Replacement Schedule for Supplies

[szeiss]

Just wondering, do you monitor your replacement schedule or does the DME monitor it?

Thanks,
Sherry

[oak]

some DMEs call or email when replacement schedule allows new stuff. i prefer they don't and that i call them when i need something. talk to your dme.

[LSAT]

I call when I think I need something. The schedule really is just for the insurance companies. The DME will try to send you supplies when you really may not need them...they want the $$$$$$.

[szeiss]

My DME says they have a service that is supposed to contact me, but I've never received a call. They've told me that most insurance companies adhere to the medicare replacement guidelines. So I've created a spreadsheet to keep track of things.


Initial Setup Next Replacement
Full Face Mask A7030 - 1 per 3 months - 5/13/2013 - 8/13/2013 - 11/13/2013
Cushion A7031 1 per month - 5/13/2013 - 6/13/2013 - 7/13/2013
Headgear A7035 1 per 6 months - 5/13/2013 - 11/13/2013 - 5/13/2014
Tubing A7037 1 per 3 months - 5/13/2013 - 8/13/2013 - 11/13/2013
Filter, Disposable A7038 2 per month - 5/13/2013 - 6/13/2013 - 7/13/2013
Filter, Non-Disposable A7039 1 per 6 months - 5/13/2013 - 11/13/2013 - 5/13/2014
Humidifier Water Chamber A7046 1 per 6 months - 5/13/2013 - 11/13/2013 - 5/13/2014

I definitely do want the new cushion each month.

Thanks,
Sherry

[Sheriff Buford]

My problem is that even though I'm on a 3 month replacement schedule, the 3 month clock doesn't start until the insurance company approves the previous order. For instance, I may be be due supplies on May 1st, but the DME can only submit the order to the insurance on May 1st. Once the order is approved... around 2-5 days, the 3 month clock will start when that approval occurs. So... I end up losing 2-5 days every 3 months....

Sheriff

[Wulfman...]

In my eight-plus years on this therapy, I've never used a brick & mortar DME. I've purchased all of my "consumables" (and extra machines) out-of-pocket and in quantity to stockpile for future use......from online sellers. The only thing my insurance ever reimbursed me for was my initial equipment order in 2005 because I had met my deductible with my sleep study (and, I purchased all of that initial order through CPAP(dot)COM). Beyond that, my annual deductible was $750 (before they would pay 80%) and I wasn't about to overpay for the supplies just so I could meet that deductible. I usually purchased up to about that amount each year in extra machines, masks and other supplies. Most online sellers will offer free shipping for orders over $100. So, that's what I do when I'm ordering online. I found the ideal mask right off the bat and all of its parts are replaceable. So, that simplifies the types and number of supplies I stock up for in that category. All of my (ten) machines are virtually identical and use the same parts. That also simplifies that category.

I would recommend checking with your insurance provider and then "do the math".


Den

.

[LSAT]

My DME says they have a service that is supposed to contact me, but I've never received a call. They've told me that most insurance companies adhere to the medicare replacement guidelines. So I've created a spreadsheet to keep track of things.


Initial Setup Next Replacement
Full Face Mask A7030 - 1 per 3 months - 5/13/2013 - 8/13/2013 - 11/13/2013
Cushion A7031 1 per month - 5/13/2013 - 6/13/2013 - 7/13/2013
Headgear A7035 1 per 6 months - 5/13/2013 - 11/13/2013 - 5/13/2014
Tubing A7037 1 per 3 months - 5/13/2013 - 8/13/2013 - 11/13/2013
Filter, Disposable A7038 2 per month - 5/13/2013 - 6/13/2013 - 7/13/2013
Filter, Non-Disposable A7039 1 per 6 months - 5/13/2013 - 11/13/2013 - 5/13/2014
Humidifier Water Chamber A7046 1 per 6 months - 5/13/2013 - 11/13/2013 - 5/13/2014

I definitely do want the new cushion each month.

Thanks,
Sherry

You are certainly taking advantage of your insurance.......most of these replacements are unnecessary. A mask is plastic and doesn't wear out...a cushion lasts a lot longer than 1 month. My current mask and headgear are 18 months old. Tubing lasts forever unless there is a hole in it. Water chamber lasts a long long time.

[szeiss]

I don't necessarily get replacements of everything according to this schedule. My face is oily so my cushion seems to wear out quickly even though I clean it daily and my face each night. My mask straps do stretch out so after 3 months I prefer a new mask/headgear. My insurance covers everything at 100% which is nice. I have tried contacting my insurance company about the replacement schedule and they have no idea what I'm talking about. So I just go thru my DME and let them deal with it. So far they haven't told me anything about NOT getting paid, so I'm assuming they are getting paid. I could have stuff shipped to me but they charge 10.00 to ship and they are right here in town so I just go by and pick stuff up.

[MagsterMile]

I hear you about the cushions for the mask. I've had my Quattro Air since Aug. 20th and it's starting to loose it's 'oomph'. By that I mean, it's not holding the seal as well as in the beginning. Schedules can be of use at times but since we're all individuals, we don't live in a perfect world of cushion replacement at set times.

[DannyPh]

My DME Contacts me when My supplies are due for replacement and what I am scheduled to receive and then I tell them what to ship to me per what supplies I need. I was just contacted this morning by DME for supplies and since I recently changed Machines to the S9 auto set I am getting a full shipment with the climate line Hose also. The only Problem I encountered was that they were only going to send me Two white Filters until I questioned them and then they said " Oh, I see where you Are due Six white filters ".

[chunkyfrog]

You just reminded me: change filters. ((smile))

[RogerSC]

Yes, DME's are interesting...I asked for a couple of nasal pillow replacements back in January, and they sent me:

1. New climateline hose.
2. New humidifier tank.
3. Five replacement nasal pillows.
4. New Swift FX mask.
5. 5 air filter packs (2 per pack).

Apparently they had lost track of me. Even though I didn't need most of this stuff, they were behind in how much money they could make off my insurance. So they did a quick catch-up.

I've used a couple of air filters and a couple of nasal pillows the rest is just sitting around taking up space. I asked them to please talk with me before sending stuff, I know that they make money on these, but I don't have a lot of space for this stuff anymore *smile*.

Oh yeah, to top it off, the nasal pillows were for a Swift LT, so I had to take them back and exchange them for Swift FX pillows. What a crew.