On-line vs DME - for the first time

JimmyKSenior · Post by **JimmyKSenior** » Tue Oct 18, 2005 6:46 am

I have finished all the studies and have a prescription. I have a fairly local DME and billmyinsurance.com, both contacting my insurance company and I apparently have a very good plan with 100% coverage and no limitations.

My question is does anyone have any suggestions on which resource to use for the first time? I am not sure the DME has all the machines that billmyinsurance has, but want to do research before getting into a situation I'll regret later. Does the DME and dealing with a person (in person, face to face) have any advantage over dealing with billmyinsurance over the phone.

The hook-up, setup, connecting, use, etc. doesn't seem too complicated but then I've only done it once with a tech for my titration study.

Since I have coverage, it seems I should get the best machine possible right out of the gate. Billmyinsurance got back to me in less than one working day (same day); the DME is going on 3 days with still no response.
Suggestions??????

Jim

Sleepless on LI · Post by **Sleepless on LI** » Tue Oct 18, 2005 7:06 am

[quote="JimmyKSenior"]Billmyinsurance got back to me in less than one working day (same day); the DME is going on 3 days with still no response.
Suggestions??????

Jim

johnnygoodman · Post by **johnnygoodman** » Tue Oct 18, 2005 8:53 am

Howdy,

There are a few things about BMI to consider that you may not be aware of:

#1. Every member of our BMI phone support team has worked on the cpap.com phone support team. Meaning, when it comes to CPAP they will either know your answer or be able to get your answer very quickly. No rookies.

The question is this: which is more valuable, a person near who doesn't know the answer to your question or a person far away that does?

#2. On request, BillMyInsurance.com will ship products to customers pre-assembled. We can do this to various degrees, from "plug it in, hit power and sleep" to "leave my mask in the original package but make everything else ready" to "set the machine and do no more assembly".

We're pretty serious about CPAP.

Johnny

Wulfman · Post by **Wulfman** » Tue Oct 18, 2005 9:34 am

Jim,

I realize these are confusing times for anyone starting on this journey. However, most everyone posting here can speak from experience.
I echo what Sleepless on LI (Lori) told you.
I dealt with CPAP.COM (which has the same parent company as billmyinsurance.com) and have absolutely no regrets about doing so.
This stuff is easy to set up if you read the directions.
I feel confident in saying that you won't regret going through BMI.

Best wishes,

Den

Guest · Post by **Guest** » Tue Oct 18, 2005 9:44 am

With my insurance and the deductable, it was about the same price to buy it outright from cpap.com. they were great!!! answered all my questions, told me how to fit the mask the best, and shipped it right away. the dme was going to rent me a machine for 3 months, then sell me one. i asked what the total price was and they could not tell me. finally, i got shuffled around to a billing person that told me what MY price was, after insurance. that was about the same as buying from cpap.com. BUT- the cost to my insurance was going to be $3800!!!!!!!!!!! Buying one from cpap.com cost me $600. I asked the dme about the cost and they said they charge for delivery, setup, and instruction on use, as well as the rental for the 1st machine for 3 months. the ONLY advantage of doing the rental would be if you don't follow thru with treatment and have them take it away after the 3 months, but we should not do that now, should we??!!

JimmyKSenior · Post by **JimmyKSenior** » Tue Oct 18, 2005 9:49 am

Lori, Johnny, Den, and guest,

This is exactly what I was looking for! I also read some other posts with similar questions.

Bonnie at BMI has been great, got my insurance verified in only a few hours, still day 4 and counting for the DME to even call me back. My feeling is this is not stuff to screw around with and I need to get going. Life or death? Hell, who knows, but it is mine they are messing with! I sent Bonnie some questions so she'd know what was on my mind and will be calling her in a few minutes.

You've all been great, the ball is now in my court.

Jim :

_________________

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

Wulfman · Post by **Wulfman** » Tue Oct 18, 2005 9:58 am

Jimmy,

PLAY BALL!!!

Good deal! Glad to hear that. Those people are GREAT!

Take care,

Den

Frustrated in Ct. · Post by **Frustrated in Ct.** » Tue Oct 18, 2005 10:37 am

I'm new to this cpap stuff and have finished my study and now am getting the run around and double talk by Apria. What a joke.... I've done reseach into the type of bipap I want and my doctor wrote out the script. For the last two weeks Apria has 1) lost my prescription twice. 2) Never called me back 3) is being evasive with the insurance/rental coverage. 4) Have a staff that seems to care less about doing their jobs. My doctor's office said there have been numerous complaints about Apria's lousy service. I'm about to give up and just buy my bicpap out right and forget my heath insurance.

Frustrated in Ct.

johnnygoodman · Post by **johnnygoodman** » Tue Oct 18, 2005 11:09 am

Frustrated in Ct.,

Because BiPAPs are expensive, it is a good idea to try to get it covered by insurance AND get the one you want. Because of this, I would visit BillMyInsurance.com, select the BiPAP you want, and fill out as much of the form as you know.

Or I'd just give them a call 1-800-266-1575 and see if they can help you.

Once you know if BMI can help or not, THEN you should start choosing between Apria and cpap.com.

Johnny

sanctacaris · Post by **sanctacaris** » Tue Oct 18, 2005 11:49 am

Far be it from me to be the defrender of DMEs, but the one reason I can think of to go with a DME rather than BMI would be that some DMEs (mine, at least) allow you to try on a number of different masks before your insurance purchases one. I found this to be very helpful when I was starting out, and I don't know if it's possible to do something similar via BMI.

On the other hand, I'm now doing battle with my DME over the outdated machine they set me up with, so I may be returning it (fortunately it's still a rental) and going with BMI instead. They certainly sound like a good operation.

Roger... · Post by **Roger...** » Tue Oct 18, 2005 1:21 pm

Before I began the process of buying equipment I had trouble getting a consistent coverage answer from Blue Shield Insurance. When I spoke with my sleep center they were evasive about equipment cost, unconcerned about coverage and didn't seem to be in a hurry to be helpful. This kind of interaction had me looking elsewhere without hesitation.

When I called BillMyInsurance, I phoned and spoke with a person who said, “If we can’t save you money we’ll tell you.” I've heard that before, but in this case they meant it. My instructions were to fill out the web form and stand back. Not long after the form was completed, an email message arrived from Bonnie. In the message it seemed like they were going to get documents from the doctor and make the deal before I knew what was happening. This prompted another phone call and this time Bonnie answered. When I expressed my concern, she cleared up the confusion and mentioned that those documents, Sleep Study & Prescription, were needed to handle any insurance billing, but that wouldn’t happen unless we agreed on the cost first.

Hearing Bonnie’s explanation made things less confusing. It was during this phone call I mentioned my three attempts to gather information from the insurance company that produced three different answers. This surprised her and she promised to handle the insurance checking personally. When I heard back from her she found out why the insurance company answers were so different. She also had a clear answer about the coverage and a net cost for my submitted equipment list. In my case, she said I would save money by going directly to Cpap.Com.

With that information, I called CPAP.Com on Monday and spoke with another can-do type named Becky. Becky easily handled my first-timer questions with ease, grace and delivered what seemed like straight-talk about the choices I was considering. By the end of our conversation with Becky, I knew some of the problems that might surface from my mask choices, the total purchase cost, the machine settings they would use, an expected delivery date and a year’s supply of filters.

In my conversations with Bonnie and with Becky, I found both of them to be knowledgeable, clear about the process, and energetic in their approach to handling questions. Analytics, like myself, need this kind of response to keep from going into checking-mode. Checking always delays my decisions and in some cases will abort a process in the gate. From my perspective, both of these business work-groups understand that it is important to have competent, pleasant and interested people answering the phones. While I don’t understand everything about these businesses, their approach sure worked for me.

Sleepless on LI · Post by **Sleepless on LI** » Tue Oct 18, 2005 2:03 pm

Jimmy,

Repeat after me, "Bill My Insurance, CPAP.COM. Bill My Insurance, CPAP.COM."

Like Wulfman/Den said, "Play ball!" Go with those who are ready, willing and able to help you and don't rip people off, like most DME's. You should be up and running in no time once you give them the go-ahead. If they were able to handle my insurance, I would have gone through them, too. I am one of the unlucky ones in that regard, although I had a great DME I never had a problem with, except they don't carry the Aura.

NOzsnAZ · Post by **NOzsnAZ** » Tue Oct 18, 2005 10:28 pm

Jimmy,

I had the exact same concerns as you when I was looking for my first (and only) machine a month ago.

After talking to several DMEs and getting nowhere in regards to the equipment I wanted, I called BMI and was pleasantly surprised with how easy it was. I was very concerned about "setting up the equipment" and "what FF mask to get" but I can now report that it's not rocket science!

I'm glad I went through BMI and now my only concern is in regards to "maintenance issues" like when will my insurance allow me to order another mask, etc.

Unfortunately like many other medical issues, you have to do your own research. This site (and others) are excellent tools for us novices to utilize to get informed.

Best of luck,
NOzsnAZ

WAFlowers · Post by **WAFlowers** » Wed Oct 19, 2005 9:46 am

Roger, I'm thinking that Johnny should post your message on the billmyinsurance.com and cpap.com sites as a detailed, well-written example of why people should buy from them!

JimmyKSenior · Post by **JimmyKSenior** » Wed Oct 19, 2005 2:44 pm

Good input from everyone - you make this process much more bearable than going it alone!

Quick update:
Bonnie from BMI got back to me the same day and verified insurance coverage by the next day. She also answered a ton of newbie-like questions. She contacted my Doctor for the PAPerwork or is that CPAPerwork, but the Doctors office has dragged their heels. A quick call from me today will supposedly get the PAPerwork sent.

The DME took three days to acknowledge me and another two to say they submitted paperwork to ins co and the machine cost $2000 so it is worth it but will take 7 - 10 days to process. Due to the fogginess and poor judgement we are trying to cure with this treatment, I failed to ask what machine. I will next time (I won't be using them, don't worry) but it does appear that they are not intending to give me any choices. The DME called magically soon after I told my doctor that were being unresponsive and I was going with BMI as my DME. She apologized and promised daily calls (none today so we know what that promise is worth and where their service standards are). Bonnie has been in contact at least once a day if not more and has a very good empathy for us and how anxious we can be to get moving.

Bonnie rocks and BMI rules!

On-line vs DME - for the first time

On-line vs DME - for the first time

Re: On-line vs DME - for the first time

Another data point on BillMyInsurance.Com & Cpap.Com

Adventure Update - DME vs BMI

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