Arrggg! DME angst!

[Snooze_Blues]

I was flipping out yesterday about finding a new DME, then I realized I just didn't have it in me to swim upstream by ignoring the sleep lab's DME recommendation, so I agreed to give the "regular" DME a try and told the sleep lab to send them my prescription.

I got a call today and was reminded why I was flipping out the day before. I selected a new office, but with the same DME business, so I wouldn't have to speak to the same RT I dealt with before. Damned if the same one didn't call me and start interrogating me about my "special order" equip requests. Same old, same old. "Why did I need that CPAP? They only carrie this one. Why can't I use the integrated humidifier they carry instead of the F&P? No one ever mixes and matches. This is all so unusual."

Patronizing. Authoritarian. Unpleasant. *sigh*

I was so worked up that I sat down and wrote a letter that I planned to send to my sleep lab in case they are not aware of the tactics at the DME they recommend. Maybe I'm naive. Maybe they know. Maybe there is nothing they can do. Maybe I'm just a whiner. Maybe I shouldn't even send this letter. Maybe rocking this boat while still adrift in the depths of CPAP ignorance just puts a target on my back. Maybe this would be counter productive. Maybe I'll wait until later when they know me better... or I'm visiting another sleep lab and not laying there vulnerable in my sleep during my next titration... Maybe I'm paranoid... Maybe I've lost it...

What do you think? (see: letter below)

< clip >

Xxxx,

( Long, whiny letter deleted. )

[Perchancetodream]

I appreciate where you are coming from, but the reader of your letter won't. Mostly because it is way too long and they probably won't even read it all.

First, I suggest you write down exactly what your purpose is in writing to the sleep lab. Is it to advise them of the difficulties you have encountered attempting to fill their prescription? Is it to have them investigate the DME that they are recommending? Is it to have them issue a prescription that specifically requests the equipment you want? Whatever it is that you want them to do you should clearly state it in your first paragraph.

Second, stop apologizing for your apnea. They know you have it, and either they will make allowances for it or they won't, but it doesn't serve your purpose to remind them of it.

Finally, try to keep your emotions and interpretations to an absolute minimum. Just calmly explain that the DME is refusing your request for the equipment that you feel will enable you to be 100% compliant. They are making it very difficult for you to get the service you need.

If I were you, I would want the sleep lab to prescribe the machine and humidifier that you want by name and model number. Get a copy of it for your own records. And then tell the RT that if it is to inconvenient for them to provide the equipment you need that you will find a DME who is more interested in providing the service you want from a DME.

Always keep in mind that it is your health that you are fighting for: you have every right to the best treatment that is available.

And come here to vent as often as you wish.

Susan

[sleepycarol]

I agree with Perchancetodream. Too long of letter and they won't get past the first paragraph and it will end up in file 13 (trash can). If you come across as always being the apologetic one they will tend to lean towards your being at fault instead of getting the issue resolved it will more than likely be shelved.

Keep your letter short as possible with only the facts!! You do NOT want your request to get so lost in the rambling that all else is forgotten!! You want your request to be SEEN and READ!! You want to sound as pleasant and upbeat as possible with the impression given that you are wanting them to help you to arrive at a solution that is satisfactory to both of you.

Tell the exact problems in simple terms, what you would like done about the situation in simple terms, and don't give them wiggle room to do less than what you ask or need.

[Snooze_Blues]

...
And come here to vent as often as you wish.

Susan

Excellent, excellent advice. Thanks for "hearing me" and thanks for the "venting" invitation. Probably best to vent here than complicate relations with the sleep lab and DME.

The sleep lab had already sent the prescription to the DME that specified the exact machine and humidifier I wanted and the STILL they called me to change it! That's what sent me for a loop.

I have an update, and it's good news. I received a call from the DME (new office, new RT) confirming they "special ordered" the equip as prescribed and recited the proper machine and humidifier.

Hopefully, they won't renege on waving the co-pay. That will be a big drag, another flip-out, and a new battle.

I can usually be objective, but I've never had to fight for medical services or supplies before, so this is new ground with new "venting" required. I appreciate any audience I might muster. Venting is so lame when no one is around to hear it.

[Snooze_Blues]

If you come across as always being the apologetic one they will tend to lean towards your being at fault instead of getting the issue resolved it will more than likely be shelved.

How about that, I'm playing the victim, aren't I? How did that sneak up on me?

Thanks for the good advice and the reality check. On one level, it's just business, and I should treat it as such regarding my communications. Direct, concise, and short.

[Guest]

I have an update, and it's good news. I received a call from the DME (new office, new RT) confirming they "special ordered" the equip as prescribed and recited the proper machine and humidifier.

I really, really hope they don't use the same trick on you that the did on me a few weeks ago. The RT called me up and said that her boss had authorized her to order me a REMStar Pro M series, and even quoted me the model number. When she showed up to deliver the machine, it was a non data capable REMStar Plus.

Long story short, I dropped that DME, ordered overnight from CPAP.com and filed for reimbursement from my insurance. I hope they pay for the machine but I won't be surprised if they don't.

Just be aware that there may be more tricks. I just don't want you to get surprised. Good luck!

[Perchancetodream]

Come to think of it, my DME did the exact same thing to me. I refused to accept the Plus model and waited for them to order the Pro that I originally insisted upon. Took a few days, but I got the right machine.

I am so grateful to the posters on this forum for steering me to the right machine from the very beginning. Of course, it means that the DMEs are giving all of those other machines to non cpaptalk members...

Susan

[sneezey822]

i too know where you are coming from. i have been using CpAp since September and now will be using a new DME. i went through exactly what you said in your letter, except it was not for the machine. it was for a mask. It always seemed like an inconvience to them. They made me feel awful. Also, their receptionist told me that maybe cpap is not for you. My doctors office flipped out over that one when i called them. Mind you I was only on cpap 6 weeks. They are not medical doctors, they are a vendor that has medical equipment. They should not question a doctors prescription. i like you felt the same way. Being sleep deprived does not help, how we see things either. i questioned, myself to think if it was me. it was not me. it is how they operate. i think they get reimbursed the same amount of money for the m series plus and the m series pro. The plus only shows compliance the pro has the smart card. Duh, which one would they want if they had sleep apnea. just compliance or one that shows apneas, compliance etc. The wording sounds the same. i just did another sleep study 2 nights ago, for bi level machine. They have to take the cpap back. A....will not be my dme next time around.

[engrdad]

Snooze_Blues,

While I agree with the comments, I appreciate you writing the letter. As I have just last night finished my second sleep study, it helps prepare me for the 'potential' of getting the same flack that you received and helps me prepare, just in case. I have only joined this site a few days ago, and already feel very informed. As a matter of fact, I seemed to know more than the sleep lab technician last night about available machines. She did not know about AutoCPAP machines and said the only machines that give exhale relief are the Bi-PAP's. She insisted that no CPAP machines reduce pressure on exhale (did not know what C-flex or A-flex meant).

I believe I am in the Immersion stage of the seven stages of CPAP that Mike Moran writes about on this site. Believe the other word used for it is obsession type search for knowledge. Congrats on getting the machine you wanted. Let's hope we all have the same luck.

Barry

[linuxgrl]

Come to think of it, my DME did the exact same thing to me. I refused to accept the Plus model and waited for them to order the Pro that I originally insisted upon. Took a few days, but I got the right machine.

It's so upsetting to me but I've heard a number of stories on this board that are just like ours. I can't believe it's such a common problem. I wonder if all the DME's get together and talk about ways to trick the patients.

Interestingly enough, I met a former RT at my titration study the other night. She said she'd been in the business for 34 years and just couldn't take it anymore. When the job at the sleep lab came up, she jumped at the chance. She seemed incredibly nice and I wonder whether all these unethical practices were just too much for her. Just a guess.

[Perchancetodream]

Barry, no matter what it is called, I always believed that knowledge was power. When my husband was diagnosed with prostate cancer I learned quickly that the more we know, the better able we are to make the right treatment choices.

I also believe that we bear ultimate responsibility for our own health, so we have an obligation to ourselves and our loved ones to become active participants in our own health care.

Susan

[sneezey822]

i may use cpap site to order too. my doctor said we could use the internet. when i go there next week i will see what he says. i am going to call my insurance and see how that works. my insurance did not buy my machine, it is rented from the dme. i am now going to switch to a bi level machine.

[DreamStalker]

Snooze_Blues,

While I agree with the comments, I appreciate you writing the letter. As I have just last night finished my second sleep study, it helps prepare me for the 'potential' of getting the same flack that you received and helps me prepare, just in case. I have only joined this site a few days ago, and already feel very informed. As a matter of fact, I seemed to know more than the sleep lab technician last night about available machines. She did not know about AutoCPAP machines and said the only machines that give exhale relief are the Bi-PAP's. She insisted that no CPAP machines reduce pressure on exhale (did not know what C-flex or A-flex meant).

I believe I am in the Immersion stage of the seven stages of CPAP that Mike Moran writes about on this site. Believe the other word used for it is obsession type search for knowledge. Congrats on getting the machine you wanted. Let's hope we all have the same luck.

Barry

Yes. There are many of us who go through that knowledge immersion stage.

... and I think the smart sleep health pros know that if we know that they know what we know, then they will know that they can't take adavantage of us because we would know, no?

Hmmm , seems like I've heard that somewhere before.

[FreeLancer74]

Dreamstalker, LOL. You remind me of the Sicillian in Princess Bride.