Update: The DME worked me over

[linuxgrl]

Have you enlisted the assistance of your sleep doctor w/getting a fully data capable CPAP?

I actually did, and he was very helpful. Hence my gleeful first post. The lady at the DME actually quoted the model number of the Pro to me and told me that she would order it that day. Then she brought the Plus over today. My eyes just about fell out of my head when I saw it.

Generally, the insurance company is NOT billed the first month whilst your compliance in use of the CPAP is established. Then it is usually late into the second month at the earliest that they get around to billing your insurance.

Didn't know that! It's definitely late into the second month for me - I've had this AutoPAP since Sept 19. Hmmmmm... If I could start fresh with billmyinsurance.com that would be great.

I'll reiterate what Guest suggested: Step 1: Call your insurance company and ask what $$ they reimburse for EO601 Cont Airway pressure device. Ask them explicitly what they PAY per month for the rental of an E0601.

I called today but it was very close to 5 and the girl on the phone wasn't real helpful. She said it was covered at 100% after a $100 deductible.

[Country4ever]

Good luck getting what you want and need linuxgrl,
Mostly I just wanted to say to not be too hard on yourself. Sometimes its just too hard to always stand up to people when we need to. But its a learning process, and each time we learn how to be better/stronger the next time. It sounds like you're doing good and working through this/around this. Good luck!

[linuxgrl]

do a search on "reimburse" and my username......I've posted it many times in the past.

Good advice! And I have BCBS insurance so hopefully they'll be cool about it.

Your (former?) DME is another money-grubber who puts their profits above your therapy. These are the ones you want to run from.

Yup. I'm running all right.

Question is, can I use the Plus machine tonight? Will they take it back tomorrow once it's been used, or am I kinda stuck with it? Ideally I'd like to wait till the new machine arrives before I dump it back in their laps.

[linuxgrl]

Good luck getting what you want and need linuxgrl,
Mostly I just wanted to say to not be too hard on yourself. Sometimes its just too hard to always stand up to people when we need to. But its a learning process, and each time we learn how to be better/stronger the next time. It sounds like you're doing good and working through this/around this. Good luck!

Thank you so much. I really, really needed to hear that, after the day I've had. What a sweet person you are. *hugs*

[Wulfman]

do a search on "reimburse" and my username......I've posted it many times in the past.

Good advice! And I have BCBS insurance so hopefully they'll be cool about it.

Your (former?) DME is another money-grubber who puts their profits above your therapy. These are the ones you want to run from.

Yup. I'm running all right.

Question is, can I use the Plus machine tonight? Will they take it back tomorrow once it's been used, or am I kinda stuck with it? Ideally I'd like to wait till the new machine arrives before I dump it back in their laps.

BCBS is supposed to be "one of the good ones" to get reimbursement from.

I don't know what to tell you for sure about the last one.....
You might want to check that out with your insurance, too.

Den

[sleepycarol]

Good luck on making the DME take the Plus back. What I did was I took my Plus back and dumped it on the counter and told them I refused to keep it as it wasn't the machine the doctor had ordered for me. I had used it for a couple of weeks before I found out through this forum that it was not what my doctor had ordered. They will probably try to bully you into keeping it but get mad and don't back down.

[linuxgrl]

Just to be safe, I think I'll skip the CPAP for a night, so I can give them back the Plus all fresh and new. (not that they deserve any favors) It'll be rough, but I have a recliner I can sleep in. My new CPAP should be here very soon anyway. I did the next-day shipping even though it was $35. It's worth it.

Thanks for warning me about that, sleepycarol. I will do my best to toughen up for a good fight before I get in there. I usually have no trouble fighting with someone over the telephone but when this woman was in my house pushing me around, somehow I just kind of crumbled. It was more the idea that she was taking my beloved AutoPAP and leaving me with no CPAP at all that really scared me.

[sleepycarol]

I called my insurance company prior to returning the PLUS and had their blessing on changing DME's. Make sure you call the insurance company and clue them in on what is going on so that the DME doesn't keep charging you for a machine that you don't have. I don't know if your insurance company has customer service 24/7 -- you might try and if so ask them about using the machine you have (the Plus) and explain you are using it till you get the correct machine. Make sure the insurance company knows about the DME's actions. If enough people complain it might help straighten out some of the DME's. At least we can hope .

Good Luck!!!

[linuxgrl]

I called my insurance company prior to returning the PLUS and had their blessing on changing DME's.

Check!

Make sure you call the insurance company and clue them in on what is going on so that the DME doesn't keep charging you for a machine that you don't have.

Will do. I don't want them to get a dime more than they should.

I don't know if your insurance company has customer service 24/7 -- you might try and if so ask them about using the machine you have (the Plus) and explain you are using it till you get the correct machine.

They closed at 5, sadly. But I'll be okay, I promise.

Make sure the insurance company knows about the DME's actions. If enough people complain it might help straighten out some of the DME's. At least we can hope

I'll give it a try. It just seems like the whole system is broken. If the DME loses money by giving the patient the machine that their doctor prescribes, then of course they're going to fight it tooth and nail. *sigh*

[RosemaryB]

I called my insurance company prior to returning the PLUS and had their blessing on changing DME's.

Check!

Make sure you call the insurance company and clue them in on what is going on so that the DME doesn't keep charging you for a machine that you don't have.

Will do. I don't want them to get a dime more than they should.

I don't know if your insurance company has customer service 24/7 -- you might try and if so ask them about using the machine you have (the Plus) and explain you are using it till you get the correct machine.

They closed at 5, sadly. But I'll be okay, I promise.

Make sure the insurance company knows about the DME's actions. If enough people complain it might help straighten out some of the DME's. At least we can hope

I'll give it a try. It just seems like the whole system is broken. If the DME loses money by giving the patient the machine that their doctor prescribes, then of course they're going to fight it tooth and nail. *sigh*

[linuxgrl]

I was helping an elderly relative, who's 82 years old.

They nearly all seem to be like this. It's hard to believe, but it's true.

Ugh. I couldn't live with myself if I did something like that to an 82 year old woman. Aren't these people supposed to be in the medical profession in order to help people? This whole situation pisses me off so much.

[mindy]

Hi linuxgrl,

I wish you good luck in getting this untangled! I was about to write what Rose just did -- that DME's don't lose money, they may just make a little less (of sometimes obscene) proft! We seem to be living in a world that has a lot (certainly not all) of greedy companies.

I know exactly what you mean about the problem when someone is actually in your house ... it makes it that much harder to handle; and that's what they count on.

Rose's elderly relative is darn lucky to have her to help

Hopefully you can get BCBS to agree to the switch (I'll bet you're not the first) and can get the equipment you need for your therapy.

I'll be thinking of you and please keep us posted!

Mindy

[DreamStalker]

Sorry if I came off a bit harsh with my replies to your posts yesterday ... just seemd like you needed a swift kick in the butt to stand up for your health.

The DME you are dealing with certainly seems less than honest and definitely values a "few" dollars more over your basic health. Some of them are worse than used car salesmen. But I guess if we can't believe what the leaders of our government tell us or even what an archbishop says, who can we trust these days?

Best of luck with your health today and hope all works out for you.

[linuxgrl]

Sorry if I came off a bit harsh with my replies to your posts yesterday ... just seemd like you needed a swift kick in the butt to stand up for your health

No, you're right, I sure did. I'll be the first to admit that I'm spineless.

Last night without the CPAP was absolutely horrible, by the way. I have trouble falling asleep without it now, after just 2 months. And the frustration of the day sure didn't help matters anyway. I was up till 3AM and then overslept and missed my appointment for taking the car into the shop. On the good side - I called the DME to let them know I'd be returning the machine and they didn't put up a fight at all.

[mindy]

On the good side - I called the DME to let them know I'd be returning the machine and they didn't put up a fight at all.

Good for you! It sounds like you just told them rather than asking

Mindy