. Doc read it when I went in last time with the card and gave me a short report. What should I be expecting from the DME?

Thanks, Madelyn

Obviously not much!!! So it becomes up to you to contact THEM for what you want. But then the same holds true for your doctor. If you need help, you need help, so you make the call.

Generally (it can vary from one insurance to another) you are eligible for a new mask every 6 months. A new hose every 3 months (but why bother if you don't need it after you get one extra to have on hand just in case). You'd have to read your CPAP's Users Manual to know how often you need to change the filter(s). They SHOULD check your CPAP's pressure output once a year.

Those download reports are part of your medical records and you have a LEGAL RIGHT to a copy under HIPAA. But be forewarned, they seldom if ever do a full printout, generally they will print out just the one Statistics data page.

Thanks Slinky...I have Medicare so I guess those are the guidelines to follow. I'll make sure to get the extra hose. I already have an extra mask. And, yes, the only reports I've ever gotten were the compliance ones. I did ask for the graphs and they sent me the graph for the one last night recorded on the SD card. Which leads me to believe they don't bother to look at all the info for every night I use the machine! They're probably PO'd that I changed my pressure (on doc's order) myself. My doctor is under the impression that I have the software for my machine and couldn't care less. He was all for it. I have the Encore Pro2.2, but hadn't installed it when I spoke to him about it. Since then I gave up trying to install it. (I plan on getting the EncoreViewer soon, maybe as a Christmas present to myself LOL!)

Guess I will have to start making calls to my DME!

Madelyn

Do not expect any help from your DME regarding installing the software. Most feel threatened by the fact that you have it and will tell you that it is illegal or dangerous to have the software. They Lie. I am not sure whether they are ignorant and ill informed or whether they know they are lying.

If you have no other option than the DME for help you might need a formal prescription from your physician for the DME to help install the software but even that might not work.

a lot of times when it come to software installs... somebody on here either has had the problem and can tell you how to fix it or can dx the problem if you can explain what you did and what you saw.

Your DME should be providing the level of assistance YOU want/need. In the beginning, mine was sending supplies (filters, hoses, masks) at the minimum time limits my insurance would allow. Once I had a spare of the important things, I was getting overwhelmed with extras. So I called and told them I would contact them when I need replacements. And that is what they do now. I have never used them for reading/printing reports as I can do that myself, and my insurance doesn't require compliance data.

I have never heard a DME say it's "illegal" to possess or use the software. Encore Pro software is designed for professional use and not to be sold to individuals. That's a company policy, not a law. I believe they have backed off that policy for the "Viewer" version. I have a "shared" copy of Pro and don't have Viewer.

My doc is delighted that I take an active role. She and I discussed the reports I took in, and she taught me a lot about interpreting them. Yes, under HIPAA you have a legal right to a copy of your records, but they can charge you for printing/copying them.

I highly recommend maintaining a cordial, friendly, professional relationship with doctors and DMEs. Those who must resort to demanding things probably need to change providers (or adjust their own attitude!) Just my two cents...

My DME is fabulous about providing what I need in a timely manner. I also am on Medicare/Tricare and they call me every 90 days and tell me what I am entitled to and ask what I want shipped to me. This time I asked for a 10' hose instead of a 6' one and they said no problem, so it along with the normal filters and 6 nasal pillows are on the way, next week.

Here is my take.
I live with my DME supplier. Even still I asked that he treat me as a normal person and that one of his assistants handle my case. Here is what happened.
Since I know the DME there were a few things out of order. First the DME recommended a company that does a Polysomnography and Tritration at home. It reduced my cost and there was nothing out of pocket. But the company was new and I don't believe they did a thourough job. It took forever to get the reports back and the reports didn't go to my doctor but a doctor I have never seen.

I finally got my S9,H5i, slimline hose and mask. I had done my homeowrk and told the DME exactly what I wanted. Funny thing is even though this no name doctor read my study my original doctor had to order the machine. In the beginning my doctor wrote the script for a 30 day trial. I wondered if he trusted the doctor reading the data. A week later my insurance came back and said that they do not do rentals and set me up with a purchase.

I looked at the charge from the DME. they gave me the same bill they submitted to the insurance. Items such as the slim line hose, head gear,and filter were charged seperately even though I know they come as one unit. (mask with head gear, slim line hose with S9, etc.) I compared the price from the DME to the prices on-line. The DME was about $200 higher on every item and then added a consultation fee even though I came to them and opted out of the in home set up.

On the last visit to discuss my bill, I asked about data and what they send to the doctor. They showed me what they give the doctor. I have the software so I was expecting to see a 20 page document with information on face mask leaks, cluster events. Instead, it was a summary with compliance information and my overall indexes. I could not believe what I was seeing. I asked the RT if they look at the information in the detailed format and provide recommendations. He said that he could not do that and that he only sent the summaries and the doctor would have to make his diagnosis from the summary. I explained to the RT that I have the software and the clinicians manual and that the software can tell you so much more than just compliance information. He gave me that look and changed the subject. Then I turn ed the subject to the new Resmed Quattro FX. He asked me where I got my information as he had never heard of it. I politely reminded him that the company I work for has it corporate offices in Austrailia and that I new "people". I didn't tell him it was from this site that I found out about he new mask. He said he would have to check with his sales department. It was then I asked him to pay me a consultation fee. (It did't work) But long story short (too late) I live with the DME company and I will not be using them again.

So I contacted my primary doctor to check when the follow up will be because I am often out of town on work. He told me the no name doctor would generally set the appointment. I asked my primary doctor to take control of the case and I am waiting on his response.

....I later asked my friend why he was so over priced, He said that it was because they would replace the equipment if something happened to it. I asked if the warranty was from his company or the manufacturer. Hre said it was a manufactures warranty. So I asked him if I would recieve the same warranty if I bought it on line. He's not talking to me right now.

But long story short (too late) I live with the DME company and I will not be using them again.

Slinky wrote: Generally (it can vary from one insurance to another) you are eligible for a new mask every 6 months. A new hose every 3 months (but why bother if you don't need it after you get one extra to have on hand just in case).

I was under the impression this was the case too per talking with 2 DME's now. I called BCBS\IL and was told that they don't have such a policy that it is whatever the DME sets up with you and that as far as they are concerned that I can get masks\parts when I need them. If they feel that I am getting them at unrealistic intervals (ie every couple of weeks) then they will ask for a letter of medical necessity.) I explained this to the DME and they were suprised and their tune changed a little.

I would suggest anyone call their insurance carrier to find out the specifics as to what they can get when.

Our DME knows that we will come back for warranty service, but since they don't 'do' Medicare--
when the time comes: (if not before)--adios