No CPAP Supplies DME says under audit

[klm49]

I went to pick up my CPAP supplies and they told me I was under Medicare Audit and there would be no supplies until that was over. When I got home I called the "therapist" (same company) and he said basically Medicare randomly audits claims and until it is over they can't bill so they won't be able to give supplies until it is over. He was nice enough to say he would send me a cushion to get me by. Has anyone experienced this, how long does it last? I I have been on CPAP for a little over 90 days. I wondered why I hadn't seen any of my CPAP stuff show up in my Medicare billing.

[Janknitz]

Hmmm, Medicare does regularly audit certified vendors, but I've never heard of it completely stopping their work in the meantime. "Hello, Mr. Jones, I'm sorry, you can't have a new oxygen tank until after our Medicare audit" would be pretty stupid.

I wonder if your DME is in trouble with Medicare???

[4kidsmom]

I recommend calling Medicare about it. Let them know what the DME said, and that you need your equipment. Ask if there are any questions you can answer that might clear things up. That's what I would do if my insurance had my equipment on hold due to an audit. I'd let them know what exactly I have been doing, and ask if there was anything they recommend I should do differently to avoid it in the future. I suspect it is not YOU, but rather the DME that is being audited. Auditing a patient isn't something I've ever heard of.

[klm49]

Hmmm, Medicare does regularly audit certified vendors, but I've never heard of it completely stopping their work in the meantime. "Hello, Mr. Jones, I'm sorry, you can't have a new oxygen tank until after our Medicare audit" would be pretty stupid.

I wonder if your DME is in trouble with Medicare???

I have no idea if they are in trouble. They have been difficult to deal with. After my first visit with Sleep Dr. after I started CPAP I realized I should be getting new cushions, it took me 2 weeks to finally get one. After 90 days they never called so I called them and got the run around so I called the Sleep Dr. and they called them. I was assured I would get supplies today and they came up with this. Just curious if anyone has experienced this? I may try and call Medicare Monday.

[mummmz]

I would call Medicare but also call the sleep doctor again. Did he refer you to this DME? He may stop referring patients to them if they are such a problem.

[chunkyfrog]

You may want to ask Medicare if the DME's coverage with Medicare is under a cloud.

[Gasper62]

After only 90 days, what "supplies" are you in need of within such a short time span ? Has some part of your PAP system become unusable already ? Even though replacements are usually allowed in 3 & 6 month intervals, that doesn't mean that they have to be changed out on the basis of time passed.

[BlackSpinner]

After only 90 days, what "supplies" are you in need of within such a short time span ? Has some part of your PAP system become unusable already ? Even though replacements are usually allowed in 3 & 6 month intervals, that doesn't mean that they have to be changed out on the basis of time passed.

Some masks need new cushions every 2 - 3 weeks. Planned obsolescence.

[palerider]

After only 90 days, what "supplies" are you in need of within such a short time span ? Has some part of your PAP system become unusable already ? Even though replacements are usually allowed in 3 & 6 month intervals, that doesn't mean that they have to be changed out on the basis of time passed.

Some masks need new cushions every 2 - 3 weeks. Planned obsolescence.

well, they wanna sell me new cushions for my p10 every couple weeks... still waiting for this one I started on 2 years ago to give out.

I *have* heard from several people who'd accidentally inverted one or both of the inner cones, and thought the cushion had gone bad after only a few weeks, till I showed 'em the resmed video on popping those back out, and they said it was good as new again.

that's not to say that there aren't masks with really crap cushions out there.

[ChicagoGranny]

Has anyone experienced this, how long does it last?

After only 90 days, what "supplies" are you in need of within such a short time span ? Has some part of your PAP system become unusable already ?

See, even Gasper doesn't always take user questions at face value and give them a straight answer without questioning what they are doing.

Good job, Gasper! You are making progress!

[Gasper62]

Has anyone experienced this, how long does it last?

After only 90 days, what "supplies" are you in need of within such a short time span ? Has some part of your PAP system become unusable already ?

See, even Gasper doesn't always take user questions at face value and give them a straight answer without questioning what they are doing.

Good job, Gasper! You are making progress!

I'm thinkin' that you very well may need some professional psychiatric help there, Grandma. Did someone officially name you arbiter elegantiarum when I wasn't payin' attention ? I never got that memo.

[Wulfman...]

Has anyone experienced this, how long does it last?

After only 90 days, what "supplies" are you in need of within such a short time span ? Has some part of your PAP system become unusable already ?

See, even Gasper doesn't always take user questions at face value and give them a straight answer without questioning what they are doing.

Good job, Gasper! You are making progress!

I'm thinkin' that you very well may need some professional psychiatric help there, Grandma. Did someone officially name you arbiter elegantiarum when I wasn't payin' attention ? I never got that memo.

I believe that was before you arrived here........

I got MY copy!


Den

.

[Gasper62]

After only 90 days, what "supplies" are you in need of within such a short time span ? Has some part of your PAP system become unusable already ? Even though replacements are usually allowed in 3 & 6 month intervals, that doesn't mean that they have to be changed out on the basis of time passed.

Some masks need new cushions every 2 - 3 weeks. Planned obsolescence.

well, they wanna sell me new cushions for my p10 every couple weeks... still waiting for this one I started on 2 years ago to give out.

I *have* heard from several people who'd accidentally inverted one or both of the inner cones, and thought the cushion had gone bad after only a few weeks, till I showed 'em the resmed video on popping those back out, and they said it was good as new again.

that's not to say that there aren't masks with really crap cushions out there.

I suspect that the use of the various "nipple butters" available may contribute to some accelerated deterioration of nasal cushions. Not certain, though.

[palerider]

I suspect that the use of the various "nipple butters" available may contribute to some accelerated deterioration of nasal cushions. Not certain, though.

I don't remember if you were around when I was pilloried for referring to it as "titty cream".

it *shouldn't* affect the silicone, .... shouldn't, but, who knows for sure.

[greatunclebill]

it may not be dme specific. if you are under audit it could be any aspect of medicare or even social security that you are involved with. that said, i believe if anyboy's under investigation it's the dme.