Fired by my DME!!!!!!! :(

[Randyp1234]

Hehehe .....well the sleep study people are apparently owned by the same people who own the DME company. So I bet they must know something. Going to be kind of awkward when I have to schedule that titration study in a few weeks....

How can you have a scrip for a machine if you haven't done a titration study yet?

[Uncle_Bob]

I tried my local DME on for size when it came to ordering a PR ONE 60 using BCBS.
They gave me weeks of run around, they wanted an Rx dated within a year.
My doctor refused to write one up unless i showed up for a consulation and paid the $40 fee.
Then after originally telling me they could get the machine they want a $250 upgrade fee because they could not afford to give it to me otherwise.
i got it from cpap.com at just 2 times their upgrade fee.

If you are in Arizona this DME talks a good game but i would not recommend them

http://valleyrespiratory.com/06_contact.html

[BlackSpinner]

How can you have a scrip for a machine if you haven't done a titration study yet?

Some places like you to get comfortable with the machine first. That was how mine was done.

[archangle]

I doubt you've got any serious "recourse" other than screwing up their relationship with the insurance company and Respironics.

Hopefully, your doctor will steer business to other DMEs in the future.

You're probably better off if you can find another DME.

Good luck.

[Spektor]

Hehehe .....well the sleep study people are apparently owned by the same people who own the DME company. So I bet they must know something. Going to be kind of awkward when I have to schedule that titration study in a few weeks....

How can you have a scrip for a machine if you haven't done a titration study yet?

I had the first sleep study done but didn't have enough time during the study to do a split night with titration. The testing company recommended I order an autopap machine and use it for a few weeks to get used to it then do the titration study. That way it might be easier for me to sleep during the test.

So my GP got the forms from the first DME supplier and filled out the prescription. They wanted me on their standard machine, an Intellipap auto, but I (and my GP...) wanted the PR1. Today, however, that DME said they wouldn't fill the script because they would, basically, spend too much on special ordering the PR 560 to make any money...... So they declined.

So then I took the rx and called some other places today and one is getting me the new machine next week. They have to order the heated tube but they didn't complain ....too much.

We'll see what surprises lie in store next week.

[chunkyfrog]

The guys that EARN your business deserve it.

[MidnightOwl]

How can you have a scrip for a machine if you haven't done a titration study yet?

I had the first sleep study done but didn't have enough time during the study to do a split night with titration. The testing company recommended I order an autopap machine and use it for a few weeks to get used to it then do the titration study. That way it might be easier for me to sleep during the test.

So my GP got the forms from the first DME supplier and filled out the prescription. They wanted me on their standard machine, an Intellipap auto, but I (and my GP...) wanted the PR1. Today, however, that DME said they wouldn't fill the script because they would, basically, spend too much on special ordering the PR 560 to make any money...... So they declined.

So then I took the rx and called some other places today and one is getting me the new machine next week. They have to order the heated tube but they didn't complain ....too much.

We'll see what surprises lie in store next week.

So all this drama and you don't even know if you will be helped by cpap or not? You basically want them to special order a machine not for long term treatment but to use short term for a couple of weeks to prepare for your titration study? Where you will learn whether it helps you or not? And they didn't want to do it? I'm amazed.

[idamtnboy]

I wonder if its even legal to own both businesses and refer your patients from one to another....

Medicare prohibits it. Many insurance companies follow Medicare guidelines for all their business. But it probably is legal.

[idamtnboy]

I suspect that this is insurance of the future. Doctor, or agency can not make enough money, "We do not want you as a patient."

It's already happening.

http://www.delmarvanow.com/article/2012 ... -hard-find

http://www.google.com/hostednews/ap/art ... e45d8bd12f

[Guest]

How can you have a scrip for a machine if you haven't done a titration study yet?

I had the first sleep study done but didn't have enough time during the study to do a split night with titration. The testing company recommended I order an autopap machine and use it for a few weeks to get used to it then do the titration study. That way it might be easier for me to sleep during the test.

So my GP got the forms from the first DME supplier and filled out the prescription. They wanted me on their standard machine, an Intellipap auto, but I (and my GP...) wanted the PR1. Today, however, that DME said they wouldn't fill the script because they would, basically, spend too much on special ordering the PR 560 to make any money...... So they declined.

So then I took the rx and called some other places today and one is getting me the new machine next week. They have to order the heated tube but they didn't complain ....too much.

We'll see what surprises lie in store next week.

So all this drama and you don't even know if you will be helped by cpap or not? You basically want them to special order a machine not for long term treatment but to use short term for a couple of weeks to prepare for your titration study? Where you will learn whether it helps you or not? And they didn't want to do it? I'm amazed.

Um no. Is there something overly cofusing here?

Got sleep study. Study then checked by a sleep tech and sent to MD as normally done. Then diagnosed with mild apnea by the sleep MD. Recommended a CPAP/APAP for apnea. Recommended to try an APAP BEFORE going to have a final titration study where the pressures are tested and fine tuned.

The plan is to keep using the APAP until, perhaps, I die of old age or get tired of it.

Just because you wait to do the titration later on doesnt mean you cant be rx a CPAP to use beforehand after all. Right? Aren't people now given APAPs to use even withhout them having had any sleep study at all, let alone the titration part?

[CrazyOldCatLady]

Have any of you gotten a direct-ship from your DME which has an insurer 100% covered invoice and which includes parts you can't identify and didn't get?

I just received a shipment with: new ResMed slimline hose (good), new FX for Her headgear kit (good), new water tank (good). All brand name stuff. Which were on the packing list. Of concern was an item referenging "Generic headgear" for $50.......Nothing else in the box.

Have any of you seen DME's adding invisible stuff on to invoices (especially when you have good insurance that has no copays and the odds are the patient won't look at the packing slip). I'm wondering if I should call the DME and ask about what it is and also notify my insurance company? Comments?

[brucifer]

Hehehe .....well the sleep study people are apparently owned by the same people who own the DME company. So I bet they must know something. Going to be kind of awkward when I have to schedule that titration study in a few weeks....

How can you have a scrip for a machine if you haven't done a titration study yet?

I had the first sleep study done but didn't have enough time during the study to do a split night with titration. The testing company recommended I order an autopap machine and use it for a few weeks to get used to it then do the titration study. That way it might be easier for me to sleep during the test.

So my GP got the forms from the first DME supplier and filled out the prescription. They wanted me on their standard machine, an Intellipap auto, but I (and my GP...) wanted the PR1. Today, however, that DME said they wouldn't fill the script because they would, basically, spend too much on special ordering the PR 560 to make any money...... So they declined.

So then I took the rx and called some other places today and one is getting me the new machine next week. They have to order the heated tube but they didn't complain ....too much.

We'll see what surprises lie in store next week.

Randy brought up a good question. What was done in your case is totally bass ackwards. Without doing the titration, your Sleep Doctor/GP has absolutely no baseline pressure (or pressure range) from which to work. You also may need a more advanced machine such as a BiPAP. Your GP simply does not have the necessary information to make an informed decision. That would be a HUGE red flag for me.

Anyway, you're an adult and can make your own decisions. I hope you have a happy outcome with your treatment.

[zoocrewphoto]

So all this drama and you don't even know if you will be helped by cpap or not? You basically want them to special order a machine not for long term treatment but to use short term for a couple of weeks to prepare for your titration study? Where you will learn whether it helps you or not? And they didn't want to do it? I'm amazed.

The initial sleep study proved that sleep apnea was the diagnosis. A titration is simply to determine the settings for the machine. The doctor had already decided that the machine was already going to be prescribed. They don't bother with a titration if they don't plan to prescribe a machine.

[brucifer]

So all this drama and you don't even know if you will be helped by cpap or not? You basically want them to special order a machine not for long term treatment but to use short term for a couple of weeks to prepare for your titration study? Where you will learn whether it helps you or not? And they didn't want to do it? I'm amazed.

The initial sleep study proved that sleep apnea was the diagnosis. A titration is simply to determine the settings for the machine. The doctor had already decided that the machine was already going to be prescribed. They don't bother with a titration if they don't plan to prescribe a machine.

How does the doctor determine which xPAP machine to Rx? Also, is the patient supposed start at a random pressure setting? Without a titration, the doctor has no idea what pressure(s) will be therapudic/useful. The CPAP-therapy experience can be tramatic for some patients, and without starting with a solid baseline, a patient's experience can be made even more stressful.

[MidnightOwl]

The initial sleep study proved that sleep apnea was the diagnosis. A titration is simply to determine the settings for the machine. The doctor had already decided that the machine was already going to be prescribed. They don't bother with a titration if they don't plan to prescribe a machine.

Unless of course the titration fails totally for one reaon or another. He can't tolerate cpap at all or develops tons of centrals and needs a different kind of machine. Anyway this probably isn't about what a doctor will prescribe or a DME will sell you but about what an insurance company requires before they are willing to pay for it all. He who pays the piper etc.