DME in San Diego or on Internet?

[pats]

I've been diagnosed with moderate OSA, and prescribed APAP. The bad/good news is that I do not have DME benefits, so I have to pay, but get to pick my equipment and supplier.

I live in San Diego. My choices are either a DME who operates here, or one on the Internet. Has anyone had good experiences with either, especially with after-sale service?

I'm good at reading manuals and setting up equipment, so I don't feel I really need anyone to come to my house to show me how to use the APAP. I plan to pick a unit with a data card and use SleepyHead to process the data.

[Julie]

Hi - the all-around least expensive way to go is online, and the sponsors of this forum (Cpap.com) are not only the best, but have more choice than any others.. and I have no personal stake here.

They are also very knowledgable about their equipment and helpful on the phone.

I would check with your insurance company if you have one, to make sure there's no problem about turning in the invoices when you get them - they will need a copy of your prescription to keep on file... forever. Make sure you're prescribed Apap, then have the choice to set it just to Cpap if you want to, plus get an efficacy data capable machine, not one that just shows compliance.

Good luck!

[chunkyfrog]

I agree with Julie.
They are not just good at customer service; it appears to be important to them.

[chunkyfrog]

I've heard nothing but good stuff about these folks, too.

[pats]

Hi - the all-around least expensive way to go is online, and the sponsors of this forum (Cpap.com) are not only the best, but have more choice than any others.. and I have no personal stake here.

I'm going to buy on-line. Only one of the local DMEs passed the basic tests of having a web site I could find, having an e-mail address - I hate being put on hold or playing phone tag - and responding reasonably promptly to a request for prices with an actual dollar number. That DME was so expensive for either of my top two choices of machine that I can buy one of them on-line, try it out, buy the other if I don't like the first one, and still save money. I expected to pay a bit more for more personal service, but not over 2x.

I will have to do some of my own data analysis, but I suspect I'm better at statistics and reading graphs than many of the DME representatives. SleepyHead looks fine. Also, it is open source, and is well enough written that if I don't like the way it handles something I can do my own changes. It only took me a few minutes to track down a Zeo data import bug once I had everything set up.

After reading some of the messages here, I'm really glad I am not paying for DME insurance. As it is, I can vote with my wallet against businesses that set excessive list prices, or don't provide the type of communication I want.

[Classic SleepCare]

Hello, my name is Ryan and I am a Customer Service/Patient Care/ Physician Liason/ Rep....Isn't that how you start this off?

What does no DME benefits mean? With an RX from your physician your insurance should more than cover the cost unless you have an unusually high deductable then it would not be advantageous unless you look at the benefit of quality follow up care. I encourage everyone to send your insurance information to verify benefits if you have any questions. There are no obligations and you can always say "No Thank You" and your on your way; no harm no foul. What about your supplies? I would be interested in hearing more about your download reading endeavors as I know physicians that cant make heads or tails of it. I know I cant without a clinician. CPAP therapy is not something that should be taken so lightly as so many health problems are being linked back to the quality of sleep one gets.


I completely respect your opinion but I ask that you think it through on the "do it yourself" path your are looking at taking. Having a Respiratory Therapist come to your home to set you up is no more expensive than just getting the machine alone. There should not be an extra charge for that if that is what you are being told. Also, you may want to rethink a smart card and look into a modem. If you did order the Respironics machine most MD's who prescribe CPAP therapy should have the software to do the downloads at their office not only to gauge the effectiveness of your therapy but to keep you in the compliance range of your insurance provider. A good DME company will be on top of that as well. I know there are quite a few terrible DME's out there, especially when it comes to CPAP as that is not where "the quick money is". Most DME will do CPAP only to get to the doctor's Oxygen or they are so big patients fall between the cracks....Then there are the mom and pop shops that operate out of their garage! Sheesh! How confusing! That is not the case with my company, thankfully! We are a boutique company that only provides CPAP and after set up support. We do have an outstanding patient care model that keeps our patient base not only compliant but maximizing the benefits of their therapy.

It's so confusing to potential CPAP patients and new patients that we are looking to start a free support group in San Diego if there is any interest. It seem everywhere else has them. It looks at this time to be a once a month thing. I will be present along with one of our Respiratory Therapists to answer any questions and help resolve any issues. Its a confusing world out there, especially when you are ne to this! Our company was actually founded upon the negative experience our CEO had when getting set up for his CPAP therapy if that tells you anything. Plus, we have a website and contact information sounds like it puts me ahead of the game already!


I invite you to visit our website at: http://www.classicsleepcare.com
and our corporate office in Los Angeles is: (818) 707-2454

If you would like to speak to me personally with any questions please email me at ryanc@classicsleepcare.com and I would be more than happy to give you a call and help in any way I can.

[pats]

Hello, my name is Ryan and I am a Customer Service/Patient Care/ Physician Liason/ Rep....Isn't that how you start this off?

What does no DME benefits mean? With an RX from your physician your insurance should more than cover the cost unless you have an unusually high deductable then it would not be advantageous unless you look at the benefit of quality follow up care. I encourage everyone to send your insurance information to verify benefits if you have any questions. There are no obligations and you can always say "No Thank You" and your on your way; no harm no foul. What about your supplies? I would be interested in hearing more about your download reading endeavors as I know physicians that cant make heads or tails of it. I know I cant without a clinician. CPAP therapy is not something that should be taken so lightly as so many health problems are being linked back to the quality of sleep one gets.

"No DME benefits" means what it says. I get my medical care through an HMO, and that is my only current medical insurance. The HMO's sleep clinic confirmed that I have no coverage for this, which is what I expected.

I do have good access to clinicians, and will be seeing a specialist in a couple of weeks to discuss Provent.

I'm perhaps more qualified for some of this than the typical clinician or physician. I'm a retired computer scientist, have installed and managed my own home computers for over 30 years, was using the Internet long before it was feasible to have home access, and have as much post-secondary education in my field as a medical doctor has to have in theirs. I was already equipped to read SD cards, and have spare SD cards lying around.

I completely respect your opinion but I ask that you think it through on the "do it yourself" path your are looking at taking. Having a Respiratory Therapist come to your home to set you up is no more expensive than just getting the machine alone. There should not be an extra charge for that if that is what you are being told. Also, you may want to rethink a smart card and look into a modem. If you did order the Respironics machine most MD's who prescribe CPAP therapy should have the software to do the downloads at their office not only to gauge the effectiveness of your therapy but to keep you in the compliance range of your insurance provider. A good DME company will be on top of that as well. I know there are quite a few terrible DME's out there, especially when it comes to CPAP as that is not where "the quick money is". Most DME will do CPAP only to get to the doctor's Oxygen or they are so big patients fall between the cracks....Then there are the mom and pop shops that operate out of their garage! Sheesh! How confusing! That is not the case with my company, thankfully! We are a boutique company that only provides CPAP and after set up support. We do have an outstanding patient care model that keeps our patient base not only compliant but maximizing the benefits of their therapy.

"no more expensive than just getting the machine" is half true. Nobody has proposed a specific charge for home set-up by an RT. On the other hand, they have proposed machine prices ranging up to $900 more than cpap.com wanted for the same machine. If a local DME had responded promptly and quoted a price that was within a hundred or so of the going machine-only price I would have seriously considered it, but that did not happen.

It's so confusing to potential CPAP patients and new patients that we are looking to start a free support group in San Diego if there is any interest. It seem everywhere else has them. It looks at this time to be a once a month thing.

Between two close friends who are experienced CPAP users for general encouragement, and this group for specific questions, I feel I have enough support, and will not be attending.

[Classic SleepCare]

Yes HMO's are tricky, I understand more now. I thought of that after my post. It sounds as if you feel you have a pretty good handle on this but consider me a resource if need be. If I don't know the answer, I am sure I can find somebody that does. Have a great day!

[pats]

Yes HMO's are tricky, I understand more now. I thought of that after my post. It sounds as if you feel you have a pretty good handle on this but consider me a resource if need be. If I don't know the answer, I am sure I can find somebody that does. Have a great day!

Yes, I do have a question. Why is the difference between the Internet machine-only price and the DME home delivery price so big?

[chunkyfrog]

Since online prices for most other consumer goods do not vary significantly from local store prices;
most of us here assume the vast differential is due to other factors.
Remember, that most folks' first visit to a DME is when they are sleep-deprived and
barely functional--mentally at the very least..
Far be it for me to say that it might be a tiny bit too easy to take advantage of the situation.

[Classic SleepCare]

Yes HMO's are tricky, I understand more now. I thought of that after my post. It sounds as if you feel you have a pretty good handle on this but consider me a resource if need be. If I don't know the answer, I am sure I can find somebody that does. Have a great day!

Yes, I do have a question. Why is the difference between the Internet machine-only price and the DME home delivery price so big?

The price quote somebody had mentioned earlier is not far from the mark from what we would do for a "cash for service" patient, depending upon machine. As I stated earlier, most DME's are in for the "quick money" or simply put CPAP second (CPAP is the red headed step child of DME) since there are more profitable ways for them to spend their time; in the short term. The second reason is that there are simply people out there that do bad business, take advantage of and simply don't care.

Without getting into a debate over profit models, simply put, a well cared for and compliant patient can be just as lucrative or more so in the long run. If you take good care and keep them compliant then who will they be loyal when it's supply time? The DME that leaves their machine on their door step, the internet where the difference is minuscule ( not to take away from the web based services as some are very good) or where they feel they are getting the proper care and personal attention with a good value? It really does boil down to customer service

I hope that was somewhat helpful

[pats]

I invite you to visit our website at: http://www.classicsleepcare.com
and our corporate office in Los Angeles is: (818) 707-2454

I took a look at your website. These are some suggestions for changes that might make it more attractive to people like me who are used to e-commerce, electronic communications, and managing their own health. Some of the things I'm asking for may be present, but I did not find them:

1. Provide an e-mail address or form for new customer queries. I regard telephone as a very inconvenient and outmoded way of doing business, because of time wasted on hold or playing telephone tag. I much prefer asynchronous communication media that let each party read and write messages whenever it is convenient to them.

2. List your local offices on the web site. That way, customers could see whether you offer local service in their area. A place where I could drop off a broken machine or pick up supplies would be worth a couple of hundred dollars a year to me, compared to having to wait for someone to come to my home or shipping broken equipment. This is one way a local supplier could offer real value compared to Internet-only suppliers.

3. Make the web site reflect modern attitudes to medical care.

I'm a responsible adult, in charge of my own health. If my primary care physician wants to know if I'm still exercising regularly, she asks me. She does not demand that I hand over my pedometer for her to check. The company that sold me the pedometer does not send reports to my doctor. Why should XPAP compliance be different?

I find "We will document any issues or problems that you may have experienced during the therapy process, sending updated compliance reports to your physician or sleep lab. We'll work closely with your physician & sleep lab to ensure that you receive the best and complete care for your apnea problem." somewhere between alarming and insulting. I don't want any equipment supplier talking about me with my doctors. If I'm having a problem following a doctor's advice, I discuss the problem with that doctor, and want the doctor to communicate any changes in treatment plan to me, not filtered through a third party business. If I were paying someone to read the APAP data card and analyze it, I would want the reports.

More subtly, there is a general flavor in both the web site and your articles that leaves me feeling as though you think that I should be doing as I'm told, depending on others to make decisions for me, down to what supplies to buy when. That may not be what you intend to communicate, but it is the way it comes through to me.

4. Put prices on your web site. I know this is not traditional, but it would make supplier selection much more convenient for customers. The more your web site looks as though customer convenience matters to you, the more likely I am to buy from you.

[Classic SleepCare]

I very much appreciate your feedback and your suggestions have been noted.

Thanks!