Shady practice?

oh_possum · Post by **oh_possum** » Thu Aug 18, 2005 11:32 pm

I have always wondered if my sleep Dr. is completely above board. When he initially wrote my prescription, he faxed it to a DME rather than give it to me. I have never really been satisfied with the DME and have stopped going to that doctor.

Does this sound like normal medical practice or is the negative vibe I've gotten from this situation justified?

rested gal · Post by **rested gal** » Thu Aug 18, 2005 11:56 pm

I suppose it's possible that a doctor might truly believe that one particular home health care supplies dealer provides better equipment and service than any other in the area. However, Doctors have been known to make mistakes, just like anyone else. They can also have "friends", just like anyone else.

I'd want the Rx in my hot little hand before I left the doctor's office, so I could choose where I shopped. I might ask the doctor what DME he recommends, but I'd sure look around before deciding. Online stores would definitely be one of the places I'd look.

WAFlowers · Post by **WAFlowers** » Fri Aug 19, 2005 4:54 am

My doc was going to fax my prescription to a DME. He thought he was doing me a favor saying that in a day or two I'd have the equipment delivered.

I asked for the prescription as I was giong out of network (cheaper to pay out of pocket than stay in network and let my insurance cover part of it -- crazy!). I then faxed the prescription to cpap.com and had everything the next day.

And, of course, 2 weeks later they start that "bill my insurance" thing .

wading thru the muck! · Post by **wading thru the muck!** » Fri Aug 19, 2005 5:13 am

WAFlowers wrote:My doc was going to fax my prescription to a DME. He thought he was doing me a favor saying that in a day or two I'd have the equipment delivered.

I asked for the prescription as I was giong out of network (cheaper to pay out of pocket than stay in network and let my insurance cover part of it -- crazy!). I then faxed the prescription to cpap.com and had everything the next day.

And, of course, 2 weeks later they start that "bill my insurance" thing .

Bill,

Don't feel as though you missed out on anything. The "bill my insurance" site is a great thing, but because they will be dealing with your insurance company the prices will be more than the "cash" price at cpap.com. One of the features that they will provide (Johnny correct me if I'm wrong) is to give you a comparison of what it would cost you "out of pocket' to purchase through "bill my insurance" and what it would cost "cash" through the cpap.com site.

It seems to be a huge undertaking since insurance companies can be notorious for not giving "hard" answers to questions regarding what they will pay. They always seem to leave the matter open to further review.

Your choice to buy from cpap.com and pay yourself was a good one. I've done it several times myself and have never regretted it.

rested gal · Post by **rested gal** » Fri Aug 19, 2005 3:03 pm

Your choice to buy from cpap.com and pay yourself was a good one. I've done it several times myself and have never regretted it.

Amen!

IllinoisRRT · Post by **IllinoisRRT** » Fri Aug 19, 2005 7:32 pm

From the DME side of things, I will say it is not uncommon for the doctors' offices to fax us orders directly. Our marketing department, like pharmaceutical companies, spends lots of money on getting the doctors to "pick" us for their patients. If they're Medicare, it doesn't matter, it's the patients' choice. For non-Medicare patients, we take most insurances, and I assume from the doctors' end that the patient does have some choice in the matter. However, I know in our area there is a hospital-based DME that has been irking lots of the local doctors by their lack of followup and slow response time. That will make a lot of doctors think twice about sending orders to that DME. So if you are going through a DME, it is worth your while to find out which DME your doc recommends. Even if they're unhappy with how their oxygen patients are treated, that might affect their recommendation to you. Sometimes patients will walk in with their own script, but it doesn't happen very often.

kenrose · Post by **kenrose** » Fri Aug 19, 2005 8:16 pm

I had the same experience that oh did. Of course I am entering my now FORMER sleep doc in the worst sleep doc Darwin awards asap.
the DME he uses wanted $1100 for Encore software so while I can't believe he would risk his license to steal......
Ken

johnnygoodman · Post by **johnnygoodman** » Fri Aug 19, 2005 9:23 pm

Don't feel as though you missed out on anything. The "bill my insurance" site is a great thing, but because they will be dealing with your insurance company the prices will be more than the "cash" price at cpap.com. One of the features that they will provide (Johnny correct me if I'm wrong) is to give you a comparison of what it would cost you "out of pocket' to purchase through "bill my insurance" and what it would cost "cash" through the cpap.com site.

This is correct. Insurance prices are higher than cash price. Dealing with insurance companies is costly!

The idea behind BMI is to take a look at a customers insurance situation and determine which way they are better off going. We check your copay and then say," Your copay is X, paying all cash is Y, the cost of non-insurance items is Z - here's your best bet". Then you take those numbers and deal with us or others as you please. Nearly all the time, we're the best option in one form or another, if we're not (as unfortunately BP found out today) then we'll let you know that as well.

It also is important to mention that we accept insurance, but YOU choose your desired equipment. This is a major difference from many other providers.

Johnny

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