whoa, did I ever upset my DME

[Slinky]

Okay, you are too far into the 13 month capped rental to return the Elite and go elsewhere for your CPAP w/o it costing you an unreasonable bundle of money. HOWEVER, Medicare purchased the rest of your equipment outright. They are bought and paid for and yours free and clear. Including the humidifier.

Most all local DME suppliers accept Medicare, its generally the bulk of their business. So call your secondary insurance company and ask them what local DME suppliers they are contracted with. Then check w/each of them to see if they will accept you for masks, supplies, etc. You are pretty much stuck w/your current DME for the duration of the 13 months as far as your Elite's payments and copays but free to get your supplies elsewhere. Some may not want to step on the your current DME's toes and might be reluctant to accept you as a client for your supplies. But I was able to find another DME for my supplies until I completed my Elite's capped rental w/the sheister local DME I first encountered.

[SaltLakeJan]

Rested Gal, I appreciate the willing attitude of the members - This is the greatest club I could have ever found. I appreciated your comment on my "learning experience" at the DME's and your mention of those who lurk here picking up tidbits of information. I didn't lurk, I parked myself in front of my computer and poured over posts, the Mile High blog, everything I needed was here. But, my once good memory lost a battle to apnea; and I forgot much of what I read. I said I lost the battle, but I know I haven't lost the Apnea War. Humor does help, I laughed and remembered much of the Lab Rat Trophy Awards. I've cut up sections of nylon tights, adapting my mask multiple ways, until one way clicked. And used the other mask "fixes" I mentioned in my post.

My DME experience was a few days ago. I was initially put off by the therapists reaction to my mask "fixes" & what appeared to be a skinflint attitude regarding purchases. But a few days, and the reaction on this site, let me see the lighter side of my visit. When I thought of it the next time, I couldn't help but laugh about the absurdity of the whole thing. With the laughter, I felt better than I have in months - no maybe years.

I join the "Rested Gal" fan club, and thank you for all you have done to make life easier for all of us with apnea. Jan

[One Tired Puppy]

Jan, I thought I gave you some clear advice. If you don't ask the DME exactly what I said, how in the world would anyone act on it? If Medicare doesn't have the reason from the DME as to why you were not given the full OptiLife bag, then what action could possibly take place to remedy the situation?

This stuff isn't that hard. Maybe you haven't read what I said.

DMEs ARE permitted to bill for separate items on a new patient. They are permitted to bill for a CPAP E0601, Nasal Interface, A7034, Headgear, A7035 as well as replacement cushions/masks that happen to come in the bag. There is nothing wrong with this. The issue at hand is why you weren't given everything you should have been given out of the OptiLife bag.

Yes, there is an approved way to clean a mask. Every DME should let you try on as many masks as necessary. They should understand that if you continue to use your equipment, you represent an annuity in replacement items.

The dean,

This is very good information and if I have any future problems with dme I will definetly follow your advice of holding them accountable for supplying what we are enitled to. Thank you.

Anne

[Bookbear]

It's a shame you have to deal with such a moron DME.

DME-bashing can be contagious, can't it?

Nice catch, RG!

[SaltLakeJan]

O.K. Guest, with your 3rd post,(I hadn't read utill today) I finally got all your points got through my presently dim mind. Now, thanks to you, when anyone makes a purchase from a DME, we should examine the bill. If charges are suspicious or excessive, DEMAND to know why you charged for for each and every item. Being sleep deprived & fatigued is not an excuse for letting a particular DME getting away with unfair business tactics--charging more than the manufacturer allows.

Until I know what masks are comfortable for me, I will buy from a local DME. But through the sites on CpapTalk.com. I can get ideas to consider about various masks, and check their prices on through Cpap.Talk or other internet sites.

With with help of all the members and your excellent suggestion, it puts newbies in a beginning survival mode. Thanks. Jan

[SaltLakeJan]

To Neurosurgery & Debjax - The fact that you have DME's that you enjoy working with, is proof that they are out there. It is just a matter of finding them.

And to Gale Hawkins, I take it from your post you are not in the USA, and have a different system and fewer choices - I hope you do the best you can. I read where someone from Canada was reimbursed for their online purchases.

I started apnea therapy feeling crappy, and expecting to be treated fairly. I've been on less than a month, and have not yet improved, but thanks to this site, we can become aware. When I finally understood Guest's meaning, he had excellent suggestion. Thanks for your comments. J

[Slinky]

In the USA you must understand that when you first receive your equipment the local DME supplier can LEGALLY charge you or yur insurance for xPAP including carrying case, filter & data card (e0601)), hose (a7037), mask (a7034 for nasal cushion type mask), mask headgear (a7035) & humidifier (a0562 if heated). A chin strap would also be individually charged for.

[Guest]

you're exactly right (and why wouldn't the DME bill for that stuff? They had to pay for it up-front).

[jules]

the filters may be billed for separately too - not part of the machine

a nasal pillow mask might have another charge for the pillows portion -

this was my dealings with Lynn doesn't give a flying leap

[Kiralynx]

you're exactly right (and why wouldn't the DME bill for that stuff? They had to pay for it up-front).

No reason they shouldn't bill for it... if it's not a set.

Let's say I'm a bookseller, retailing a boxed set of six books, for, oh, $30. (This probably means my price is around 50-60% of the retail price, since I'm supposed to make a profit on this.)

But the individual books are $6.99 each. or $41.94.

Now, is it fair if a customer comes in and only needs one book to break open a box set, sell them the one book they want for $30.00, then sell the other books in the set to other people at full price, and gross $65.95 instead of $30? Or worse, sell each of the individual pieces for the price of the boxed set? Tidy bit of extra profit. But not what the publisher intended when they boxed the set. OK, maybe the analogy doesn't quite hold up.

Just incidentally, thanks for your excellent advice on reporting incompetence. It'll be interesting to see what my DME, who screwed up this week, thinks, since the party I reported them to appears to have taken the complaint quite seriously.

[SaltLakeJan]

Hey Wulfman, You quoted "DME bashing can be contagious" I haven't been on site long enough to know. But after several days, I found my DME experience starting to become a challenge - one that I didn't feel I was up to yet. I also find lots of humor in the therapists strong reaction to my home-made mask adaptions. He has been a therapist for 2 years, but he must have lived in a compliant world, with obedient customers. I appreciate reading your sage comments throughout the site. Jan

[Wulfman]

Hey Wulfman, You quoted "DME bashing can be contagious" I haven't been on site long enough to know. But after several days, I found my DME experience starting to become a challenge - one that I didn't feel I was up to yet. I also find lots of humor in the therapists strong reaction to my home-made mask adaptions. He has been a therapist for 2 years, but he must have lived in a compliant world, with obedient customers. I appreciate reading your sage comments throughout the site. Jan

Hi Jan.

Unless you have a really "good one", and given a little more time, you too will also join the ranks of those who enjoy the sport.

There ARE some good ones and some of them come here to get educated...... But, when you think about some of the reasons why many people find the forums, some of those reasons are that they don't know what is the norm for how they're being dealt with by the brick & mortar DMEs. Dealing with the doctors and insurance are a couple more reasons.
In our (previous) sleep-deprived state, it's far too easy to take advantageous of those would-be hoseheads.

I've been watching this stuff for about four years and after awhile, it becomes infuriating that there are those types of businesses out there.

The best we can hope for is to educate those DMEs.....one at a time.

Den

[SaltLakeJan]

Hi Slinky, You were almost spot on, and my DME is PERFECTLY legal.they charged for everything, but the user manuals. But, on my my invoice the code for filter is A7038, cost $6.47. Would a piece of fluffy quilt batting work as well?

From the time I posted "Whoa" I think I was in the "poor litl' ol me" stage. of apnea. After you and others smartened me up, I'm feeling down right combative, if I have to. I have a question before I go into the fray. I got my equipment 12-31, with mask #1, it didn't fit at all. I couldn't wear it, the DME gave me a medium pillow, which was 1'2 inch outside of my nostrils. I called my Dr. she said to return it, and the DME gave me Swift for Her on January 16th, Even tieing it on with a nylon stocking, I couldn't keep it on. So on the January 20th, the DME said I didn't need to call my Dr & reluctantly exchanged it for the Mirage Swift 11, which is doing O.K.

But, on Monday, Feb 10th when I was in their business, I asked them to look at the pillows, could they be defective? They had sunken in the middle, and difficulty staying in my nose. They said, they are a little out of shape, but you will have to buy them. Did my 3 masks disqualify me from one set of pillows per mo? I would like to know where I stand before I take myself into their stiff opposition. I am not opposed to buying my own stuff, but I too want to be PERFECTLY legal. Jan

[jules]

how many masks were you billed for?

there is this 30 day return policy of some of the manufacturers where the DME can return the mask to them and get credit for it - does this DME follow this?

you need to find someone who has posted about it with knowledge... that isn't me.

[SaltLakeJan]

Jules, I was billed for the original mask, Swift Nasal, $141.17, code 60560, but there is annotation, 'show other mask as well, A7035'. The invoice is dated 1-31-08, the day I received the original equipment, and I only got one mask at that time. The headgear was billed separately.I returned the orignal 1-16 when I got the Swift for Her. I called the 1-17, told the DME, the headgear was too small. They brought a Swift Mirage to my home 1-20, & asked to return the Swift for Her before the end of January, I did. On the invoices for the last two masks, the price is 00. My Dr. had mentioned after the first mask that had not been fit to me, perhaps I would want to change DME.

In an earlier post you said that the DME could have ordered the Optlife mask with large & medium cradles. That probably is what they did, but they are going to charge me for the small or petite cradle, separate for the mask & headgear.

You mentioned that DME's could charge for the filter, and they did. My first invoice lists a $6.47 charge for 1 A708 Filter.

Jules,thank you, and I do appreciate your advice. Jan