My First Two Nights with CPAP

[energyguyoly]

First,

Thanks to all for your help navigating the DME environment. What a bunch of slimeballs. First they tried to sell me a discontinued S8. Forced me to get a new prescription before they would sell me the S9autoset, which I finally got along with the Swift FX nasal mask. Interestingly I took a look at their bill and noted that they are trying to charge for the mask, which comes with the headset, of course, and for a separate headset.

When I called them on it, they said "even though they come in the same package, we bill for them separately." Called them on that too, and it just so happens that the referring medical clinic is a client of mine. I've let them know that this (DME) is definitely not the kind of company they want to refer people to if they care at all about their reputation.

But on to the first two nights. First night was very difficult. Took the mask off after about 2 1/2 hours of fitful sleep. Last night, the second night was quite different. Slept about two hours and then awoke uncomfortable. Took the mask off and slept for about an hour. Woke up and put the mask back on at midnight and slept like a baby till it was time to get up at 4 AM (Yes, 4 AM. My wife and I are training for a triathlon, and here in Tucson, if you don't start by 5 it's too hot in the summer to train).

Again thanks to all for your help. If anyone finds this forum and wants to know the name of a DME supplier not to do business with, shoot me a private message, although I understand they are a national company.

[Guest]

When I called them on it, they said "even though they come in the same package, we bill for them separately."

I think that's typical, and insurance supports that.

[Janknitz]

Billing separately for each mask component is typical. Skanky but typical. Insurance companies allow it because there are separate billing codes for each component. But don't allow it if you are paying oop or a large co-pay. If that's the case you're better off buying online once you've settled on a mask.

[energyguyoly]

You identified the problem. I have a high deductible HSA account which means I pay (insurance contracted rates) for the mask and the headgear. The way it is set up I would pay for the mask (which comes with headgear) and for the headgear again. I don't care what insurance allows, it's my money.

I've already used the mask, but they do have a two week exchange policy. Can I simply return it then and tell them I will get my own? That is certainly a leverage point.

The other is to simply not pay for the headgear once I get their bill.

Any thoughts. I have no problem tangling with this company.

[JoeFromSC]

You must be my brudda from another mudda!
I too am on my third night tonight! Same machine, same mask! Same issues! But alas triathlete! I bow on that one!
I just ordered a new soft pillow mask, the Sleep weaver, google it, pretty cool. I tried to support CPAP .com (the sponser of this site) but they cannot take a word document for the prescription for fear of virus' so I ordered from another vendor.
I had sent my script and requests to three DME's , two played the "you need a different prescription" for this S9 game, even though my ENT wrote RESMED AUTO S9 on the script.
The third however, stepped right up and took care of business. Got me fixed up quick as she could . I too have a $5,000.00 deductible, and pay 1,000.00 a month for insurance. I have met my deductible due to an auto accident.
Very similar events of sleep, but I must admit I feel pretty energetic today. We will see.
I will keep checking this thread!

Sleep Well.

Joe

[energyguyoly]

Finally got resolution today with DME who wanted to bill separate for the mask headgear in a Resmed FX nasal pillow. I gave them three choices.

1. Do the right thing and simply bill for the mask that comes with the headgear.
2. Bill whatever they please knowing that I would pay only for the mask.
3. Let me know when they would be coming by to pick up their equipment, including the mask.

Their accountant called to let me know they would bill only for the mask.
A nice ending to a totally unnecessary ordeal. Does anyone need to wonder why healthcare costs are so out of control. Honestly!