buying online?

tig26 · Post by **tig26** » Thu Aug 23, 2007 12:54 pm

I just got diagnosed with minor sleep apnea - my rdi is only 14, but I have been exhausted all the time and often have to take 4 hr naps despite already having slept 10 hrs a night. I also wake up 3-4 times in the middle of the night. I did a titration study which got my rdi down to 2, and left me feeling much better the day after.

I have heard horrible things about Apria, so I decided to contact SleepQuest even though they said the insurance would only cover the cpap 60-40 with them. Because my rdi is under 15, they say they need an LMN in addition to my prescription.

My question is whether I should continue through SleepQuest or consider just going it alone without insurance coverage online (cpap.com?). The cpap.com prices looked quite reasonable, such that I might be able to get a join cpap/humidifier and mask/tubing for only about 600. I am wondering if this would be worth it considering I would have to pay at least 40% of the price my DME gives me anyways. Does anyone have experience ordering from online companies? I can afford the couple hundered dollars, but is it a mistake to skip my insurance on this?

Thanks from a newbie

msheda · Post by **msheda** » Thu Aug 23, 2007 1:02 pm

40% being based on them being out of network?

Call your insurance and check,but they should cover your online purchase just like they would an out of network as well. Just takes some negotiating and not accepting, We wont cover that for an answer....

luneman · Post by **luneman** » Thu Aug 23, 2007 1:05 pm

DME pricing is inflated dramaticly. Your % is likely to be the same or more than an out right purchase, and you are likely to get a bare bones unit without the features you want or need.

DeltaSeeker · Post by **DeltaSeeker** » Thu Aug 23, 2007 1:16 pm

If your insurance will cover in full if you order from Apria rather than SleepQuest, the heck with their reputation. I think they suck too but I had to get my equip from them to have it covered - but I STILL got what *I* wanted - just had to raise a holy stink about it.

I did go to a different DME for my new Hybrid only because Apria doesn't carry it and wouldn't order one for me. So I told on them to my insurance provider

I got me my Hybrid (and paid for 100%) - that's all that counts!!!

roncron · Post by **roncron** » Thu Aug 23, 2007 1:29 pm

I never even bothered to call the DME that my ENT doctor recommended when he wrote me the Rx for cpap. I'd read some horror stories about DME's on this forum and elsewhere, so I just decided to take matters into my own hands and buy my gear direct from cpap.com. Their prices and service were great.

It is likely that my insurance will reimburse part of my expense (I haven't submitted the paperwork yet, I was busy getting married). I'm not counting on getting more than 25-40% back from them. But even then, my total outlay will have been less than the out-of-pocket expense of many folks who go through DMEs.

From all of the stories I've read here about DME's, I have come to perceive them as expensive middlemen (or "middlepersons"?) who jack up the prices because your insurance rather than you is paying most of the cost.

I personally don't have much sympathy for health insurance companies - many of them try to boost their profits by purposely screwing their customers, not paying claims when the customers have major health issues.

Yet, I also strongly oppose medical providers (like DMEs) overcharging insurance companies for things that are available much more cheaply, such as cpap machines at cpap.com. The result of overcharging insurance companies is ever-rising premiums, which makes it harder for small businesses to provide health insurance to their employees, and makes it harder for families at the low end of the income distribution to have any sort of health care coverage.

Whoa! That was a major rant, there. Sorry for getting off topic. I hope some of you found it entertaining, though.

Guest · Post by **Guest** » Thu Aug 23, 2007 1:57 pm

Talk to your insurance provider first.
Ask them if they will reimburse YOU for out-of-pocket purchases. (particularly at "in-network" rates, since many providers will consider their members that way)

This is what I did:

Found out they would reimburse me.
Purchased from CPAP.COM on my credit card. (also uploaded a scanned copy of my prescription to them)
Received equipment and the invoice from CPAP.COM.
Made out an invoice TO my insurance provider as the party being billed, FROM ME as the billing party. (used the description and codes from the CPAP.COM invoice to make mine almost identical)
They (insurance) then sent me a check for 80% of my equipment purchase. (in-network rate)

Be sure to do the math. In many/most cases, you can purchase a better machine (of your choice) for what copays and deductibles would be from the over-inflated prices from a brick and mortar DME. At least that's how it came out when I got my stuff in April of 2005.

I've never had any regrets about the way I did my CPAP equipment purchases.

Den

oceanpearl · Post by **oceanpearl** » Thu Aug 23, 2007 2:05 pm

I wonder if anyone here ever considers the "brick and mortar" issues of dme's. They provide a service, a physical location, trained technecians and home delivery service. You just have to imagine that if the online sellers had all these expenses, their prices would be in the same range. EVERYTHING IS CHEAPER WHEN PURCHASED ON THE INTERNET!

A friend of mine whose wife is a r/t just finished r/t school a few months ago and was offered what I consider a nice signing bonus by a Vegas hospital. He dsaid that all the people in the class had offers.

There are poor dme's out here , but it's nice fo me to be able drive a couple of miles to the local Apria office to replace a broken hose fitting, etc. If it hadn't been for the local Aoria branch I would have been without CPAP for several days. I called an online company and they couldn't identify the part that I needed. It was nice to carry the part in and have it identified.

At least once a year I take my machine into Apria and have the pressure checked. I call make an appointment and am usually there about 10 minutes.

If you want service from Apria, you have to browbeat them into giving it to you. I have seen people here that said that they couldn't get a Hybrid mask from Apria. I got one from them after going to the local manager.

YOU GOTTA WONDER HOW ALL THE DME BASHING GOT STARTED HERE!! IT COULDN'T BE THAT FACT THAT THE FORUM IS PROVIDED BY AN ONLINE RETAILER, COULD IT??

roncron · Post by **roncron** » Thu Aug 23, 2007 2:17 pm

oceanpearl said:

I wonder if anyone here ever considers the "brick and mortar" issues of dme's. They provide a service, a physical location, trained technecians and home delivery service. You just have to imagine that if the online sellers had all these expenses, their prices would be in the same range. EVERYTHING IS CHEAPER WHEN PURCHASED ON THE INTERNET!

These are all good points.

YOU GOTTA WONDER HOW ALL THE DME BASHING GOT STARTED HERE!! IT COULDN'T BE THAT FACT THAT THE FORUM IS PROVIDED BY AN ONLINE RETAILER, COULD IT??

No, I don't think it could. Except for a few administrators, who do not appear to censor anyone's posts, hardly anyone here is affiliated with cpap.com. I can't imagine that people who relate their negative experiences with DMEs on this forum are influenced by a desire to boost the profits of cpap.com, or that people fabricate negative stories about DME's to get people to buy more gear from cpap.com. And, like you, plenty of people have shared stories of their positive experiences with DME's.

Again, sorry for off-topic.

oceanpearl · Post by **oceanpearl** » Thu Aug 23, 2007 2:23 pm

Having had my share of problems with Apria, I never said positive.
It's just the fact that they are a for profit business and I can think of very few for profit business that I haven't had some sort of problem with. But they are better than than not having a local dme location. I have found that if I go into Apria with a good attitude I get better service.

msheda · Post by **msheda** » Thu Aug 23, 2007 2:31 pm

oceanpearl wrote: I have found that if I go into Apria with a good attitude I get better service.

That would apply to most any purchase / service transaction.

However, I must say, that our hosts here have been the easiest part of getting going. This is after waiting 14 days to get back the sleep study from the sleep center (please dont tell me something just got ready when it has a timestamp of 3 days ago) to waiting on the Dr's office to verify that they got the fax (which never happened, I drove over there with my copy of my sleep study in order to get the script written) (another reason to ask for your paperwork... others tend to lose it, or at least lose mine). Then were talking about we will fax it tomorrow... (I'm leaving tomorrow night for 2 weeks, we have 40 minutes to get this done so that I can have the machine with me when I travel).... one frustration after another. Then called CPAP... yup.. we got the fax, yup, we got the orders, nope, we are out of stock on 1 item, yup... we have the alternate item in stock... yup... it will ship out today for delivery tomorrow. And they were the friendliest to deal yet thus far also.

BTW... You can run a click and mortar store, still make money, still keep your customers happy, and still have a great price...I did it for several years. Bottom line is, if you treat your customers right, don't screw them on price, then you'll survive and people will talk about how good you are. Let them catch you screwing them once (and let's face it, we see the same machine that the DME was billing 3500 for online at 1200, we start asking why we didn't get kissed... ) and they will talk about you to everyone they know.

tig26 · Post by **tig26** » Thu Aug 23, 2007 3:11 pm

Thanks for all the responses!

It seems pretty clear to me from talking to my DME and Insurance provider that buying online would be cheaper overall. I guess the question is if it's worth it to pay a little bit more to have the local DME available.

And after talking to my doctor/insurance rep person I would definitely be going with SleepQuest over Apria.

Guest · Post by **Guest** » Thu Aug 23, 2007 3:29 pm

The "DME bashing" probably occurred because they did it the old-fashioned way.....they earned it.
(to paraphrase the old Smith-Barney commercial)

I've never actually used a local DME for equipment purchases......because I checked them out BEFORE I made my decision to buy online. Just because they're "local", doesn't mean I owe them a thing.

I could get newer, higher-end equipment from CPAP.COM than the locals.

I have premiums withheld each month from my paycheck for my group policy. WHY WHY WHY should/would I make them pay more for my equipment then they should have to......in other words, why make them WASTE my premium dollars??? It's MY money, dammit! Especially when I know that I would never use the local DME anyway......and for WHAT?

I can read.....I can figure out MY therapy better than my doctor could.

As soon as I found out I had sleep apnea, I went online to find out as much as I could about it.....including the equipment. I also looked at a number of online suppliers to check prices and particulars about equipment.

In all honesty, I had purchased all of my stuff from them BEFORE I started reading this forum.

What sold me on CPAP.COM was this part of their website:

https://www.cpap.com/aboutUs.php

I read it and each of their profiles (when you click on their picture) and knew without a doubt that this was as fine a bunch of people as I could ever deal with.

They're a "class act". AND, I think they honestly care about US.

Den

Slinky · Post by **Slinky** » Fri Aug 24, 2007 5:55 am

oceanpearl wrote:I wonder if anyone here ever considers the "brick and mortar" issues of dme's. They provide a service, a physical location, trained technecians and home delivery service. ....

.... There are poor dme's out here , but it's nice fo me to be able drive a couple of miles to the local Apria office to replace a broken hose fitting, etc.

.... If you want service from Apria, you have to browbeat them into giving it to you. I have seen people here that said that they couldn't get a Hybrid mask from Apria. I got one from them after going to the local manager.

YOU GOTTA WONDER HOW ALL THE DME BASHING GOT STARTED HERE!! IT COULDN'T BE THAT FACT THAT THE FORUM IS PROVIDED BY AN ONLINE RETAILER, COULD IT??

1] Yeah, I have. My CPAP DME does NOT provide delivery service!!! Its a 3 state wide "chain". My 02 DME does provide home delivery service and they cover only a portion of our state, much smaller outfit than my CPAP DME. My CPAP DME's RT is either dumb as a rock or a liar. I suspect she is both. Their EMT is better to work with than their RT!!

2] My CPAP DME doesn't carry "parts". I had to fight w/them to get them to order the nasal cushion that Medicare will pay for every 30 days when the cat punctured one of my cushions. They tried to tell me that Medicare would NOT pay for them and even that you couldn't get just parts but had to get a whole new mask. I had to find the HCPCS code for the darn cushion and rub the DME's nose in it.

3] Why in the devil should I have to fight w/my local CPAP DME to get the "service" they supposedly deserve higher prices for their equipment for?? If they are getting paid higher prices for "service" then they darn well outta provide it - and WITHOUT A FIGHT!

4] I have Medicare and good secondary insurance so to this point I've not purchased anything from our host. That doesn't mean I sure don't appreciate them! Not just for this forum but also for the ease of information provided at their "online store" site for the various equipment, masks, etc.

Are there good local DME's out here? Yep, darn right there are. My 02 DME is GREAT. I now get my CPAP supplies from them. They are a lot closer to me than my CPAP DME so I pick supplies up at their store as often as they deliver. If I'm going their way I pick up, otherwise they deliver. They haven't lied to me yet. I can't say that for my CPAP DME. My only tie to my CPAP DME is finishing the capped rental for my CPAP, then they are history!!! Except for me to bad mouth them every chance I get!!!!

And, yeah, I have bought TWO autoPAPs online. A brand new RemStar Auto w/C-Flex, complete, including humidifier and BOTH manuals at yahooauctions when they were still in business (couldn't pass up $100 cheaper or I would have gone w/cpap.com) and then when the opportunity came up for a used Resmed S8 AutoSet Vantage, complete, w/only 505 hours on it I purchased it from a forum member since I prefer the Resmeds. My son in law now has the RemStar.

Would I have bought a second or backup xPAP out of pocket from a local DME?? Uh uh. Not unless they would meet cpap.com's prices I wouldn't!!!!

mindy · Post by **mindy** » Fri Aug 24, 2007 6:30 am

Good morning, folks!

I think there are as many experiences with DME's as there are numbers.

Mine was very helpful ... met with R/T immediately after sleep lab and went home with machine the same day. She had already gotten insurance authorization before meeting with me, helped me with fitting mask and explaining various things. She set up my machine and left the set up instructions with it. I asked about software and she said I could bring in my card anytime and she could download and show me what's happening.

I'm *very* lucky to have excellent insurance. What I hadn't realized beforehand was that the costs are on-going (regular replacement masks, replacement chin straps, replacement hoses, etc.). My DME has a phone reminder call every 3 months to check on what I need. She also provided me with a one-page summary of their recommended cleaning instructions. And they deal with the insurance company. I can walk in any time to see if she is free.

That said, I wouldn't hesitate to use on on-line vendor such as cpap.com . However, with my insurance and a good DME, it's easier to stay where I am. If I want a special mask, then I go on-line and order one on my dime.

I wish everyone had a good experiences like this. I realize that there are some of you who have had a very difficult time. So like many other things, it comes down to experience and trying options. I don't mean to sound breezy about it .... if I had some of the problems I've read about I'd be fuming, too.

Mindy

Slinky · Post by **Slinky** » Fri Aug 24, 2007 7:33 am

What all this goes to show is that it is to a person's advantage to educate themselves BEFORE accepting ANY xPAP equipment.

And that means learning and KNOWING your DME coverage with your insurance company(ies), DISCUSSING your xPAP needs w/your sleep doctor, COMING TO AN AGREEMENT on which xPAP the doctor is willing to script, SHOPPING the local DMEs contracted w/your insurance, PRICING that equipment online AND w/the local DMEs AND getting a good feel for just what any of the local DMEs are going to do for you, how well they will work w/you, how comfortable you feel w/them.

buying online?

buying online?

reply to oceanpearl