WHAT TO SAY to get better machine

[jeffishere]

As a newbie I would just like to say thanks to everyone who has responded to my posts...i'm sure you've all heard these questions a million times, but you still respond w/out a condescending tone!

After 3 weeks of diff. problems every night, and many hours researching and reading these forum posts, it seems I need a data-compatible machine. I rely on insurance (Anthem BlueCross of California) so I'm hoping they will replace my machine ( but I actually speak with the company who did the sleep study and "sold" me the machine.... Advanced Sleep Medicine Services Inc....are they in any way obligated or incentivized to make me happy with my machine?

So I'm wondering if anyone has any advice as to what to say to increase my odds. Should I say my current S8 escape is not working for me? (It's actually fine...just lacks the data-capable feature.)

Should I just say, "i think i really need to be able to see my data so i can solve this issue with air being forced into my gut and thus being awakened by pain in my gut?"

If I get a "no" what should be my next step? Ask to speak to a supervisor?

Thanks again for any advice!

[BlackSpinner]

There is the same code for both bricks and data capable apaps. The thing is to wear your army boots when going to the DME and insisting you want something data capable. They won't be happy about it because you are cutting off their excess profits. You can call other DME's in your network and see if they are prepared to give you what you want. With this take your brick to the DME and tell them you want to exchange it for a real machine and if they won't give it back to them and tell them you will be doing all you future business with the other DME. Note that the machine is probably being rented for you by your insurance. Don't let them talk you into signing a paper saying that you refuse therapy against doctors orders.

The other thing is to get your/ a doctor to write a prescription specifying exactly the machine you want with the note "dispense as written".
Also check on line the costs of the machine you want, then calculate your copay - it might be worth your while to pay out of pocket.

[EricinNC]

Threaten them. Tell them if they do not give you a data compatible machine at the minimum, you will file a written complaint against them with either/or your State Medical board (sleep doctors) or if they are an RT in a DME, threaten to complain about them to your State Respiratory Care board or equivalent...every state is different and each has a difference in name for the licensing board for RTs.

Also, tell them you sometimes binge drink alcohol and take anti-histamines for colds/flu/allergies or sometimes take sedatives for anxiety and your pressures increase and you are concerned you will have a stroke or a heart attack from an O2 desat.

Usually this will do the trick.

On the high end APAPs, Ive gotten several using these tactics. You just have to be a pushy person.

Also, you can decrease the stress element by just paying out of pocket and buying off the Internet from a site like this or some others.

Eric

[EricinNC]

the underlying threat of a written complaint filed against them and the slightest possibility they will lose their RT license or have to go thru a bunch of crap with their state respiratory board will usually, not always, but oftentimes move them to get the ball rolling in your favor. I actually enjoy doing it.

Eric

[rested gal]

Jeff, I looked back to see how long you've had your present machine. Since you're in your first month, there's a great chance you can walk out of your DME with a swap...swapping your Escape for an S9 Elite CPAP.

EMBARRASSING question
viewtopic.php?p=580853#p580853

Thanks all for the informative replies! I agree that I'm not swallowing air but that it's being forced down into my gut. It was painful last night!

-------

I will call on Monday & see if it's too late to change machines...I'm still in my 1st month....not sure if my insurance will allow that. Anyone know?

Thanks again!

As Blackspinner said, first check to see which other DME stores in your area your insurance deals with. If you find one or more, check with those stores to see if they will give you an S9 Elite if you give them your business. Check that out first, before you go to your original DME to ask for a swap.

You may be pleasantly surprised. Your DME might say, "Sure." And you won't have to stomp around in army boots after all.

If they hesitate or hem and haw, I'd try reasonable persuasion, keeping it friendly as long as you can. Politely pull out your ace card... "Well, I've checked with my insurance and with a couple of other home health care stores. Another store is willing to give me an S9 Elite. I don't mind waiting a few minutes if you want to check in the back to see if there's an S9 Elite you could swap for this Escape."

If that doesn't work, and they flat out refuse or get arrogant with you, you can always end it with a calm, simple "OK, here's your machine back. Bye."

No need to threaten or be pushy. Not if you know for sure there's another store covered by your insurance, and that the other store will give you an S9 Elite. Or if you're willing to pay out of pocket for what you want. Buying a machine yourself online is sometimes cheaper in the long run. You could still use the local DME (and your insurance) for masks and replacement items if you wanted to.

[Jade]

"Sorry, that machine is not acceptable [or isn't going to work for me]. I want ((fill in your machine(s) of choice))."

Said calmly and pleasantly. With a slight smile if you can manage it. And repeated at least several times without variation. They won't even hear it the first couple times you tell them--doesn't register with the mindset they typically have going.

Once you start giving a bunch of reasons, you have just given them fodder to argue with you and try to wear you down. Discuss end result only. I've had a lot of success with difficult people in several different areas of my life by mostly using this basic technique.

[mcdover]

Caveat Emptor! The time for negotiating for a better machine, was BEFORE you walked out of the store with it. I'd be willing to bet that your RX said CPAP @ ? cmH20, humidifier, and mask. If it does, then you are SOL and you are dependent on the charity of the DME if you do get an upgraded machine. As far as the advice to threaten to write letters to various state agencies, remember extortion is illegal, and if you actually do write those letters, I would consult an attorney first. Nothing like having to defend yourself against a libel suit.

With the exception of one or two, you have been given some terrible advice here. As a DME owner who only puts out the high end machines, here's what I suggest to get what you want. First the difference in cost between an Escape and Elite is somewhere around $150-$200. Knowing that, I would suggest that you go into the office and ASK for an upgraded machine. If they won't do an even swap, offer to compensate them for the difference. Remind the manager that you plan on being a long term customer and the periodic replacement of supplies (masks, tubing, filter, etc..) have to come from somewhere. Contrary to popular belief on this site, DME's are not making a killing on selling CPAP's. With the increased regulation, tax increases, increased cost of doing business, and the increased games insurance companies are playing to keep from paying claims, there have not been a darker day for DME companies. That being said, more and more companies are going to the less featured CPAPs in order to keep costs down, because reimbursement rates have consistently dropped while cost of goods have risen. If you want a upgrade, be prepared to pay extra on top of what insurance pays.

[Pugsy]

First the difference in cost between an Escape and Elite is somewhere around $150-$200.

Hmm, maybe you need a better supplier. S9 Escape with EPR $758. S9 ELite with EPR $805 and the So Autoset $853

posting.php?mode=reply&f=1&t=62077#postingbox

https://www.cpap.com/cpap-machine/resme ... chine.html

https://www.cpap.com/cpap-machine/resme ... chine.html

These are from our hosts here. Difference of about $50 to $100 for the Autoset.

Depending on the insurance involved (like Medicare) upcharges may not be legal. Where is your store? I want to make sure I don't go there.

[Slinky]

Yup, yup, what Pugsy and RestedGal said. You can catch more flies w/honey than w/vinegar. Be FIRM, but be tactful. And Jade spoke MUCH wisdom as well. I wish I had Jade's tact!!! Just pleasantly stand your ground and don't budge.

[kentoboo]

I had to pay an extra $159 to upgrade to a data capable machine. I probably was hosed ( no pun intended) but sometimes it is just easier to switch than fight!

[Pugsy]

I had to pay an extra $159 to upgrade to a data capable machine. I probably was hosed ( no pun intended) but sometimes it is just easier to switch than fight!

It may have been a legit fee, just depends on the insurance (like HMO or PPO thing). Straight Medicare though? That is fraud.

But sometimes "peace of mind" costs are well worth it. If it didn't take food off the table and paying the extra helped your stress level by not having to go to battle, then peace of mind cost is not so bad. I bought out of pocket so I didn't have to fight with anyone. Gave me peace of mind knowing I got what I wanted and I didn't have to battle for it.
Overall the cost was probably a wash after deductible and co pays. I had the cash, didn't take food off the table so worth it to me not to fight that battle.

[BlackSpinner]

Caveat Emptor! The time for negotiating for a better machine, was BEFORE you walked out of the store with it. I'd be willing to bet that your RX said CPAP @ ? cmH20, humidifier, and mask.

The problem is that sleep deprived people often can't think straight or absorb new information easily. I am a computer programmer and systems analyst but before I got my machine I was in such bad state that non of the information on this site made much sense. I was lucky in getting a good machine and adapting easily. Two weeks on the machine made a world of difference in my cognitive ability. Most DME's take advantage of this state of mind, most people expect service like they get at the pharmacy where the pharmacist will verify that what is prescribed is actually what you need and won't interact with other things and your allergies, my pharmacist will make sure I understand how to take the medication (in 2 languages) and its side effects. I expected the same quality of service from my DME and I didn't get it.

Remember sleep deprivation is a torture technique used to break down resistance by creating confusion.

[Jade]

Yup, yup, what Pugsy and RestedGal said. You can catch more flies w/honey than w/vinegar. Be FIRM, but be tactful. And Jade spoke MUCH wisdom as well. I wish I had Jade's tact!!! Just pleasantly stand your ground and don't budge.

Slinky, believe me, there's plenty of times I wish I had my tact also!!

[mcdover]

First the difference in cost between an Escape and Elite is somewhere around $150-$200.

Hmm, maybe you need a better supplier. S9 Escape with EPR $758. S9 ELite with EPR $805 and the So Autoset $853

posting.php?mode=reply&f=1&t=62077#postingbox

https://www.cpap.com/cpap-machine/resme ... chine.html

https://www.cpap.com/cpap-machine/resme ... chine.html

These are from our hosts here. Difference of about $50 to $100 for the Autoset.

Depending on the insurance involved (like Medicare) upcharges may not be legal. Where is your store? I want to make sure I don't go there.

Apparently, you don't know the difference in "cost" vs. "price". Just because the price is closer, doesn't mean the cost is. I see that you don't run a business, evident by the fact that this concept is lost on you. Also, before mudding up the water with claims of illegal activity, it would behoove you to keep your incorrect thoughts to yourself.

[EricinNC]

Caveat Emptor! The time for negotiating for a better machine, was BEFORE you walked out of the store with it. I'd be willing to bet that your RX said CPAP @ ? cmH20, humidifier, and mask. If it does, then you are SOL and you are dependent on the charity of the DME if you do get an upgraded machine. As far as the advice to threaten to write letters to various state agencies, remember extortion is illegal, and if you actually do write those letters, I would consult an attorney first. Nothing like having to defend yourself against a libel suit.

With the exception of one or two, you have been given some terrible advice here. As a DME owner who only puts out the high end machines, here's what I suggest to get what you want. First the difference in cost between an Escape and Elite is somewhere around $150-$200. Knowing that, I would suggest that you go into the office and ASK for an upgraded machine. If they won't do an even swap, offer to compensate them for the difference. Remind the manager that you plan on being a long term customer and the periodic replacement of supplies (masks, tubing, filter, etc..) have to come from somewhere. Contrary to popular belief on this site, DME's are not making a killing on selling CPAP's. With the increased regulation, tax increases, increased cost of doing business, and the increased games insurance companies are playing to keep from paying claims, there have not been a darker day for DME companies. That being said, more and more companies are going to the less featured CPAPs in order to keep costs down, because reimbursement rates have consistently dropped while cost of goods have risen. If you want a upgrade, be prepared to pay extra on top of what insurance pays.

If you were my DME supplier and you gave me a cheap machine, I could guarantee Id get a high end data compatible machine out of you. I am glad to hear darker days are here for DME companies, as most DMEs do not treat their customers well, like most insurance plans do not treat their customers well. I have no sympathy for you.


Eric