Being Forced to use a Reconditioned Machine

[ProfessorEd]

I was concerned that my old Respironics Auto Bi-pap was malfunctioning, and made appointment with Sleepmed expecting them to look at it.

They took the position that since they had not set me up, they would not touch it and to ask for help from the firm that did the set up (say five years ago and the machine is paid for and mine). I have had no machines paid for by Medicare, and it is expected they will pay for a replacement, and my doctor has written the prescription. Replacing the tank for a more modern units is probably wise (as several advised in an earlier discussion) with the major downside being the loss of the option of upgrading easily if a new and much better machine comes out soon (but I gather this is unlikely).

The Sleepmed technician had brought a reconditioned machine and kept insisting that Medicare required that only machines be used (obviously false) and would not supply new ones. I left with the one she brought as a loaner, and it was clear her intention was that once they got the insurance paper work to have me keep that one on a rent to own.

Couple of questions. Has anyone had any experience with such reconditioned machines, or know how to find out their histories? It will probably be easiest to go along with their scheme, but I am inclined to fight. Any one actually know the Medicare regulations on this? Any suggestions on how to fight this. The women who set up the appointment said they would lend me one, but indicated it would later be exchanged for a new one.

Will the reconditioned machine prove any cheaper for me, or am I just taking a returned one off of their hands. She seemed to think Medicare would absorb the full cost of the machine, but for various reasons, I do not think much of her competence.

While from what I know the Respironics Auto Bipap is as good as others, I probably could try to get another if there was any advantage to doing so. The doctor thinks they were now making the software free. Is he right? and that there is another software product that can be used with it that is free Dating from years ago when they were declining to sell their software to anyone but doctors, and I raised the issue on this forum, a mysterious disk showed up in my mail (thank you kind lady). Will this work with the new machine?

[Pugsy]

While from what I know the Respironics Auto Bipap is as good as others, I probably could try to get another if there was any advantage to doing so. The doctor thinks they were now making the software free. Is he right? and that there is another software product that can be used with it that is free Dating from years ago when they were declining to sell their software to anyone but doctors, and I raised the issue on this forum, a mysterious disk showed up in my mail (thank you kind lady). Will this work with the new machine?

Is this what your new "reconditioned" machine looks like?
https://www.cpap.com/cpap-machine/respi ... iflex.html
If so your old software won't work with it.
That's no problem though...check your private message box for some information on obtaining the latest software that will work with the new PR System One machines.

I don't know what to tell you about the "reconditioned" thing. Personally...I think it stinks but mainly because they are telling you a load of crap and they are going to be charging the same price as they would for a "new" machine. I don't like being told a load of crap...but that is me. There probably is nothing really wrong with a reconditioned machine...I just don't like being lied to.

Look on the bottom of your blower unit for a little sticker with a 3 digit number (that's the model number) and on the same sticker is an 8 digit number. That would be the manufacture date in year/month/day format.

[DreamStalker]

That's just bad business and I would not deal with those types of people. As Pugsy said, there may be nothing wrong with reconditioned and if they were discounting it I would not mind so much.

But the fact they lied to you and are likely not giving you a discounted price, I would take it back and find another to do business with.

[Janknitz]

Medicare will pay for a NEW machine. They are all set to screw you big time. Do you like being treated that way?

Unless this is the ONLY in network provider for your secondary insurance within 1000 miles, run, don't walk away from them. Find a real DME who will at least provide you with a NEW machine.

If they are really and truly the only providers on your supplemental policy, consider buying your own used machine from Secondwind.com for a price less than the co-pay you'd pay for a supposedly NEW machine with Medicare. Why should this DME get away with getting paid $1200 to $13000 (your co-pays plus Medicare's payments) for JUST the blower portion of a CPAP while you get screwed with a machine that is used and won't last as long? When that one dies before five years is up, good luck getting a replacement if Medicare has paid for this one.

And learn this if you learn nothing else: NEVER, NEVER, NEVER, NEVER NEVER trust anything a DME says. Your case illustrates why.

[LSAT]

Leave that DME...(do not pass go....do not collect $200) . Medicare pays the DME for a new machine. If the DME gives you a reconditioned unit they are in violation of Medicare rules. They should be reported to Medicare.

[archangle]

You'll probably pay the same for a reconditioned machine as a new one with insurance.

As long as it's a current model, you're probably not really being harmed by it. In theory, you're usually renting the machine to own, so you don't "deserve" a new machine in theory. With insurance, you usually rent it and can return it if it doesn't work for the first few months.

If you feel the DME is not giving you good service, or is being dishonest, consider another DME, if you can find another local one who is "in network." Of course, the new DME may not be any better.

[ProfessorEd]

Is this what your new "reconditioned" machine looks like?
https://www.cpap.com/cpap-machine/respi ... iflex.html
.[/quote]

Yes, the code is 20 120213, but I don't know how to interpret it. Knowing whether it is only slightly used (most likely), due to someone being unable to accept therapy and quickly returning it, is important.

[DreamStalker]

Is this what your new "reconditioned" machine looks like?
https://www.cpap.com/cpap-machine/respi ... iflex.html
.

Yes, the code is 20 120213, but I don't know how to interpret it. Knowing whether it is only slightly used (most likely), due to someone being unable to accept therapy and quickly returning it, is important.[/quote]

Again. Don't trust the DME. they could be calling it "reconditioned" when it's actually "returned" equipment.

[teachcsg]

I work for a DME so you can believe SOME things we say
We DO NOT practice this (giving a used machine for MDCR pts) but I can see where some companies may. What hapens (and this is from the DME point of view) is that MDCR will only pay for the first 3 months and then the DME has to provide a download showing that the patient is using the machine (at least 4 hours per night 70% of the time in a 30 day period) AND the pt has to be seen by a physician and they have to submit a form to MDCR saying that the pt is using the cpap, its beneficial etc..
Well as you can imagine, we have many MCR pts that we setup that are not compliant (they did not use 4 hours) or they do not see their doctor again within the time frame req by MDCR. When this happens we have to pick up the machine. That's easier said than done. SOmetimes you cant find the pt, they wont pick up the phone, they are not home, they dont open the door etc..
Now from DME point of view thats a $300-$500 or more piece of equipment plus a mask and tubing and filters that someone did not pay for. The DME lost money.
Becuase this happens quite often the thought has been suggested, well what if we set these pts up with a refurbished machine and then after the 3 months if they are compliant we switch them to a new machine.
You can see why a DME would want to do this.
So as usual there is always two sides to the story its not as easy as one side is bad and evil and the other side is purely innocent.

[StuUnderPressure]

Since this is the OPs 1st machine under "Medicare" he will have to meet with his Sleep Doctor to determine that his Sleep Study (before he enrolled in Medicare) meets the Medicare requirements at this time.

Doctor will also have to document in his records that he has a diagnosis of OSA AND he continues to use the PAP device.

There is NO requirement for a clinical re-evaluation or for objective documentation of adherence to use of the device. (Medicare's EXACT words)

So, there is no way the DME would (or even could) take back the machine and therefore he should DEMAND that he receive a new machine with zero machine hours on it.

I will add also that "I" would NEVER accept a used or reconditioned machine under ANY circumstances, much less under these circumstances.

[DreamStalker]

I work for a DME so you can believe SOME things we say
We DO NOT practice this (giving a used machine for MDCR pts) but I can see where some companies may. What hapens (and this is from the DME point of view) is that MDCR will only pay for the first 3 months and then the DME has to provide a download showing that the patient is using the machine (at least 4 hours per night 70% of the time in a 30 day period) AND the pt has to be seen by a physician and they have to submit a form to MDCR saying that the pt is using the cpap, its beneficial etc..
Well as you can imagine, we have many MCR pts that we setup that are not compliant (they did not use 4 hours) or they do not see their doctor again within the time frame req by MDCR. When this happens we have to pick up the machine. That's easier said than done. SOmetimes you cant find the pt, they wont pick up the phone, they are not home, they dont open the door etc..
Now from DME point of view thats a $300-$500 or more piece of equipment plus a mask and tubing and filters that someone did not pay for. The DME lost money.
Becuase this happens quite often the thought has been suggested, well what if we set these pts up with a refurbished machine and then after the 3 months if they are compliant we switch them to a new machine.
You can see why a DME would want to do this.
So as usual there is always two sides to the story its not as easy as one side is bad and evil and the other side is purely innocent.

I cannot see why any DME would make up their financial losses off innocent patients. That's like saying well I got ripped off so it's ok to go rip someone else off to balance things out.

Just because Medicare rules are all messed up .... let me rephrase that --- just because the healthcare system is all messed up does not justify a DME from lying and misrepresenting themselves so that innocent patients can get ripped off.

[chunkyfrog]

Just my opinion; but it sounds reasonable to require 3 months compliance, and then a guaranteed swap for a NEW unit.
Of course, an older unit may not have features that help the patient USE the mchine, like exhale relief, and ramp, or heated humidifier.
I could also understand not wanting to dispense an expensive machine to an obvious meth head.

[StuUnderPressure]

I cannot see why any DME would make up their financial losses off innocent patients. That's like saying well I got ripped off so it's ok to go rip someone else off to balance things out.

Twice as insulting because the DME sells that USED equipment & collects the FULL NEW price - even though the prior patient & his insurance (Medicare or otherwise) has already paid a portion of the new price.

I can see where the DMEs have a problem with having to take back machines from non-compliant patients.

But, they should be honest about it.
Give the patient and /or insurance the discount of what has already been paid by someone else.
Also, give the patient the CHOICE of accepting such a machine or getting a new one.

In most cases, the patient is NOT even told he is getting a used machine.

As long as DMEs continue to operate this way, how can they expect us to think that they really have our best interests at heart?

[StuUnderPressure]

Just my opinion; but it sounds reasonable to require 3 months compliance, and then a guaranteed swap for a NEW unit.
Of course, an older unit may not have features that help the patient USE the mchine, like exhale relief, and ramp, or heated humidifier.

I would agree with that as long as the subsequent swap to a new machine is really GUARANTEED - - - AND the used machine is the EXACT model of what the new machine will be & what the patient requested.

[chunkyfrog]

Good point, Stu.
My first DME was planning to rent me an S8 Escape--sure grateful to the folks here I dodged that bullet!