Round One with DME

Favabean · Post by **Favabean** » Mon Jan 28, 2008 8:26 am

Well, I now understand what you all mean about un- or ill-informed clinics, doctors and DME's. As I mentioned in a previous thread my DME first tried to tell me that my doctor specifically requested the S8 Compact. After I made noise they replaced it with a Remstar Plus, which I have since found out is no better from a data perspective than the S8 Compact.

So this morning, I called the sleep clinic and asked if they had specifically requested a model of machine for me. The woman assured me that they never do that. The recommendation is simply CPAP with pressure of X. So I explained to her what I was trying to do, she said "You have to be real careful of that stuff you read on the Internet". I assured her that I was looking for a way to monitor my own therapy with my doctor. She said she understood and that she wasn't sure such a machine even existed. Then very abruptly she said "Hold on there is a guy here". When she comes back, it turns out the ResMed rep has just stopped in. He assured her that there was a model of the S8 that was capable of the data collection I was interested in. Kind of sad that the sleep clinic didn't know that, although in her defense she is a receptionist and not a technician. She apologized (since she is the one who put me with this particular DME) and said they should be able to accomodate me -- the ResMed rep assured her they "could" provide me with what I was looking for. She said if the DME didn't accomodate me that I should call her back and let her know (they send a lot of business to this DME) -- and that ultimately, I could get my doctor to write a prescription for a specific machine and then the DME would have no choice.

SO.... Next call was to DME(btw this is a regional DME, not a national). I explained to customer service what had transpired and what I wanted. Immediately, I get escalated to second level. I again explain. She wanted to know "why I wanted that stuff". I told her that it was so I could keep track of my own therapy with my doctor. I fully intended to provide my doctor with the data and ensure my therapy was working as prescribed. She informed me that this required supervisor approval. I said, that's fine, but tell your supervisor that if they don't approve it, I'm prepared to return the equipment and take my business elsewhere. She assured me she wasn't disagreeing with me, but that she couldn't approve it herself. I was promised a call this afternoon with an answer.

Now to me -- given the cost difference between the two machines -- and the fact that according to the bill, they charged my insurance company close to 5 times what I could buy it for online -- it seems like a no brainer. Why risk losing a lifetime of selling supplies over what is probably a 60 or 70 dollar difference.

Patrick A · Post by **Patrick A** » Mon Jan 28, 2008 9:22 am

If it were me I would do my research get a copy of my scrip, get prices.....then I would call my insurance company and speak to them about it.
Then ask them if you can get them to pay for one from cpap.com I think they would be willing to atleast look into it for you.

GumbyCT · Post by **GumbyCT** » Mon Jan 28, 2008 9:30 am

Favabean wrote:Now to me -- given the cost difference between the two machines -- and the fact that according to the bill, they charged my insurance company close to 5 times what I could buy it for online -- it seems like a no brainer. Why risk losing a lifetime of selling supplies over what is probably a 60 or 70 dollar difference.

Exactly - I don't think many DME's have yet accepted an educated client. Most seem to want to play "DME says" - should it all be about control?

DreamStalker · Post by **DreamStalker** » Mon Jan 28, 2008 9:36 am

GumbyCT wrote:
Favabean wrote:Now to me -- given the cost difference between the two machines -- and the fact that according to the bill, they charged my insurance company close to 5 times what I could buy it for online -- it seems like a no brainer. Why risk losing a lifetime of selling supplies over what is probably a 60 or 70 dollar difference.
Exactly - I don't think many DME's have yet accepted an educated client. Most seem to want to play "DME says" - should it all be about control?

It's called greed!

mindy · Post by **mindy** » Mon Jan 28, 2008 10:32 am

It seems to me that there are chasms between docs and DMEs and DMEs and patients and docs and patients in the area of sleep apnea.

I don't think all of us who use data capable machines let their docs know about it and some docs don't ask or discuss. DME's existed before xPAP and with the other things they rent/sell, there isn't the necessity to have an educated user. It always takes time for the system to catch up with changes in the patient side of things. The internet has changed things so drastically so quickly, that there hasn't been time for things to settle out.

I'm sure there are incompetent docs, incompetent DMEs and difficult patients .... but I somehow doubt they are in the majority. Many times (in my own experience) the system is just not set up to react to changes and handle empowered patients.

That doesn't help those of us struggling to get help!

Mindy

Wulfman · Post by **Wulfman** » Mon Jan 28, 2008 10:35 am

If you do talk to your insurance provider, ask them if they will reimburse YOU (if you purchase it out-of-pocket). Many/most insurance providers consider their members as "in-network" and will reimburse at about 80%.

If you ask them if they will pay CPAP.COM, they will probably say "No" or consider CPAP.COM as "out-of-network". CPAP.COM includes a form with their shipments and also has all the insurance codes on their invoices.

Den

Favabean · Post by **Favabean** » Mon Jan 28, 2008 10:57 am

w00t! I just got off the phone with DME, they are "special ordering" me the M Series Pro. The made sure to tell me that they don't care this machine normally.

They promised I'd have it by the end of the end of the week.

Thanks again to EVERYONE for your support -- without you guys I would have just blindly accepted what they were telling me!

Now, I have to figure out how I get data side of things working...

sleepycarol · Post by **sleepycarol** » Mon Jan 28, 2008 11:02 am

My doctor has admitted I know more about the data than she does. What I know I learned off from this forum----

I say ----

WAY TO GO GUYS AND GALS!!!!!!!!

Slinky · Post by **Slinky** » Mon Jan 28, 2008 4:42 pm

Buy the EncoreViewer software (or EncorePro) from cpap.com and the necessary cable reader from two_factors.com in HongKong. The cable reader is cheaper there than at cpap.com and only takes about 10 days to 2 weeks to get to the USA from HongKong. ($32 reader and shipping when I bought mine early last spring).

Guest · Post by **Guest** » Mon Jan 28, 2008 4:46 pm

Slinky, can you double check that URL for the smartcard reader? two_factors.com is 404ing on me.

Wulfman · Post by **Wulfman** » Mon Jan 28, 2008 4:58 pm

Here's the one you need......but they're outta stock.

http://www.two-factor.com/shop/index.php?productID=115

This one is a little higher, but in the USA so it wouldn't take as long to get.

http://www.cpapusa.com/item.php?productcode=DT3500

CPAP.COM should also price-match the last one, too.

Den

Slinky · Post by **Slinky** » Mon Jan 28, 2008 5:07 pm

Thanks, Wulfman! I couldn't remember the USA URL and I never seem to get twofactors, two-factors, two_factors straight. Duh.

WNJ · Post by **WNJ** » Tue Jan 29, 2008 7:57 am

[quote="Wulfman"]If you do talk to your insurance provider, ask them if they will reimburse YOU (if you purchase it out-of-pocket). Many/most insurance providers consider their members as "in-network" and will reimburse at about 80%.

If you ask them if they will pay CPAP.COM, they will probably say "No" or consider CPAP.COM as "out-of-network". CPAP.COM includes a form with their shipments and also has all the insurance codes on their invoices.

Den

Favabean · Post by **Favabean** » Wed Jan 30, 2008 6:16 pm

Well -- they told me I would have it by the end of the week, this was after all a "special order" (it sounded like it really put them out to put in such a special order)

If they don't call me by tomorrow afternoon, I'll be calling them. If they give me the run around -- I will just order from cpap.com.

shardebhow · Post by **shardebhow** » Wed Jan 30, 2008 9:06 pm

Fava,
I had the same type of run around. It's amazing as one article that was mentioned via this forum. . .we are trusted to take our own medicine, if diabetic, monitor our insulin and give ourselves injections. . .if high bloodpressure. . take our own pressure with a cuff. . yet, not be able to know about our own CPAP therapy. I really think they like to keep it a mystery because they want control. . . or, people are being diagnosed with apnea at alarming rates. . they see a cash cow.. . .or, a simple solution is just give a basic CPAP . . .and then ask the questions. . .are you snoring. . .did you get up during the night to go to the bathroom. . .ah, answer no to the above. . .voila. . your apnea is under control. . yeah, right.

Now I feel better.

Round One with DME

Round One with DME

Re: Round One with DME

Re: Round One with DME

Sounds like my runaround

Machine