Bad DMEs and Switching Machines

[TiredEngineer]

I'm 27 years old and I've had sleeping problems as long as I can remember. I was finally prescribed CPAP in December, and I was called in for my fitting where the DME gave me a CPAP machine. Although I was smart enough to ask her if it logged performance data (she said yes), I was naive enough to accept the machine she gave me without question. At no point was I given my prescription or asked to choose a machine or a DME.

Two months later I finally met with her to download the data, only to find it recorded compliance data only! I can't describe my disappointment that (a) I was no closer to finding out what is actually going on with me every night, (b) I had been lied to, and (c) I was stuck with the wrong machine. I have slowly come to distrust my DME rep and have accepted that she's only concerned with her bottom line. Here are some of the things she has told me:

"Your doctor prescribed this specific machine." (initially)
"The prescription doesn't specify the name of the machine, but it specifies Thermo Smart." (after I pushed harder. at this point I had still never seen my prescription)
"You need a respiratory therapist to download and analyze the data, or you won't know what you're looking at." (it was just Time Used and Time Complied, charted per day!)
"There are no machines with data logging for your prescription"
"You can't return the machine."
"Even if you stopped using us, no other DME would take you when they found out you returned a machine."
"To stop renting with us, you would have to go to your doctor and fill out an Against Medical Advice statement and have your prescription cancelled."

I now believe that many of these are downright lies, and I feel frustrated and helpless. How do you argue or defend yourself in a field you know little about? The more I pushed to get a different machine, the more she told me "Just talk to your doctor first. Don't try to treat yourself. We won't take a machine back after you've used it." Should I find a new DME? Is it even possible, considering the insurance hurdles? Should I give up and buy online out-of-pocket? And, I can't believe I need to ask this, but how do I MAKE them cancel my rental? I have given up that there is anyone in this situation acting in my best interests... any help would be greatly appreciated.

(My prescription is for CPAP, pressure 7, heated humidifier, lifetime. My machine is a Fisher and Paykel 604.)

[nursedeborah]

I called cooporate office, and told them the kind of treatment I was getting,
and also had documented all that was said to me. I filed a verbal complaint,
and then also sent one via e-mail.

Now they are calling me daily to see if I am ok, if my equipment is working,
and they now deliver to me, and I have my own in home RT.

Go for it!

Debbie

They are liable if anything does happen to you!!!

[DreamDiver]

I now believe that many of these are downright lies, and I feel frustrated and helpless. How do you argue or defend yourself in a field you know little about? The more I pushed to get a different machine, the more she told me "Just talk to your doctor first. Don't try to treat yourself. We won't take a machine back after you've used it." Should I find a new DME? Is it even possible, considering the insurance hurdles? Should I give up and buy online out-of-pocket? And, I can't believe I need to ask this, but how do I MAKE them cancel my rental? I have given up that there is anyone in this situation acting in my best interests... any help would be greatly appreciated.

Glad you could join us, TiredEngineer. Welcome.
Absolutely call corporate and complain. I agree with Debbie. Yes - in fact - they probably lied.

First, you're likely renting the machine through your insurance - in which case you can swap it out for anything you want, as long as your doctor specifies. And you should get your doctor to specify an auto with full-data-capability. The S8 Autoset II is a solid performer that many people say is a perfect dream machine. There's also the new S9 Autoset. These are both fully data capable.

Before you do anything, get a full compliance data printout from your current DME. They must give it to you under HIPAA. If, after complaining to corporate you still get bad service, start looking for other options. If you're set up as rent-to-own via insurance - as is usually the case, get a full list of costs you are paying to the DME - what's coming out of your pocket every month, what the insurance is paying for your machine every month and any other extraneous costs for every month previous and coming until the payment contract is finished. Add them all up. Chances are, for the ten to thirteen months you'll end up paying, it will be cheaper for you to call cpap.com and find a machine that will be less expensive than your total out-of-pocket for the life of your DME contract - even if you've already made payments on the current machine. If it's thirteen months, anything after next January will restart with fresh out-of-pocket costs at the beginning of the year, possibly costing you even more in the long-term. Make sure to include that in your cost analysis if this is the case.

If you still feel disatisfied after complaining to the DME corporate, write to your insurance company showing you've been fully compliant using the compliance data from your current DME. Tell them you're unhappy with the service of the same DME and that you will be shopping for a new one. Also tell your doctor that you find the DME's service unsatisfactory and that you would suggest them not sending that DME any business because they are misleading CPAP users.

Regardless of whether you actually do shop for a new brick and mortar DME, you will still need a new machine. Be sure you have that in hand before you bring back your current machine, even if it's another month with this machine through the current DME.

You'll work this out. Hopefully others here will have good suggestions.

[jmelby]

You have a right to your prescription, but the DME won't provide that--you should call your doctor's office and have them mail it to you, as well as a copy of your sleep study results.

You may be better off buying online than continuing with the DME... figure out your lowest cost option to get a good data-capable machine. If your insurance has a high deductible, it is likely that buying online would be your cheapest option. You will need to call to get the real pricing--for ResMed and Respironics at least, they don't allow web sites to publish their real prices.

I second the recommendation of the S9 AutoSet or S8 AutoSet II... I have the S8 currently, but just ordered the S9 from cpap.com today... looking forward to the climate control feature.

[SleepingUgly]

Is your doctor someone who will help you with this? I may be naive (but I doubt it!), but I think that if your doctor calls and says he/she wants you on another machine, and names it specifically, they will switch you. (If a doctor writes a prescription for one drug, and then requests another similar one in the same time frame that ordinarily one wouldn't be taking the two drugs, he can write "change in therapy".) Anyway, the DME gets referrals from the doctor, so they are motivated to please the doctor. They'll clean it out as best they can, and pass the used machine on to some other unsuspecting victim (DMEV should be the acronym for a DME victim).

I think your power lies with a doctor who is willing to help you, if you have one.

[GumbyCT]

Certainly if you get your doc to write a make/model specific script the DME will provide another machine. Anything else is time consuming and frustrating to all involved.

You have some good advice but I would talk to your insurance sooner because they make the rules - incl. how the rental works. I am willing to bet it will be replaced if you get another script

This won't happen overnite so you will need to educate yourself - this is a self-serve forum so help yourself.

viewtopic/t35702/Where-A-CPAP-Newbie-Should-Start.html

Learn to search - search.php

The "Advanced Search" option can be found on the very top of each forum page directly under the "Home" icon. Drill down - search again using another term.

For Acronyms & Definitions
http://www.sleepnet.com/definition.html

Good Luck