Received a new machine

[jules]

If you suspect that I am not happy with this DME, you are Right On.
Bill

Don't blame you.

[nightjar]

The tech that showed up at my door also confirmed that it is Auto BiPAP. I asked him what the IPAP and EPAP were set for. He said 14/9 cm h2o. I trusted him and the DME, my mistake. [. . .] If you suspect that I am not happy with this DME, you are Right On.
Bill

Bill, I sure hope you get the right machine, too.

And is there any way you can talk your insurance company into letting you deal with another DME? I know there are some good ones out there, but that particular DME isn't one of them. And their staff seems incompetent at best, and outright liars at worst.

Good luck--and let us know how it turns out.

nath

[boston]

I wonder how many people may get the wrong equipment, it doesn't work for them, is set wrong, etc., so they stop therapy.
Way to go DME's.

[Snoredog]

Bill had a bipap plus. He does need to carefully check the new script.

If the doc just wrote apap or auto, then the DME can bill the insurance for a new machine as this is a change in treatment.

If the new script indicated bilevel need, then the DME can balk and say the existing machine (Bipap plus) meets that.

If the new script specifically indicates Bipap Auto then there can still be a fight with insurance on paying for a new machine.

Bill didn't say that the DME asked for the new machine back yet. Also interesting.

My original script was written April 2008 for a BiPAP Plus. My sleep was better, but not as good as it should be. I had a regularly scheduled visit with the doc in November and he wrote a script for an auto BiPAP. When the DME called to arrange for their person to deliver the unit, I suspected that the model he quoted was Auto APAP. I refused to accept the machine and called the docs office to make certain the script was for Auto BiPAP. The nurse faxed an accurate script for an Auto BiPAP. The DME called to make arrangements to deliver and I asked if it was Auto BiPAP and they confirmed that it is. The tech that showed up at my door also confirmed that it is Auto BiPAP. I asked him what the IPAP and EPAP were set for. He said 14/9 cm h2o. I trusted him and the DME, my mistake. It turns out that the Auto Max is 14 and Auto Min is 9. BTW, my insurance is renting the machine on a monthly basis. Not sure how long, maybe forever? So it should not be a big problem to swap machines. For the record, the DME wanted to deliver the machine, then bill the insurance company. They also wanted me to guarantee payment if the insurance did not pay. I suggested pre-authorization and the DME prefers to deliver, then bill. I called the insurance company, talked to a nice gentleman, and agreed that the DME should call them first. He also mentioned that my diagnosis code was ok for an Auto BiPAP. If you suspect that I am not happy with this DME, you are Right On.
Bill

I would write them a letter, demand that they fill the prescription as written.
They did NOT fill the script with the correct machine even though Respironics are idiots and call it a bipap on the bottom of the machine. It is still NOT a bipap, Respironics just allows DME's to rip patients off, you don't know the difference when you get the machine, it is all about greed and money.

I would write that letter demand they take the Aflex back and give you the Bipap Auto your doctor wrote the script for.

I would CC: a copy at the bottom of the letter to:

your doctor
your insurance
your state board of medical practice in control of DME governance (i.e. State Licensing Board)

Give them 30 days to comply or sue them, the doctor, the dme and insurance for malpractice. Now that I look at where you live
it is probably "thedean" you are getting your equipment from

This is simply another case where the DME is trying to maximize profits by taking advantage of a patient who didn't know the difference between machine types.

[nightjar]

I would write them a letter, demand that they fill the prescription as written.

I would write that letter demand they take the Aflex back and give you the Bipap Auto your doctor wrote the script for.

I would CC: a copy at the bottom of the letter to:

your doctor
your insurance
your state board of medical practice in control of DME governance (i.e. State Licensing Board)

Give them 30 days to comply or sue them, the doctor, the dme and insurance for malpractice.

Yep, what he said. Though the doctor seems to have done the right thing, and may help you get it all straight. But the insurance company should get on the DME's case, too, once they get your letter. Or a phone call from you.

But if you do write a letter, and you have in hand the script for the BiPAP Auto that the doctor wrote you, be sure to include a copy of it with the letter.

What you really need is a new DME. That's what you need to crusade for--along with the right machine, of course.

Let us know what happens. . . .

nath