DME Bovine excrement

Patrick A · Post by **Patrick A** » Fri Sep 15, 2006 10:47 pm

I called the clowns at APRIA today and asked about getting a new mask. Or getting a nasal pillow st up. The BIMBO on the other end of the TELEPHONE said "You ned to get a new prescription and a letter of permission from your Doctor to change masks!!" BS
I can not believe it. I was told by the ADAM HENRY that set my machine up and fitted me with a mask that I could get a new mask every six months .
Beware of APRIA Health Care. I guess being as BC/BS is no longer paying rent on my machine I am at their mercy.

APRIA SUCKS

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CPAPopedia Keywords Contained In This Post (Click For Definition): nasal pillow, Prescription

inacpapfog · Post by **inacpapfog** » Sat Sep 16, 2006 4:40 am

Bummer, Patrick!
I know I'm confused about my BC/BS mask schedule also!
Last time I talked with someone from BC/BS, they simply would not give me an answer as to how often am I allowd to get a new mask! All she kept repeating was something to the effect....."If you have a need to change mask because of a problem, contact your DME and they will work with you....."

snoregirl · Post by **snoregirl** » Sat Sep 16, 2006 6:21 am

I got some answer like that from APRIA, I called back again and got someone else and they said the prescription was because I was asking at 3 months and my insurance only pays for headgear (needed for the new mask) every 6 months. I guess we will see in late Nov is I can get a hybred without a new prescription.

I can easily get the prescription, it is the principle. I think I will fight a bit first before I go bother my doc.

Since they would go for nasal pillow in 3 months, I got a new swift pillow which amazingly they charged total of $22 for (less than online price so my copay was $4 -5. Sometimes you just can't figure it out.

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CPAPopedia Keywords Contained In This Post (Click For Definition): Prescription

Patrick A · Post by **Patrick A** » Sun Sep 17, 2006 3:56 pm

I called my ask a nurse at BC/BS and she said we were eligible every six months and she was not sure about how APRIA work so I should call the people at BC/BS FEHB DME on Monday. And see if I needed permission from the prescribing doctor. She said she did not think they(APRIA) could get away with that so I guess I call Monday

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CPAPopedia Keywords Contained In This Post (Click For Definition): DME

whatrdreamsmadeof · Post by **whatrdreamsmadeof** » Sun Sep 17, 2006 5:17 pm

I had the same trouble with sentara optima insurance and did have to get a script........i just got the script from my pcp as my sleep dr like my dme is no help at all good luck

Guest · Post by **Guest** » Sun Sep 17, 2006 6:02 pm

I am assuming you are at 6 months and not any earlier. If you are any earlier than 6 months than none of this applies.

Perhaps just call them back up and ask again. It is POSSIBLE that the person you were speaking to simply misunderstood or even just made a mistake. We are all human. We all make mistakes.

If you get the same answer, then just ask them why. Calmly and politely just ASK them 'Hey, I understood that at 6 months I was eligible for a new mask. Did I misunderstand something, or is there more going on?"

Heck, MAYBE, just maybe your doc wrote a perscrpiption that said they were not to change your mask. Who the heck knows? Sure it aint exactly very likely, but did you ask?

Don't get me wrong - I think that on the whole Apria's Customer Service is lacking - but at the same time we do need to give people a break. Everyone is human and can make mistakes or have an off day or even just misunderstand something. That goes for us and those we deal with.

Patrick A · Post by **Patrick A** » Tue Sep 19, 2006 11:46 pm

I talked to my Insurance company today they said they would contact my DME and set them straight. Being as a Had a letter of medical Necessity on file they had to give me a new mask every six months wether i needed it or not.

apria · Post by **apria** » Wed Sep 20, 2006 3:12 pm

i work at apria healthcare. and i was actually looking for some good feedback on the company. but i found nothing but complaints.

apria healthcare follows procedures that are enforced by the government. being that mask are prescriptive items. we need to have a rx for a new mask, in relations to your mask not being the one that you like.

you cant put the entire blame on apria healthcare. working in the company, i will say that it's a great company. it has millions of dollars of great equipment and products and of course. it's # 1 in the nation.

but before jumping into conclusion. i think the truth should be shed upon, the insurance companies. on most insurance, you can get a new mask every 6 months. but in between those six months, thats a totally different story.

from my experience i have seen that the insurance companies would seen the patients to call us. so they wouldnt have to deal with anything.

apria is willing to trade mask. but for that you need a prescription that your doctor can easily fax over to the branches. " fit for mask" is all it has to say. if apria could do it for you, they would. but doctors prefer their patients to request such things.

as long as you have a prescription, apria will gladly like to cover it. if your insurance does not want to pay for the replacement. then thats a different story.

in the end, i would blame many of the difficulties in relations to replacing mask, the fault of your insurance companies, and the policies you pay for.

Bellcrest · Post by **Bellcrest** » Wed Sep 20, 2006 3:19 pm

Masks require a RX? I don't think so. At least it hasn't been my experience. My Doctor is far too busy with patients etc to waste his time writing scripts for something that can be purchased quite easily without one.

This whole apena thing is out of control. A script for a machine that blows air, and now for a mask. Give me a break!

My insurance won't pay for a cpap/apap cause it only blows air, now then why should I need a script for something that only blows air?

I am quite fed up with the whole scenario.

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CPAPopedia Keywords Contained In This Post (Click For Definition): CPAP

neverbetter · Post by **neverbetter** » Wed Sep 20, 2006 3:22 pm

That is because at apria they get a commission if you take a swift.

apria · Post by **apria** » Wed Sep 20, 2006 3:26 pm

just as you expect much from the customer service department of apria healthcare. you can expect even more from your doctors. the medical assistant in your doctors office can easily get the doctor to get you the rx.

all it takes is a simple phone call to the office of your doctor, they too will gladly fax it over to apria.

APRIA does NOT GET A COMMISSION if you take a swift. that is pure nonsense. a swift is no different than a breeze . except swift are once again more CHEAPER ON THE PTs ( depending on your insurance), and they bring all sizes that you might need.

bdp522 · Post by **bdp522** » Wed Sep 20, 2006 3:35 pm

After dealing with Apria I can tell you...

Talk to 4 different people at apria-get 4 different answers
Call with a question for RT-SOMETIMES they call you back
They tell you they are sending supplies-they aren't
Make an appointment-they call to reschedule
Complain to corporate headquarters-They start doing their jobs for a while
They fit you for a mask-you have to refit it yourself so it works
They tell you what machine you'll get-They bring a different machine because
someone else needed the one they promised you
Tell me again how nice it is to WORK for Apria-It's not so nice to have them
WORK for you!

Brenda

roadwarrior · Post by **roadwarrior** » Wed Sep 20, 2006 6:15 pm

While that particular instance was not why I too dropped Apria on their head, I felt that the desire to charge $2300 for a machine I could get from CPAP.COM for $709.00 absolutely unforgivable. I don't give a rats patootie if they are so called entitled to charge whatever they want.....it us usery pure and simple. Besides, they didn't help me at all. They also wanted $179 for the Activa...and the list goes on and on. Yea.......they are basically worthless.......

Patrick A · Post by **Patrick A** » Wed Sep 20, 2006 11:11 pm

I again talked to my insurance carrier BC/BS FEHB it is not an hmo They told me quote un quote I do not need permission to change masks and or a new prescription. Also because I'm now on Medicare it should cost ne nothing because what medicare doesn't pay they will.

Also I have tried to get a return phone call from an RT at the apria branch I am at and have yet to get one . And I called everyday for a week.
Customer service at APRIA is worse than at the Ca. DMV at least after an hour on hold with them they atleast talk to you for a minute or two.
Enough Said.

My insurance pays 90 % on DME before I went on medicare

ldemmery · Post by **ldemmery** » Thu Sep 21, 2006 5:14 am

My private insurance asked me to put a reference file number for any claims I make for apnea. Too simple.

I only get a new mask once a year. And now they only cover 80%, our insurance changed this year... sucks. But on the bright side, my husband also has insurance through his work and it covers the 20% not covered. So now I'm basically 100% again.

Living in Canada, I also have provincial health insurance over and above this. We're lucky, our insurances don't tell us who to see and where to go when it comes to health care.

Lynne

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