Insurance paid for 3 machines!

[glassman]

I have insurance with one of the major companies and they contract exclusively with one DME (the one usually mentioned here).

I was diagnosed with severe apnea last year and the doctor prescribed a CPAP. I got a tank Respironics CPAP with humidifier; no other bells and whistles. I tried it for a month or so; told the doctor that I wasn't feeling any better. He said "let's try a BiPAP" and sent off the new prescription. Later, I called the DME to see if I was getting one with data download. They said that they had such models but could only furnish me with one if the doctor wrote it on the prescription. I called the doctor's office and left a message about this. I got a callback from a nurse who explained that it's the (sleep) clinic's policy not to "support" (I can't remember exactly the term used) data download, even back to the clinic. I asked if this meant that I would have to get another sleep study to monitor my progress. She said "not necessariy, they could get information in an office visit and having me answer questions". So, I ended up with a Respironics M BiPap Plus (no data download). After a couple of months, I did go back to the doctor and we discussed my progress. It was clear to me that nothing could be diagnosed through such an interview. As the last straw, I said that I'd like a prescription so I could get a travel machine (but really I wanted one with download); the doctor said that I would need to tell him which travel machine I wanted and they would then approve the machine and write a prescription for that machine...

Therefore I changed doctors and went to another sleep clinic. I explained what I wanted: a machine with download capability. The doctor wrote a prescription for a BiPap with download and for the DME to download two weeks of data and fax the results to the doctor.

It took a month, but I finally have the M BiPap Auto. So the insurance company paid for all three machines in full. When I called them to ask if they would pay for the third one, they basically said, sure if the doctor prescribed it.

The DME didn't seem concerned about it either. They were out of stock of the humidifier. I said that it wasn't a problem because I already had a M series humidifier (from the second machine). RT said that I should get it as a backup and they would mail it to me tomorrow.

[lvwildcat]

Finally a DME that caters to the patient and their needs. Sound like a keeper.

[GumbyCT]

Finally a DME that caters to the patient and their needs. Sound like a keeper.

Actually it is the DME that IS making out here, Surprise.

[Wulfman]

glassman,

Do you actually HAVE all three of the machines?

Den

[glassman]

Yes, I physically have and own the three machines.

[Goofproof]

And some wonder why our Insurance rates are so high, profit for everybody Jim