I should get an award for being DUMB

[DJD52]

The DME gave me problems changing out masks the first 30 days when I started CPAP. They really didn't have much to select from but still didn't want to give me a second one to try. My insurance gave them a call. I got a Wisp as it's all they had. I ordered other masks from Cpap.com to try on my own dime since they refused to full fill the claim that for 30 days they fit you until something works.

I should get a new mask every 3 months after the first one. I didn't call them at 3 months as they had nothing I wanted. I called today since my RT said they got in the Elan. I was told that since a few weeks ago my DR ordered a Mirage Liberty for me to use with the prescribed auto machine for a week so he could read the data, that I now have to wait 3 months. The DR thought it wouldn't be counted because he ordered it. So much for what he knew and I should have known better.

Live and learn. $80 will buy the Elan from the DME.

[BlackSpinner]

Umm he can read the data anyway? What does it have to do with the mask?

I seriously think the the adjective "dumb" should apply to the DME and Doctor and not YOU.

[oak]

I would find a new DME. isnt there more than one in your area that works with your insurance?

[DJD52]

Umm he can read the data anyway? What does it have to do with the mask?

I seriously think the the adjective "dumb" should apply to the DME and Doctor and not YOU.

The Sleep specialist wanted me in a FFM when using the auto test machine. Why? He's a believer in FFM I guess. He didn't believe that I had dry mouth before starting CPAP and assumed I had to be mouth breathing.
I used the word dumb in regards to me as I just plain should have known better if I had thought about how the DME works.

[DJD52]

I would find a new DME. isnt there more than one in your area that works with your insurance?

I really wish I had more choices.

I'm in a rural part of Central Pa. There is only one other supply co that I could use with my ins and they are very small and everything is done out of a small bldg. The co I'm using is supposed to be the best tho they do have set companies and rules they follow. I really like the RT I have with this group. He tries to do the best possible for his patients, goes out of his way for them, and he comes to the house.

I'm wondering tho... if my PCP sent in a script to the dme for the Elan, would they have to provide it? It's easy to tell I haven't dealt with much of this.

I'd just go ahead and buy it, probably should but having to wait 3 months or pay cash just irritated me.

[jnk]

I've read a few of your posts. You aren't dumb. Not at all.

Be proud of the fact that thinking like a DME doesn't come naturally to you.

[DJD52]

I've read a few of your posts. You aren't dumb. Not at all.

Be proud of the fact that thinking like a DME doesn't come naturally to you.

Gee, Thank you!
I spent most of my life working with, raising, training, boarding, and showing horses. I could rattle off meds, injuries, problems, bones, muscles, tack, etc. I could talk with the vets, trainers, etc with ease. Now I feel like my brain is fogged and sometimes I just seem to make no sense, but I'm not doing those things every day anymore. (this Apnea is not simple... like the pcp who sent me for a sleep test told me it would be! Some of the technical posts here on the forum give me a headache just reading!)

I'm glad I don't think like a DME!

[Julie]

You HAVE choices - Cpap.com will let you try different masks (and possibly machines - I just haven't asked) for a fee so that if you return the mask (which you otherwise normally couldn't once the bag is opened) they'll let you do it, and then you can try others in the same way. It's not free, but if you can afford it, you'll have some way of vetting different ones.

[jnk]

It warms my heart every time I see someone arrive here who, despite the brain fog that often comes with OSA, still finds a way to ask the right questions to get help with the fight for better sleep and better health.

You will get there.

Please don't be shy. This stuff is too important. Every question you ask helps all the people who make it here to read it.

There is some technical stuff here that I will never quite get. But I'm glad it is here.

I spent several years spending an evening or two a week googling older posts at this forum made in the days of yore by the likes of Rested Gal, Ozij, and -SWS discussing the technical aspects of the condition and treatment. I highly recommend it/them.

[Janknitz]

I'm wondering tho... if my PCP sent in a script to the dme for the Elan, would they have to provide it?

Yes, they would, BUT . . .

If you turned out not to like the Elan, they wouldn't let you try any other masks BECAUSE the prescription is ONLY for the Elan.

However, if you ask for the Elan rx, you could ask the doctor at the same time to write a second script for "Mask of Patient's Choice" and you just hold on to that one. If the Elan doesn't work out, just whip out the second script and say "HA--I'm smarter than you jerks!".

[DJD52]

I'm wondering tho... if my PCP sent in a script to the dme for the Elan, would they have to provide it?

Yes, they would, BUT . . .

If you turned out not to like the Elan, they wouldn't let you try any other masks BECAUSE the prescription is ONLY for the Elan.

However, if you ask for the Elan rx, you could ask the doctor at the same time to write a second script for "Mask of Patient's Choice" and you just hold on to that one. If the Elan doesn't work out, just whip out the second script and say "HA--I'm smarter than you jerks!".

Hmm.... I like your thinking!

[SleepWellCPAP]

I agree, with BlackSpinner and the rest who feel the term "dumb" should apply to your DME.

I don't think I will ever (EVER) be able to comprehend why any provider of CPAP equipment would have a hard time with exchanging masks that don't work. I'm at a loss to figure out how others think saving $50 or $100 in the short run offsets the cost of an unsuccessful patient. In many cases the "swapped" and practically unused masks can be medically sanitized, then used as "loaners". In addition to that, most manufacturers replace unacceptable masks for providers at no cost.

Regarding the Liberty, if you do try that one, I'd recommend using a mirror at least initially to make sure the nasal pillows are in their proper position.

Good luck!

[Janknitz]

I don't think I will ever (EVER) be able to comprehend why any provider of CPAP equipment would have a hard time with exchanging masks that don't work. I'm at a loss to figure out how others think saving $50 or $100 in the short run offsets the cost of an unsuccessful patient. In many cases the "swapped" and practically unused masks can be medically sanitized, then used as "loaners". In addition to that, most manufacturers replace unacceptable masks for providers at no cost.

I'm glad to hear you say that, SleepWell. I just don't get it either.

I know that the profit margin on CPAP masks must be pretty low, but still, if a DME gives good service to a new patient and facilitates their adjustment, they have a customer for LIFE! Many businesses live and die on their repeat business. And that's how you build volume, too. Businesses who see their customers as a nuisance can't possibly thrive in the long run. And part of the problem is that DME's don't really see CPAP users as their customers--instead it's the insurers and referring doctors.

I also think that these DME's must be selling their free sample masks from the manufacturers right out the back door.

It's good to know there are some "good guys" in the business, too, like you.

[JamesAllen828]

I'm wondering tho... if my PCP sent in a script to the dme for the Elan, would they have to provide it?

In my experience working at a DME. They will not provide another mask regardless of what prescription you have. DME's go by insurance guidelines and if the insurance will not pay for the mask because you have not waited the 3 months (per your insurance) you won't be able to get one. But that is here in TN. Not sure how other states regulate DME's.

[DJD52]

[/quote]In my experience working at a DME. They will not provide another mask regardless of what prescription you have. DME's go by insurance guidelines and if the insurance will not pay for the mask because you have not waited the 3 months (per your insurance) you won't be able to get one. But that is here in TN. Not sure how other states regulate DME's.[/quote]

That is true. The DME isn't in it to lose money. They only give you what your insurance pays for and allows.
In my case what ever the DR writes a script for, be it a new machine or mask, my insurance will cover it.

*I* should have known. It occurred to me but the DR and my RT said I should still be able to get the 3 month mask. I should have known that wasn't gonna happen.

That said, this DME isn't at all concerned about patient compliance. They supply what the Dr orders IF they carry it, if not they bring you what they carry that they feel will work. There is no other DME in the area so there is no choice.

Since you work for a DME, are they paid X amt of money each month from INS even if the patient gets nothing or do they just get money for what the patient gets from them? I'm curious because they really don't seem to care if I get replacement cushions, hoses, filters, or even new hoses, etc for my husband's oxygen.