Is it me or are the DME's lacking customer service?????

[elazarus]

Maybe I am too new to the OSA game.....but I had an appointment with a new DME/RT today but they had to cancel because they said they did not receive the Pick up from the old DME or the Sleep study report.

On June 14th I told them that I was going out of the country for 10 days and returned last night and I expected to pick up the machine kit today....

So at 4pm I drove to the old DME and picked up the PU and the sleep study report.....really tough!!! That is when I told the new DME that if I need them I will call them.

Why are we beholding to the DME's that the Doctor's suggest? Don't the internet companies bill insurance?

What am I not seeing. What I also find scary is a lot of new people will be diagnosed and be led, like me, like lambs to the slaughterhouse???

Thank you

Elliot

[snoregirl]

You have the general idea.

No you are not beholden to the DME that the Dr recommends, only to the ones contracted with your insurance co, if you actually have benefits that make using them better than buying out of pocket online.

Get your sleep study, contact Bill-my-insurance.com to see if they work with your insurance.

Call your insurance and find out your copay and deductable (what wasn't sucked up already by the sleep study) and run the numbers. If you will pay more than $600 or $700 for the machine and humidifier, scrap the insurance and purchase out of pocket.

Cpap script can be used for any cpap including APAP

do not let the DME give you a non-data recording machine.


Make sure you check prices online so you can compare that to your copay.

Base model machines that they try to give you (and they get the same reimbursement as the better machines) can be only $300 or $400 out of pocket.

Research, Research, Research.

Once you walk out of a DME with a machine it is harder to get it changed or to change DMEs

Good luck and good for you finding this board.

[darthlucy]

I dare you to find someone on this board who does not share your pain! Not only did I tick off my sleep center by choosing to do my own DME shopping (within the confines of in-network providers for my insurance) (I think I cut into their kickback or something), but many of the DMEs I called were so appalled at the fact that I was calling them directly, rather than them getting the order from the sleep center. It took me about 10 calls to find one willing to work with me, and I'm still having to fight for everything, including getting the machine that was prescribed for me.

Like snoregirl said, the only hope you have at getting through this with the best equipment for you is research, research, research. I went in armed with all of the information necessary to refute their half-truths, and boy, was I proud of myself! They weren't exactly thrilled, but I couldn't care less. I have to look out for me, because if I don't, no one will.

[Slinky]

... I have to look out for me, because if I don't, no one will.

Well said, DarthLucy!!!

[luneman]

customer what?

[elazarus]

Excellent input...thank you.

I had things backwards but I see now I was wrong......

Lucy said the DME's make the same money on a BASE machine as a better model......so why should they give you a good machine?????

That advice is worth a million nights sleep in itself.

I am glad that my doctor wrote the prescription for an automatic c-flex with data, humidifier, coffee maker and oil change.

That being said, the DME's never get a second chance to make a first impression.....

This palce and the people who come here are great!!!

Regards

Elliot

[snoregirl]

Even though the doc wrote the prescription for Auto, be prepared for trouble.

I certainly hope you don't have trouble, but let me explain how it will happen if it does.

1) DME calls the doc to try to get the prescription changed to non auto

2) Your insurance has a doc of their own on the payroll and the insurance contract doesn't cover "deluxe" machine. If they choose to call an apap deluxe you won't win by trying to convince the unless you are lucky. Doc can write a letter of medical necessity and their own doc can review and decide whatever he wants.

Next option if that happens is keep telling the dme that you "want what the doc ordered" as if they bill the insurance co E0601 (cpap, which an auto is a cpap just with auto pressure adjustments) the insurance co will pass it through since they really only care about the code.

You might have to try multiple dmes and/or just keep telling them no, I want what the doc ordered (this was my route and it worked on the third try)


So to sum up. Great, you got your prescription as without it saying APAP you have zero chance with a local dme, but just be ready for the fight and don't be too trusting. Know what models are auto and which have exhale relief if you need that.... The Remstar ones have AUTO written right on them in big blue letters I don't know exactly what to look for on the other models.

Good luck!!

[darthlucy]

I am glad that my doctor wrote the prescription for an automatic c-flex with data, humidifier, coffee maker and oil change.

No matter how good your prescription is, snoregirl is right...know your stuff before you go in. Here's my recent experience (still ongoing!)

viewtopic/t21304/Three-cheers-for-cpaptalk.html

[Patrick A]

I am glad that my doctor wrote the prescription for an automatic c-flex with data, humidifier, coffee maker and oil change.

No matter how good your prescription is, snoregirl is right...know your stuff before you go in. Here's my recent experience (still ongoing!)

viewtopic/t21304/Three-cheers-for-cpaptalk.html

[Wulfman...]

Research, Research, Research.

I find it truly "amazing" that people will do a significant amount of research on less-expensive things (like a digital camera for example) before purchasing them than they do on something that is essentially a "life support" or "life saving" device like an XPAP machine......and just take what is handed them (including the masks).

If only the information in this thread (and others) could be conveyed to the potential users BEFORE they need it........

It's YOUR therapy......YOUR life......YOU deserve the best equipment to treat your condition.

Den

[Guest]

I have a good story.

I had a GREAT DME provider. They were called Homefelt Healthcare here in southeast Michigan. This company again and again has gone WAY above and beyond what they actually needed to do for me. They set an appointment and delivered my machine to my house.....Then he spent an hour showing me how to clean and setup my machine every night. They were AWESOME!!!! I can't say enough about them.

Now the horror story.

Last Decemeber my daughter sat on and broke my mask that was under my pillow (I used to put it there so I wouldn't forget to use it every night). I had to get a new mask. When I called BCN I was told that Northwood now handled all DME claims. So I called them to get an authorization to get a new mask. I was told that they no longer used Homefelt Healthcare and that I would have to find a new DME provider. So I called the closest one to my house (about 25 miles). I was told they couldn't do it without my sleep study. But they couldn't get my sleep study from the doctor for 48 hours because the records were all stored off site. So after about 2 hours of frustrating phone conversations, I called Homefelt. They said that I could come and buy the broken piece from them for a fraction of the price this new DME provider wanted. And that they didn't need the sleep study because they had it on file. Only problem is, is that they are over 40 miles away because I had moved. When I asked if they could fax my sleep study to the new place she said she would call me back in 10 minutes and let me know because they kept all their records....off site. In 5 minutes she was calling me telling me that my study had been faxed. THEY WERE AWESOME!!!! They didn't have to find and fax the study because they were losing a customer, but they did. The new DME never even called me to confirm that they had received the fax or that I could pick up my new mask!!! I had to go and get my new mask. Homefelt had delivered a new mask to me when I decided that I wanted a full face mask. I can't say enough about their customer service......unfortunatly I can't use them anymore because my insurance says I have to go elsewhere. Maybe I was just spoiled.........

[rested gal]

Research, Research, Research.

I find it truly "amazing" that people will do a significant amount of research on less-expensive things (like a digital camera for example) before purchasing them than they do on something that is essentially a "life support" or "life saving" device like an XPAP machine......and just take what is handed them (including the masks).

I know what you mean, Den. (And great info as always, snoregirl!)

I think there are several reasons newly diagnosed people don't "research" the equipment they are going to receive:

1. Many are under the assumption that "cpap" is "cpap" -- that there's one machine called a "cpap" machine to treat sleep apnea. Different brands, maybe, but all just "a cpap machine."

2. A general assumption that the doctor is "the expert" in all health matters. And that whatever the doctor prescribes is exactly what we are supposed to have for our treatment. Especially if it's a doctor specializing in "sleep disorders."

3. A general assumption that the doctor (especially a "sleep doctor") knows ALL about the machines and has actually directed the DME to give the person the exact machine the doctor knows is best for that person. Of course we know that other than prescribing "cpap" or "bi-level" the doctors usually leave the actual choice of machine up to the DME, and the DME usually gives the most basic of "whatever" to the person, for maximum profit.

4. An expectation on the part of the newly diagnosed that not only has the doctor chosen the exact machine they are to have, but that the DME is also an "expert" health care professional who knows all about the machines, too.

In other words, complete trust in all the medical professionals involved. Sometimes well placed trust. Sometimes not.

People expect to do their own research before buying the usual consumer product like a camera or a TV...or a toaster. They forget that a piece of medical equipment is also a "consumer product" and that there can be choices.

They think the doctor is making a choice for them. They don't realize that more often than not the doctor has left it up to the DME to make the choice. People don't realize that more often than not, the DME pushes only what makes the most money for them, and that many DMEs are too often ignorant about comfort issues with the various machines. And masks!

Add into the mix, "Well, insurance will pay for it." Plus a fatigued brain and body that just wants relief as soon as possible....

If the doctor and the DME say, "This is what you need...." there it is.

If only the information in this thread (and others) could be conveyed to the potential users BEFORE they need it........

Yup.

It's YOUR therapy......YOUR life......YOU deserve the best equipment to treat your condition.

Den

Indeed.

[John_M]

An expectation on the part of the newly diagnosed that not only has the doctor chosen the exact machine they are to have, but that the DME is also an "expert" health care professional who knows all about the machines, too.

Yep, before I found this group, I drove 100 miles to rent a CPAP. I thought I needed a DME "expert" to help me select a mask. While they had lots of pictures of masks on the wall, they only had two masks in stock.

But he did give me some good advice, he told me to be gentle with myself while getting used to the mask and he gave me a tip on the Swift,"make sure the letters are the right way up".

But the service I have got from BillMyInsurance (another Johnny Goodman enterprise) is fantastic.

Thanks Bonnie and Claudia

John M

[snork1]

It took 2 years before Apria figured out I dropped them and then all I got was a robotic message on my answering machine, reminding me that I MIGHT need some replacement parts or something by then.

Its been over a year since I stopped using my "better" DME, and they still haven't seemed to figure out or care that I stopped using them.

Like clockwork, I do get an a yearly "invitation" from my sleep doc to do another pricey sleep study, which is the last I will hear from him until the next sleep study. My new insurance has a HUGE copay/deductible for sleep studies now.

Customer Service? Whats that?

[Patrick A]

[quote="snork1"]It took 2 years before Apria figured out I dropped them and then all I got was a robotic message on my answering machine, reminding me that I MIGHT need some replacement parts or something by then.

Its been over a year since I stopped using my "better" DME, and they still haven't seemed to figure out or care that I stopped using them.

Like clockwork, I do get an a yearly "invitation" from my sleep doc to do another pricey sleep study, which is the last I will hear from him until the next sleep study. My new insurance has a HUGE copay/deductible for sleep studies now.

Customer Service? Whats that?