Another DME headache

[Chewtoy]

Hello all, my name is Jeremy, and I've recently become a hosehead. A frustrated hosehead.

I'm sure you've all heard this story many times, please allow me to vent. After my titration study, I woke up feeling great. I went home, took a shower, went to work, worked all day.. didn't even need my wakeup triple shot of espresso.

Then after several awful nights I got a call from the DME company my insurance wanted me to use: my machine was ready. Hooray! I would finally be rested! My sleep issues would be treated! It was right, it would work, and nobody would have to be nailed to anything.. sorry, different story.

Anyway, I went to pick up my machine, expecting something nice and shiny like my wife's Elite II, only to see the saddest little machine I'd ever seen. In all fairness, it turned out to be a pretty decent, well designed basic machine, but not what I wanted. No bells, no whistles, no EPR or C-Flex or data logging or anything. "It's your insurance" they told me. "It'll only cover a basic machine." I tried to educate them, to no avail.. I called my Dr's office to confirm they wanted me to have a logging machine, they did, so he wrote out a new prescription specifying the s8 II, wrote a letter of medical necessity to get the insurance to cover a more "advanced" machine. (Probably not necessary, but my insurance company is greedy enough that I wouldn't mind seeing them pay a bit more, even if the DME company is seriously marking up the machine).

So I call the DME company, tell them that I got the insurance to approve a more advanced machine, request the elite II.. "We don't sell resmed" they tell me, "only respironics".

"Ok, an M Series Pro has the same features."

They have to order it. A week later I get the call saying that my machine is in.

My brand new.... M Series Plus.

"This logs all of the data you're looking for." they told me.

"Pretend I'm from Missouri and show me." I replied.

Of course they can't, because there isn't any data on the card and they can't show me another patient's info.

Are they crooked, or just ignorant? I know hanlon's razor says to "Never attribute to malice that which can be adequately explained by stupidity", but it's getting frustrating.

I've since called their head office, e-mailed their customer support address, called the "quality assurance" person from my ins. co. that called yesterday to see if I had gotten my new machine, called my dr's office to confirm that they do, in fact, want me to have a fully data logging machine.

Ugh.

Ok.. venting done. Thanks for your patience.

Good night and good luck,

Jeremy

[Severeena]

Jeremy you should have gone to a different DME that is in your insurance network.

I am lucky that all of the DME's I need are in my insurance network.

You may want to get another script, tell that DME to get stuffed and then get the machine you need from someone else..

This is the key word, NEED.

[OmniMarconi67]

I got my equipment directly from the sleep clinic, is this unusual?

[sleepycarol]

Yep, my first DME, a locally owned mom and pop type did the same with me. I usually try to keep my money local to help our local economy so my first choice of DME was this particular one. Gave me the plus and argued till they were blue in the face that it provided "data". Of course couldn't "prove" it. Fired them and found me that would give me what I was scripted.

[Victoria]

Oh my gosh!!! This is EXACTLY what I am going through right now!!! I *think* I might have solved this problem...I *hope*. Ugh. All I can suggest is, can you find another DME? That would be my next suggestion.

[Chewtoy]

My current plan is to change DME companies, I'm waiting for a list of in-network companies so I can call around and find the one that will give me the machine I need.

Omnimarconi67: Some sleep clinics also provide machines. Mine does, but they aren't in-network for my insurance so I would have had to pay for the entire machine out of pocket, including the astronomical markup.

[Wulfman]

Are they crooked, or just ignorant?

YES! and YES!
I would select one from "Column A" and one from "Column B".

If you're paying insurance premiums (withheld or otherwise) and your insurance provider is footing most of the bill, it's YOUR money.....and YOUR therapy. YOU'RE entitled to have the machine and technology YOU WANT.

Den

[GumbyCT]

My current plan is to change DME companies, I'm waiting for a list of in-network companies so I can call around and find the one that will give me the machine I need.

You are on the right track, my friend. Some insurances have a listing on their website.

Are they crooked, or just ignorant? I know hanlon's razor says to "Never attribute to malice that which can be adequately explained by stupidity", but it's getting frustrating.

I've since called their head office, e-mailed their customer support address, called the "quality assurance" person from my ins. co. that called yesterday to see if I had gotten my new machine, called my dr's office to confirm that they do, in fact, want me to have a fully data logging machine.

Keep calling, keep a log too, and don't give up, just remember not to loose your temper, I know, I know. I got that hat, and the shirt

Practice just asking simple questions in a low voice, repeat their answer to be sure you understood them correctly. If they are like my DME, the people that answer the phones are hired off the street and are clueless; so you have to ask for a supervisor or RT.

Stupid, ignorant, incompetent, or crooked - which do you want working on you? You're paying the same price.

Just be thankful they don't do medical emergencies, I am.

[Slinky]

And then they wonder why "local DME supplier" are not just dirty, but FILTHY, words to so many of us.

[THE HARD TRUTH]

I WAS FIRST DIAGNOSED WITH OSA IN JULY 2008 AND LIKE EVERY ONE ELSE WHO HAS THIS DIAGNOSES,IS WAS TOLD ABOUT THE GOLD STANDARD.EVERY APNEA WEBSITE THAT I GO TO YOU READ THE SAME THING.FIRST OF ALL I AM NOT IN DENIAL,I HAVE APNEA AND IT CAN KILL ME.FOR SOME PEOPLE THEY ARE TOLD OVER AN OVER AGAIN THAT CPAP IS THE ANSWER.APNEA PATIENTS ARE BRAIN WASHED INTO THINKING THAT THERE IS NO THERAPY BUT CPAP.AT TIMES I THINK THAT MOST SLEEP DOCTORS HAVE A LOT OF STOCK IN THE CPAP COMPANIES AND THE DME'S.AND MAY BE GETTING KICK BACKS FROM THOSE COMPANIES.THE DOCTORS AND THE DME REPS TELL YOU JUST GET USED TO HAVING HURRICANE KATRINA STRAPPED ON THEIR FACE.JUST GET USED TO THE OVER PRICED MASKS THAT LEAK AND THE 50 LBS OF TIGHTNESS ON THEIR STRAPS JUST TO HOLD THE THING ON YOUR FACE THEN THEY TELL YOU THAT THE PERFECT MASK IS JUST AROUND THE CORNER.IT REMINDS ME OF THE SCENE IN THE FIRST ALIENS MOVIE WHEN THE HALF SQUID AND HALF CRAP CLIMBS ON TO YOUR FACE.FIRST OF ALL CPAP'S ARE OBSOLETE.THEY TELL YOU YOU WILL GET USED TOTHE RESISTANCE OF YOU LABORED BREATHING OUT AGAINST THE INCOMING PRESSURE. YOU KNOW WHAT I MEAN,IT'S LIKE BREATHING INTO A BALLON ALL NIGHT LONG.I AM A AIRCRAFT MECHANIC i KNOW ALL ABOUT OXYGEN MASK REGULATORS. PILOT DO NOT HAVE TO BREATH AGAINST 300 LBS OF PRESSURE.THERE IS ABSOLUTLY NO REASON THAT YOU HAVE TO ACCEPT THAT YOU CAN'T EXHALE NORMALLY. THIS IS THE 21ST CENTURY.BIPAS AND CFLEX ARE OPTIONS FOR A LOT OF PEOPLE.THEN YOU HAVE PEOPLE LIKE ME,THAT EVEN THOUGH YOU HAVE A HUMIDIFIED FISHER AND PAYKIIL AND A HUMIDIFIER IN YOUR BED ROOM.YOUR RINITUS MAKES YOU APNEA THROUGH YOUR NOSE.THEN THEY TELL YOU THAT THEY HAVE TO CUT OUT YOUR SEPTUM AND PACK YOUR NOSE COMPLETELY WITH GAUZE FOR THE NEXT 6 WEEKS SO YOU CAN'T BREATH. THE ONLY REASON THAT I AM WRITING THIS IS TO SAVE YOU FROM WHAT I HAD TO GO THROUGH.I DECIDED TO GO THE ORAL APPLIANCE ROUTE AND I AM SURE GLAD THAT I DID. SINCE I HAVE NO TEETH A TAP WILL NOT WORK FOR ME BECAUSE I CAN NOT MOVE MY JAW FORWARD. AND THEN A DENTIST IN COLUMBUS OHIO FOUND A SOLUTION FOR ME. iT IS CALLED AVEO tsd AND IT IS MADE IN NEW ZEALAND BUT IS APPROVED BY THE FDA. APNEA IS SIMPLE MECHANICS. YOUR TONGUE BLOCKS YOUR AIRWAYS. THE TOUNGE STABILIZING DEVICE THROUGH SUCTION HOLDS YOUR TONGUE OUT.IT REALLY WORKS.100% COMPLIANCE FROM THE FIRST DAY THAT YOU USE IT.iT COST THE SAME AS ONE CPAP MASK $150.YOU JUST HAVE TO GO TO A DENTIST AND YOUR SLEEP DOCTOR CAN FIND A GOOD ONE FOR YOU. BUT IF YOU STILL WANT TO BELIEVE THAT YOU HAVE TO ACCEPT CPAP GO AHEAD AND KEEP TELLING YOURSELF THAT IS IS THE ONLY THING THAT WORKS OUT THERE.kEEP LISTENING TO THE BULL THAT YOU WILL JUST GET OVER IT

[OldLincoln]

Hard Truth.... Please, not all caps as it is very difficult to read.

[Wulfman]

Hard Truth.... Please, not all caps as it is very difficult to read.

He (?) is posting to many threads.....and is approaching SPAM status. I didn't realize it when I responded to a post in a thread a little while ago. Then, I saw the others.

Den

[AuntieNae]

Definitely spam level to me

[coloradogal]

You can win this, I did. I had my sleep study in November 08, and the Dr. from the sleep lab, sent a prescription to a DME. Of course I was given the REMSTAR PLUS with C-flex. I had never heard of CPAP, and was clueless. All my DME cared about was my compliance, and making sure I sent in the smart card on time. I did everything I was suppose to, then when I’d had the machine for two months, the DME started sending cards for a RESMED, and insisting that was what I had!!! The local branch of the DME was ok, but once I had the machine, all contact was from Oklahoma, and I’m in Colorado. They told me my insurance (Medicare) had bought the CPAP, and I was stuck with it, then I found your website and “educated myself”. I obtained a copy of my prescription from my records, called a different DME , explained the situation, and told them I wanted a REMSTAR PRO, since I already had the humidifier. I took the REMSTAR PLUS back to the old DME, got a receipt, and my new machine was delivered 2 wks ago. I found out I had met the Medicare requirements for compliance after the first 30 days. I wish I had found cpaptalk.com earlier, but better late than never. Good Luck.

Coloradogal

[Slinky]

Good on you, ColoradoGal, I LIKE your spirit and gumption! Nothing like dumping a crappy local DME supplier for a good one to make our day! Not only did I have the pleasure of telling my first local DME supplier WHY I was dumping them, I had the pleasure of doing so a second time when the main office called to ask why I changed suppliers!!!