Expecting a battle with a DME provider

[plr66]

On another couple of threads, I have been asking about my re-evaluating the provider I initially chose to provide me with all my cpap needs following the sleep study and Rx. After 2 weeks on a "rent to own" deal that my BCBS requires (billing has not yet gone through, as far as I could learn today), I am wanting to can this agency, return everything, and order the whole bundle online for what seems like a lot less, given that I have $1000 deductible and only 3 months till that $1000 deductible begins again! I do not expect this return-effort to go smoothly, and need a bit of support here, as I partly feel uncomfortable or guilty that I have been using their new equipment and now expect to just return it and cut my losses.

On the other side, I had to pay $125 up front for the first month (non-reimburseable by insurance), which I bet will be completely forfeited (not clear from the written contract). Also am not sure what my insurance company will have to say about the part they may be billed for this first month. (BCBS reps have not been greatly helpful with details when I've called this week). This DME provider lied to me regarding my questions about online companies, and so I have little guilt here....but need some ammunition to face the onslaught I expect with them wanting to hold onto their contract/money.

The other thing I am concerned about is that my MD is and will be wanting me to do various things in the future like oximeter readings (I think that's what it's called), and don't want to burn bridges in a small town....

[Slinky]

If this local DME supplier is your only local option I don't see that you have much choice but to diplomatically but firmly return at least the CPAP (most insurances buy the other stuff outright) and tell them, thank you, but your annual deductable starts next month and for the amount of your deductable you can get the same CPAP and equipment online so you feel you have no choice from a financial standpoint. You can always tell them you weren't aware of your DME benefits and the applicable deductable or you wouldn't have troubled them. In our area, $135 is the monthly rental fee for a CPAP so assume that you will not be getting your copay on the CPAP rental back, nor your copay on the mask, etc. if they were purchased outright. Fair is fair. Bite your tongue if necessary but remain polite and diplomatic if at all possible. Thank them and then beat feet outta there!!!

[CorgiGirl]

I returned my first APAP to the DME I originally selected at the end of the first month. (I opted to do this because insurance had already paid for the month and my deductible situation isn't like yours.) I also gave them a letter I call "how you lost my business, let me count the ways." They are the "preferred CPAP provider" for a local medical network, so I sent a copy of the letter to the sleep center doctor (who is also my doc) and the head of the network. I haven't heard anything from any of them, but that's beside the point. I live in a suburb of a big city, so I have lots of choices and could afford to piss them off....

I called a couple of weeks ahead to let them know I would be returning the machine and going with another provider. I think calling ahead might help. Returning the machine and buying online will save you money. I think that's all you need to tell them, if you tell them that.

I wasn't required to tell my DME anything about why I was switching, but they did require permission from my doctor to "stop therapy," which my doc happily provided. This is their own policy and was not required by insurance or my doctor. You might want to check into what you need to do when you return it, in case they have a crazy policy like this one.

Good luck! You'll do fine!

[Slinky]

Oh, h*ll, the first DME supplier I got a device from brought out a Plus when my script specifically said M Series Pro w/C-Flex late on a Friday afternoon. First thing Monday morning I called to tell them I was returning it. They tried handing me those horsepuckies that I couldn't return it w/o a doctor's order too. WRONG THING TO TELL ME! Don't tell me I HAVE to keep something I'm paying for that is NOT what I expected to be paying for. I had it in their office w/in a half hour!!!! And I walked out w/o it and went straight to my sleep lab to tell them what I had done and to make sure the next local DME contracted w/my secondary provided THE RIGHT CPAP or I'd return that one too. That is when they suggested the Resmed S8 Elite w/EPR from another local DME supplier and I got the Elite.

Just make sure you get a receipt for the return!!!!

[IndyJudy]

After my rental period, I returned the new, rental CPAP to my DME. My organization only has one 'approved' DME. I told the RT I was returning it because: 1) the machine they gave me was not fully data capable, and 2) I could get the new, data capable machine I wanted from the web for a lot less $$ than my portion not covered by insurance. When I did return it, I had to sign something about 'not following medical advice'. My doctor knew I was purchasing it off the web, because he gave me a script to fax to cpap.com.

My insurance pays 50% and I pay 50% of the retail price. I did ask my insurance if they would pay for 50% of the CPAP from cpap.com, since it was such a savings. But NO, they wouldn't. I now pay for all cpap supplies out of my own pocket.

Next year I plan to purchase a new humidifier for my cpap and will increase my medical spending account contributions at work to pay for it for the tax advantage. Unfortunately, I wasn't diagnosed until after we signed up for benefits at work in 2007 for the 2008 calendar year.

Best of luck! Please don't feel guilty at all!! Business is business.

[Wulfman]

I'm fairly sure you won't have to return the humidifier.......if you haven't purchased it yet, you probably will have to as those things are pretty much non-returnable......but at least you won't have to buy another. The bad news is that unless they packaged the whole machine into the total (which I doubt) the costs for humidifiers from brick & mortar DMEs are around $400. You'll want to check this out in your paperwork and with your insurance provider. No sense in giving something back that you either have or will have to pay for.

Den

[CorgiGirl]

I'm fairly sure you won't have to return the humidifier.......if you haven't purchased it yet, you probably will have to as those things are pretty much non-returnable......but at least you won't have to buy another. The bad news is that unless they packaged the whole machine into the total (which I doubt) the costs for humidifiers from brick & mortar DMEs are around $400. You'll want to check this out in your paperwork and with your insurance provider. No sense in giving something back that you either have or will have to pay for.

Den

I had no problem returning both the APAP and the humidifer to my original DME...my insurance (Tricare) rents both the xPAP and the humidifier until it's "paid for." So be sure to check whether or not it's been purchased...

[Snoredog]

I'd return that rented junk ASAP. Tell them you are going with alternative therapy.

Then order a Sandman Auto online, can get the whole ball of wax for less than your deductible. Submit a copy of your PSG, prescription and machine invoice to BCBS and they will apply the monies spent towards your $1000 deductible.

https://www.cpap.com/cpap-machine/covid ... chine.html

Just order it online with a credit card, email or fax over a copy of your prescription, it shows up at your front door with all the instructions included. You can optionally get the Sandman software then print out reports to track your progress, all very easy to use.

Then for 2009, start a $500 medical savings account at your work if they offer it, and buy replacement supplies from that, you will be money ahead especially when you write it all off your taxes. You can buy a new top of the line machine every year with what deductibles are now.

[Guest]

I'm fairly sure you won't have to return the humidifier.......
Den

Den, are you talking about the water chamber or the whole humidifier? I could see them not reusing the water chamber.

[Wulfman]

I'm fairly sure you won't have to return the humidifier.......
Den

Den, are you talking about the water chamber or the whole humidifier? I could see them not reusing the water chamber.

Depends on how it is/was billed.......and what you may HAVE to pay. I would think that it would only be the water chamber, but I've never been through this......just reading about the experiences of others. It's been my understanding that the "humidifiers" are usually paid for up front and non-returnable. However, that's why I'd like some others to weigh in with their experiences.

Den

[Guest]

Listen - the extra money that a DME is able to earn by charging the nationally-recognized billable amount for EO601 is SUPPOSED to cover the equipment cost ALONG WITH a long-term professional service and level of compassion and caring focused toward the patient. Buying online shouldn't be advertised by you guys as a way to "save money" alone. This is not the case in all cases. If the manufacturers wanted to, they could raise the prices overnight to all of their internet providers thereby eliminating any of this "savings" you perceive.

The one poster CorgiGirl made a good point. If you are getting SHIT&Y service and/or dealing with a moron at your local DME, then true, it is your right to go online or elsewhere. For you to encourage people to keep telling their DME "I can get it cheaper online" won't benefit the online suppliers in the long-term (believe me, I know).

This whole treatment should revolve around a high and competent level of service provided by the DME. Remember that online providers are also DMEs. It seems they do a better job at customer service. Forget encouraging price wars.

[Wulfman]

Listen - the extra money that a DME is able to earn by charging the nationally-recognized billable amount for EO601 is SUPPOSED to cover the equipment cost ALONG WITH a long-term professional service and level of compassion and caring focused toward the patient. Buying online shouldn't be advertised by you guys as a way to "save money" alone. This is not the case in all cases. If the manufacturers wanted to, they could raise the prices overnight to all of their internet providers thereby eliminating any of this "savings" you perceive.

The one poster CorgiGirl made a good point. If you are getting SHIT&Y service and/or dealing with a moron at your local DME, then true, it is your right to go online or elsewhere. For you to encourage people to keep telling their DME "I can get it cheaper online" won't benefit the online suppliers in the long-term (believe me, I know).

This whole treatment should revolve around a high and competent level of service provided by the DME. Remember that online providers are also DMEs. It seems they do a better job at customer service. Forget encouraging price wars.

Why or why not? These are exorbitant prices for this equipment and for the most part, the insurance industry is paying for it and guess whose money they're using????? OURS!!! If we cut the amount our insurance providers are (stupidly) paying out, then we're ultimately saving OUR money.

There are also a huge number of people out there without insurance coverage (and it's only going to get worse) who still need therapy.

As far as the lousy service and lying DMEs........seems to be a way of life with them from the numerous and frequent stories I've read on the forum. Seems like the few good ones hang out here on this forum.

The sleep industry is ripe with morons.......who just expect to get paid for their service regardless of how bad it is. And, they've looked at the insurance industry as their "cash cow".


Den

[Slinky]

Listen - the extra money that a DME is able to earn by charging the nationally-recognized billable amount for EO601 is SUPPOSED to cover the equipment cost ALONG WITH a long-term professional service and level of compassion and caring focused toward the patient. ...

... This whole treatment should revolve around a high and competent level of service provided by the DME. Remember that online providers are also DMEs. It seems they do a better job at customer service. ...

I sure do have to agree w/Guest on these statements!!!!!! Well, there ARE good local DME suppliers out there but it does seem percentage-wise, the online DME suppliers are doing the better job.

I was gonna say, "gotta give the devil his due", but Guest doesn't seem like such a bad guy (or gal). Matter of fact, Guest sounds like he/she just might be one of the "good guys".

[plr66]

I very much appreciated all the thoughts and suggestions given to my original post on this thread--have been ruminating and waffling over what to do for the past week. Mostly struggling with whether to give up the possibe convenience of a brick & mortar DME if I should have problems with the equipment in the next year. Went in to my DME today to exchange my CPAP Pro C-flex for an M-series Auto A-flex--which my MD was perfectly fine with my requesting, after my researching this with everyone's posts here in this forum. Was given the new box without any accompanying manual, and said I certainly need that manual. The RT said "oh the only functions you can change are the same as on your first machine, so you can just use the manual you have." No, I said--the new machine has many more functions and I am purchasing this for that reason. "No" she said. "Only the MD or RT can adjust the extra functions." Yes I did politely tell her she was mistaken. I actually have no problem asserting myself.

This is the same RT who (as nice as she actually seems...) told me that residents of my state absolutely can not order cpap equipment online, and that I simply had not pursued that far enough to realize I was wrong to assume otherwise. She also has told me pretty emphatically that no one but the MD's and RT's can purchase or obtain software and readers.....despite my telling her I knew otherwise for a fact. The list goes on, and I'll spare you all the rest.

Yes I really do understand that DME's need to do what they can to stay in business and to not advertise what people can do for themselves that the DME might benefit from providing to us.

But today, she made my decision for me. I let her know in a polite manner that I am not comfortable at all with the way this is going, and will be returning my original machine next week at the end of the forced-rental-to-own. Hope I am not making a mistake here, since I have never been able to clarify which parts of the package I have to "own" (as I think Den pointed out), and which are returnable.

[OldLincoln]

Your 9/25 experience sounds EXACTLY like mine with my ex-DME, SleepMed. Is that perchance your's? Even after I caught her in a dozen or so outright lies, she just told more to cover it up. Now I am doing business with another DME and so far it's great.