I want to scream!

[Emilia]

I knew things were going along much too smoothly.... easy sleep study, amazingly easy titration, sleep doc was perfectly accommodating to my request for the S9 Auto CPAP and mask that I want. His office staff is truly wonderful and forthcoming with information and support. So what is it that makes me want to scream? The gal at my doc's office tells me that my insurance, BCBS/FL Health Options, uses some odd middleman company called EMP who in turn doles out the Rx's to a local DME in my area. I have no idea who EMP is since they are only accessible via an 800 #. She tells me that they are horrible to work with and that I may wait weeks if not months to get my equipment.

Has anyone in FL or anywhere else had to deal with this mysterious company called EMP? If so, please share your story! I may be calling them daily to pester them into moving on my Rx's.

Arrrrggggghhhhh!!

[Wulfman]

I knew things were going along much to smoothly.... easy sleep study, amazingly easy titration, sleep doc was perfectly accommodating to my request for the S9 Auto CPAP and mask that I want. His office staff is truly wonderful and forthcoming with information and support. So what is it that makes me want to scream? The gal at my doc's office tells me that my insurance, BCBS/FL Health Options, uses some odd middleman company called EMP who in turn doles out the Rx's to a local DME in my area. I have no idea who EMP is since they are only accessible via an 800 #. She tells me that are horrible to work with and that I may wait weeks if not months to get my equipment.

Has anyone in FL or anywhere else had to deal with this mysterious company called EMP? If so, please share your story! I may be calling them daily to pester them into moving on my Rx's.

Arrrrggggghhhhh!!

Did you try to verify that with your insurance provider? Have you been given your prescription? (you NEED to have the physical document) While you're talking to your insurance provider, ask them if there are other DMEs in your area you who are "in-network". Otherwise, buy your equipment from an online seller like CPAP.COM.......in the long run, it'll come out about the same anyway......and you'll have alot less hassles.


Den

[Emilia]

Did you try to verify that with your insurance provider? Have you been given your prescription? (you NEED to have the physical document) While you're talking to your insurance provider, ask them if there are other DMEs in your area you who are "in-network". Otherwise, buy your equipment from an online seller like CPAP.COM.......in the long run, it'll come out about the same anyway......and you'll have alot less hassles.

Yes, I did my preliminary work calling the insurance company a couple of weeks ago. They defer all equipment to EMP to handle, and it is entirely up to them to designate a local DME to provide said equipment based on the RX. I guess not all DME's carry all brands so they will choose the one that carries ResMed for me. The Rx is specific for the S9 Auto CPAP machine and states it is to be dispensed as written. I cannot use any 'out of network' providers for equipment per my policy so I am at the mercy of EMP. I will wait until I speak with someone at EMP later today to see what I can find out on how to expedite my Rx's. I don't hold much hope for help from them, though. The gal at my doc's office said she has one patient who has been waiting for equipment (not sure if it is cpap or some other) since last SEPT. On the other hand, she has seen folks get their stuff in 2 weeks time. I have 100% coverage with no co-pay at all so it is certainly worth fighting for this for a while. If nothing is happening within a couple of weeks, I may choose to just buy my own stuff on cpap.com...... so much for insurance! My biggest let down is that I hoped to be sleeping better by the end of this week

[chunkyfrog]

If your insurance is through your employer, there should be a person in the Personnel department who you could 'sic' on somebody.
Our benefits manager at the county can really lay into insurance folks who are just jerking us around.
We worked him a lot when we had United Healthcare. He is a honey.

[Wulfman]

I would be doing some Google searching on that EMP company. Your situation sounds a little "shady" to me. (like maybe somebody is greasing somebody's palms)


Den

[sepool]

I was curious about this relationship between your insurance and EMP and I did some googling.

I found:

http://www.empmed.com/

and I found that BCBS/florida HMO uses EMP. I don't use an HMO, but I do hear that HMO plans sometimes means exclusive arrangements with providers.

[Emilia]

@ sepool, yes.... I did some research and found them, too. I do see on their website that they have a patient survey that can be submitted. The first question on it asks, "Was your equipment delivered timely and as expected?" LOL.... I've been thinking that for each person with whom I speak at EMP, I will submit an evaluation on their customer service! They show an email for their human resources dept. as well as for customer service. They are going to know me very well, I suspect!

Their Mission Statement:
We are a customer focused home care services management company dedicated to coordinating high quality home care services to rehabilitate and restore the health of our patients.

And for a good laugh, here is their Values statement:
Ethics and integrity is at the heart of our company’s approach to improving patient outcomes, with a strong belief in coordinating quality care and continued support. We are the "we care" provider in the industry.

And so a new adventure begins..... I'll be keeping you posted!

[Emilia]

@ chunkyfrog -- I am a retired educator, and my benefits are provided by the school district until I reach Medicare age. You are correct, I believe the district does have a contact person for BCBS/FL, and I will contact them should the need arise. Thanks for the suggestion!

[jules]

if you are in a HMO you are at their mercy regarding equipment - they don't have to follow all the rules - they make up their own rules and decide what YOU need, not you, not your doctor but the HMO decides

[LoQ]

Welcome to rationed health care.


Things you might want to consider:
1. Check craigslist.com
2. Ask your doctor to write you a second prescription that lets you buy any cpap and get one from cpapauction.com. I just checked, there are a few less than $100 that you might be able to get for a temporary solution.


Sorry for your bad fortune, and I hope it works out quickly for you.

[Emilia]

@ LoQ .... good idea on the temporary solution while I am waiting. I really have never had a complaint about my insurance. It has always been easy to work with, and when I had my gall bladder removed, I only had a small co-pay to pay. I have never needed any type of medical equipment before so I am seeing now how this is an incredible money-making segment of healthcare. These machines are basically simple air compressors with equally simple onboard computers....probably a lot less complicated than my netbook which I paid less than $300 to buy. It is a sleep-related cottage industry, for sure!

[elena88]

Oh Emelia,
I am so sorry to hear you hit this huge snag, that is so frustrating!

I knew you were going to be feeling better so quickly too..

Well, its going to happen, keep fussing, at least you will eventually end up with your shiney s9..

Be that squeeky wheel!

good luck!

elena

[unadog]

I paid $120 for a machine and mask on Craislist for the 2+ weeks between my titration and when I could get a machine frm the DME. I was desperate to get started. You can always sell it for about what you paid for it.

Good luck!
Michael

[Janknitz]

It's also a good idea to have a back up machine for travel or for times when your main machine needs servicing. So if you absolutely cannot wait, an inexpensive machine isn't a bad idea. Plus, it will REALLY help you appreciate the S9 when you get it

[LSAT]

Emilia...It sounds like you have no first hand experience with EMP. You are going strictly by what one person told you. Why not wait until you see what your personal experience is . You may be making a big deal out of nothing.