DME wants to know what happened to my old machine

[snardo]

Brief history: I've been on therapy for over 6 years. This past May I decided that it was time for a follow-up study to make sure my settings were still good. Bottom line was that I needed a slight bump in pressure. I also found out that, because it had been so long since I got my machine, I was eligible for a new one. I did my reserach and waded throught the typical baloney from the DME and ultimately got what I wanted. Now, four months later the DME just called wanting to know what happened to my old machine. They say it's for "insurance purposes". My suspicion is that perhapsthe insurance company doesn't want to pay for the new machine now. Has anyone else experienced this? I was under the impression that it was fairly standard practice to be eligible for a new machine every 5 years or so. Any thoughts?

Part of me says it's none of their business, especially since I've changed ins. companies since my first machine, so the current company didn't pay for the previous machine.

[nanwilson]

Maybe they want it back to they can clean it up and re-sell it If I were you I would just keep it as a back up machine.
Call them and ask "WHY" they want to know.

[snardo]

Called back and found out that the DME had screwed up the pre-auth for the new machine and the ins company wanted to know why I needed the new one. Apparently though, when the DME got my voice mail they called the ins company back and they told the DME not to worry about it and that they would cover it "this time".

[Roger2]

You did not say if you were on one of the Medicare Supplement or Medicare Advantage plans or regular insurance such as might be had from an employer. If you are under one of the Medicare plans, the information pasted below is from one of their pamphlets;

you should know about the new rules that start January 1, 2009.

Previously, the law stated that you would own the oxygen equipment after you rented it for 36 months. Under the new law, the rental payments will end after 36 months, but the supplier continues to own the equipment. The new law then requires your supplier to provide the oxygen equipment and related supplies for 2 additional years (5 years total), as long as oxygen is still medically necessary.


CMS Publication No. 11405


For more information about Medicare’s coverage of durable medical equipment, visit http://www.medicare.gov/Publications/Pubs/pdf/11045.pdf to view “Medicare Coverage of Durable Medical Equipment and Other Devices.” You can also call 1-800-MEDICARE.

You might want to check out their website from the url in qotes.

Roger

[rcummings54@hotmail.com]

it is for insurance purposes, they pay for one about every five years, most machines wont last that long, and the ins. co will probably say you need to take another sleep study, i am an rt, and worked for dme's for 16 years, they want to sell you a machine but its all up to the insurance co. i have some used cpaps in relatively good shape if you need a back up or dont want to mess with the ins co.-rc

[Slinky]

While CPAPs and oxygen concentrators are both "durable medical equipment" they are NOT subject to the same Medicare regulations. CPAPs are NOT considered "oxygen equipment".

Wasn't your old CPAP wheezing and noisy and sometimes stopped on its own and you had a tough time starting it again??