DMEs Take a Swing at CPAP Internet Retailing - Please help!

brasshopper · Post by **brasshopper** » Fri Jun 16, 2006 6:12 pm

Seems simple to me. The manufacturers create a standard of care that everyone must adhere to. Do they want to require follow-ups? Fittings? Instruction time? Machine swaps in case of failure? Talking the end user through setup - or providing someone to go to the home to do the setup? Whatever it is, write it down and negotiate it with their DMEs of all sorts.

Now, then they take it to their dealers and make it part of their contracts. That simple.

Finally, they put it in the user documentation and on their consumer web sites:

You should have gotten this machine from a XXX retailer. As part of the purchase price, you have the right to personal training you understand as to how to fit the mask, how to set the user settable parts of the interface (like the ramp time or the c-flex level). You have the right to this and that, whatever the agreement says. If you don't get it, start by asking for it and quoting this to the seller. If they still don't give it to you, then you can escalate here."

The point is that I've seen a lot of people saying, "Gosh, you need to go to a local supplier because they will provide better service," but other than mask fitting, no one can define that better service is.

Alternatively, DMEs can charge what they want for these fitting services and price them separately. You go in to your brick and mortar DME and you just want an X, you just ask for an X and they charge you one price. You want a mask fitting, they have a sign on the wall, "Mask fittings, $150 - all masks you use for fittings are sterilized between users, and this is an expensive process - plus, fittings take technician time."

What is killing them, frankly, is that the local DME charges minimum $165 for any mask - including the ones that sell for $45 on the net - they recoup those fitting costs on every mask.

The problem is that there is some belief that the high prices are justified, somehow, because the high prices are paying for some unlisted, mystical extra services that are not itemized - and as we have observed, are not given to many/most of the brick and mortar customers.

If there are supposed to be services bundled into the cost of the machine, then they should be listed somewhere - and all sellers should be required to provide them, Internet or brick and mortal.

As a final point, the manufacturers should solicit actual feedback and should tell tales about their sellers - brick and mortar or Internet. My guess is thatr extensive sites like cpap.com's give you more information than you would get from the average storefront DME.

Guest · Post by **Guest** » Fri Jun 16, 2006 10:43 pm

Isn't it always going to be a fight between online and storefront DMEs?
Ever since internet commerce started there's been this battle between the local and the online, whether it be selling CDs, DVDs, clothing, and medical equipment. Then there's the phone orders vs the online-only. As long as there's a broad marketplace, there's going to be lots of name calling and finger pointing, some cloaked in the disguise of setting standards. Somewhat true standards, ones that paint a broad stroke, typically involve issues of fraud or product quality. Pricing is left to a supposed free-market society.

Hey, but look at the bright side, you online DMEs. As long as the local DMEs charge very high prices, the online DMEs continue to make those profits, there's no need to reduce prices any further. Wouldn't that make it a kind of win-win situation for the online DMEs? .... Hmmm. Maybe not. There's the competition among online DMEs.

I suppose the only losers are those who don't have internet or do not trust it to shop. Guess that's why we have insurance!

snork1 · Post by **snork1** » Sat Jun 17, 2006 12:18 am

Anonymous wrote:Isn't it always going to be a fight between online and storefront DMEs?
Ever since internet commerce started there's been this battle between the local and the online, whether it be selling CDs, DVDs, clothing, and medical equipment. ....................... Pricing is left to a supposed free-market society.
.................

And there-in lies the problem. They are talking about eliminating free-market capitalism.

This would be the equivalent of store-front CD stores being able to pass a law banning on-line sales of CD's. And look how bad it is even without that capability.............

Tujunga1 · Post by **Tujunga1** » Sat Jun 17, 2006 12:36 am

[quote="DME_Guy"]I saw that survey. I think there is pressure being put on the manufactures from the national DMEs - Lincare and Apria. I don't know this. It's just a feeling.

I think you are 100% correct! Apria did an awful job for me when I first got my CPAP. I now have to use Providence Home Health in Portland, OR and they just foisted the Swift mask on me, which I detest! Thank goodness the timeframe I have to wait for a new mask is up so I will try again, this time being more forceful. If it weren't for the fact I only have to pay 10% of the cost if I use these DME providers I would really prefer to buy online. At this point, I am actually considering doing just that. I haven't been using the CPAP at all due to lack of a decent fitting mask, and it's killing me! It is far easier to call the DR and ask for an RX then go get my own choice of a mask than working with these idiots and then seeing them overcharge for everything! It's even worth spending my own money!!

Darth Vader Look · Post by **Darth Vader Look** » Sat Jun 17, 2006 1:05 am

I took this obviously one sided survey which is in favour of the evil DME and me's think that the results will be skewed to favour the DME. Who'd a guessed that I didn't add any comments figuring that they would figure out that I am not a DME or employee for one, as if they wouldn't with the answers for those questions. BTW, to answer those questions, did anybody have to resort to using a cheat sheet .

Guest · Post by **Guest** » Sat Jun 17, 2006 5:40 am

Darth Vader Look wrote: ...... I took this obviously one sided survey which is in favour of the evil DME ......

Haha! Be careful of your terminology.
Technically the online providers are DMEs. Semantics, I know.

Local DMEs definitely need improvement. Many can do what they like because they have a captive market, or of those who do not use the internet or phone services to shop. Some local DMEs are the only choice in town. As bad as some may be, and despite many bad experiences with them, there are many people who are pleased with the service they get. Just as the survey should not imply that all online DMEs suck, neither should we assume that all local DMEs suck.

snoregirl · Post by **snoregirl** » Sat Jun 17, 2006 7:29 am

Tugunga,

You don't need an Rx for a mask. Do it now, just order and get back on CPAP now.

wading thru the muck! · Post by **wading thru the muck!** » Sat Jun 17, 2006 7:43 am

brasshopper wrote:
As a final point, the manufacturers should solicit actual feedback and should tell tales about their sellers

brasshopper,

The corruption of the HME manufacturer/Brick'nMortar DME relationship will prevent this.

The solution is the cpap.com/cpaptalk.com model... Superior service, Low prices and open forum feedback that is available to all to read and comment. This is a completely transparent process which leaves little or no room for corruption.

Guest · Post by **Guest** » Sat Jun 17, 2006 8:38 am

wading thru the muck! wrote:The solution is the cpap.com/cpaptalk.com model... Superior service, Low prices and open forum feedback that is available to all to read and comment.

The other solution would be to let Walmart start selling XPAP and accessories - watch the price come down...

wading thru the muck! · Post by **wading thru the muck!** » Sat Jun 17, 2006 9:31 am

Anonymous wrote:
wading thru the muck! wrote:The solution is the cpap.com/cpaptalk.com model... Superior service, Low prices and open forum feedback that is available to all to read and comment.
The other solution would be to let Walmart start selling XPAP and accessories - watch the price come down...
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Yes, that would bring prices down, but then we'd be back to the crappy local DME type service. Walmart is great for cheap prices on commodity type items, but if you need the benefit of some expertise to make your purchase, with Walmart your out of luck (at least at my Walmart)

MaskedMechanic · Post by **MaskedMechanic** » Sat Jun 17, 2006 10:09 am

NOBODY, stocks or ever will stock as broad a selection of cpap related products as the larger internet retailers. Not even Walmart, ever. Neither will the big box retailers be able to keep up with the rapid product changes we see with sleep apnea treatment. The cpap internet retailer's performance in the availability/selection component of service is far beyond what others do. Whoever wrote the poll is either in the dark or has an agenda.

I hope everyone is taking one minute to take the HME poll on first page of this thread. It would be very cool to see a big vote for the free market!!

different guest · Post by **different guest** » Sat Jun 17, 2006 10:37 am

We're only considering sales of cpaps/etc here. The local DME provides a considerable variety of medical products. The business is sales not service (as we well know). Our wonderful Cpap.com specializes...ain't that great!

Going back to page one to take the survey. Thought I should accumulate your opinions for help. Thanks.

Wulfman · Post by **Wulfman** » Sat Jun 17, 2006 11:01 am

different guest wrote:We're only considering sales of cpaps/etc here. The local DME provides a considerable variety of medical products. The business is sales not service (as we well know). Our wonderful Cpap.com specializes...ain't that great!

Going back to page one to take the survey. Thought I should accumulate your opinions for help. Thanks.

We realize that the locals handle a wide variety of products.

If you don't have the "service", you eventually won't have the sales, either.

And, if you gouge people long enough on prices, that'll come back to haunt you, too.

Den

Guest · Post by **Guest** » Sat Jun 17, 2006 12:57 pm

Wulfman wrote: ..... If you don't have the "service", you eventually won't have the sales, either.

And, if you gouge people long enough on prices, that'll come back to haunt you, too.

Den

Oooooo, the evil local DME mongrels again.
Next you're going to tell me that all physicians suck.
Hmmm, think that's been said here already.

Aren't you doing a disservice implying that all local DMEs are crap? I've heard many people tell me they had good experiences, and there have been equal numbers who have had bad.

Do you think you can coerce every single person into buying online? I think not. I'm sure the online services would like to think they can grab every customer. This survay may be implying bad things about online DMEs, but aren't online DMEs implying the same about the local ones?

I buy online too. But I know my father sure as heck would never do it. Luckily the people who aren't using the internet to purchase aren't reading these totally anti-local-DME comments. Otherwise they might be discouraged against getting the help they so desparately need.

RedThunder94 · Post by **RedThunder94** » Sat Jun 17, 2006 1:10 pm

DMEs Take a Swing at CPAP Internet Retailing - Please help!

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