Anyone else heard about ResMed stopping Internet sales?

[Guest]

Hello! Serious question please.

If you needed a new mask or tube, etc., and the cash price for this item at your local DME or other retail outlet was exactly the same as the price online, would you still buy online? This question has nothing to do with Map policies, etc. nor insurance or copays.

Thank you.

[BleepingBeauty]

<snip>
let me offer some suggestions:

1. Use only an accredited DME company. What does that mean? Accredited by whom?

2. Use only a company with a Respiratory Therapist on staff. I do, and she's of absolutely no help when I have a problem. She knows NOTHING about CPAP.

3. If the mask fitting takes less than 30 minutes be wary of the skill of the fitter. When I need a new mask, I get "fitted" for all of five minutes while sitting in a chair. When I asked to be hooked up to a machine running at my pressure to test the fit, I was met with sighs and an eye-roll.

4. Make sure the company has a professional relationship with your physician. (Our RTs constantly inform the prescribing physicians about any problems with their patients.) To my knowledge, the only time there's any contact between my DME and my doctor is when the doctor initiates it.

5. Ask about mask replacement programs. Usually masks can be replaced free of charge within 30 days if it is not working out. My RT wasn't even AWARE that any mask manufacturers offer this.

6. Look for companies that use ONLY auto CPAP devices with compliance monitoring capability. These have ALL the capabilities your physician would prescribe without having to buy a different CPAP. As was mentioned they are all billed as E0601. Again, I have to . My DME gave me an M-Series Plus. When I asked for a fully data-capable machine, I was told, "Your insurance won't cover it." They LIE to improve their bottom line. I subsequently purchased my current machine, the M-Series Auto, from a seller on CraigsList.

7. Look for in network providers with your insurance as this will save you money. In my case, I'm using the only DME who's approved by my insurance. So I have no choice in the matter. If I could afford to buy out-of-pocket online, believe me, I would.

8. Be patient and overcome any mask issues and you will sleep like you did as a child. I have, and I am. But there's absolutely NO credit due to the DME or the doctor for that; it's thanks to this forum and the education and advice I've gotten here.

Nice "perfect world" pipedream you've got going on there, lee. But with all due respect, it's time to wake up to the harsh reality that we patients have to deal with.

[johnnygoodman]

Howdy All,

Gil and leejgpt, thank you for posting. CPAPtalk operates as a free marketplace of ideas. We welcome yours.

Thank you to all CPAPtalkers who have contributed to this thread. Please keep in mind that posts like "I think X because of Y" is respectful and moves discussion forward, whereas "that point is a load of ****" leaves little room for intelligent rebuttal. The goal here is getting to see to the bottom of each position so that we can all read and judge for ourselves. This thread is a positive development and an important step.

From the DME and Manufacturer points of view I'm hearing "these are the things that must be done in order for good patient care to exist. We are professionals who can succeed in the right environment, let us set it up so that patients are well served. Resmed still sells on the internet but puts restrictions in place to promote patient care."

From the user point of view I'm hearing "the solution the DMEs and Manufacturers advocate is or has been harmful to my personal health and finances. I'm better off using the new system, but am being forced back into the old one. You may sell on the internet, but your restrictions are onerous."

Johnny

[Wulfman]

Hello! Serious question please.

If you needed a new mask or tube, etc., and the cash price for this item at your local DME or other retail outlet was exactly the same as the price online, would you still buy online? This question has nothing to do with Map policies, etc. nor insurance or copays.

Thank you.

Absolutely! For me, my nearest DME locations are 30 and 60 miles ONE WAY. So, it would cost me more in fuel and time to go pick up one. That would not come out to be the same exact cost. I would presume there may be some other glitches over time that I would encounter (necessitating returning to the DME shop). The other thing is that if it went through my insurance, I would still have to fulfill my deductible.....which means I would be paying full price for the mask (since I have never had any other medical bills since 2005 when I had my sleep study).

I never order one thing at a time and have combined multiple items to get the cost over $100 for the "free" shipping. (all my orders with CPAP.COM have been MUCH larger than that) And, after my initial purchase when I started (which was also from CPAP.COM), all of my subsequent purchases have been out-of-pocket.

Also, none of the brick & mortar DMEs sponsor user forums.


Den

[frapilu]

We recently revised our Internet Policies, providing a better experience for shoppers that choose to source our products over the web.

Thank you for participating on this message board, Gil.
You mention recently revised Internet Policies. I wonder... is it now possible for someone who lives in Canda and who has a CPAP prescription to order a ResMed CPAP machine online from cpap.com and have cpap.com ship the machine to the buyer in Canada?

Thank you RestedGal. I was about to post a similar message.

France (from Canada)

[jnk]

I did not say Resmed was a lesser brand. In fact, it was only the Resmed rep. who spoke of lesser brands.

I did put Resmed on the same level as those "lesser" brands by stating that:

Resmed's A10 autoset algorithm is just as likely to be inferior for some patients as are the algorithms of Resmed's competitors.

I also said:

None is perfect. Each will be the best for part of the population. And terrible for a small group. A sales pitch, ignoring that fact so blatantly is just that: a sales pitch.

I do not believe medical devices should be marketed like cars. When a company rep comes here talking about their older model auto as opposed to "lesser brands"I am turned off -- and this had nothing to do with this or that algorithm.

This is not about specific algorithm efficacies. This is about selling medical devices as though they were dishwashers and ignoring the fact they may harm some people. If you knew the car you sold (Ford, Chevy, Kaia, Lexus) lost its breaks consistently for part of the population, would sell it as though it was the best car in the world for everyone?

And kudos to Gil. For posting here and clarifying. When the Ford sales rep speaks to me, I expect him to be arrogant about Fords and not to try to sell me a Chevy. I applaud personal belief in products

I appluad integrity -

I treated the "Ford" as generic, jeff, not as a substitute for "Resmed".

As for algorithm efficacies on a personal basis: I am actually trying a Resmed and enjoying it tremendously -- I couldn't tolerate the Respironics. Which is neither here nor there in this context .

O.

That helps. Sorry that I had missed your point, ozij.

I agree 100% that all manufacturers of medical machinery should provide detailed explanations of how their machines work so that better assessments might be made by medical professionals, and patients alike, regarding which segments of the patient population might benefit most, or least, from the design of the medical products being sold. Still, I've never met a hype-less marketer.

[momof2inmn]

I am not anti-DME, however I have also had some bad experiences with mine. My DME carries the same name and is affiliated with the hospital across the street where I had my sleep study done. The hospital is a reputable hospital and so is the DME that carries it's name. When I was given my machine I was offered a choice of four masks only (I chose the Comfort Gel). This mask did not work for me but I was told that it "was a buy, not a rent" and as such was not returnable. I was able to choose another mask, this time from a choice of about twelve, but was warned that, again, it was a buy and could not be returned. I had a RX for the new mask from my MD and was also told if the mask ended up not being covered by my insurance company the price of the mask (the price of ALL the masks) was $199.00. I chose the Swift LT and so far it is working well for me but in the future I will definitely be purchasing any new mask off of the internet should it not be covered by my insurance. At a cost of $199.00 for a replacement mask I would be one of those non-compliant persons simply because I could not afford to keep trying until I found a mask that worked for me.

I am stunned, quite frankly, to learn that there is a return option on masks that don't work for you within 30 days when I was told that there was no option like this. I was also surprised to learn that a mask fitting should take longer than 5 minutes. I was fitted right there at the hospital along with another person who did a sleep study the morning after my study was done and neither of our fittings took more than a minute at best. My second mask fitting took another minute and for neither fitting was I hooked up to a machine to actually experience how the mask would feel when getting therapy.

I only recently joined this forum and am learning many things that my DME would never have mentioned. Perhaps instead of trying to curb internet sales where people would not receive adequate training, manufacturers should focus on providing mandatory training for DMEs and provide them with information that they are mandated to provide to the patient.

Maybe they already do and it is ignored . . . this is just my two cents.

[Guest]

please name names - your DME was obviously a jackass. The situation can be fixed. What's interesting though is that you're your doctor's customer - not the mask manufacturer, not the DME, etc.

The doctor should be concerned about your health too, but, as many have pointed out....it's YOU that has to become edumacated.

Internet retailers just throw stuff in a box and ship to you. Yeah, yeah, they provide phone support. Great. I want to see an internet retailer perform a mask fitting or read a data card. I'd like to see an internet retailer monitor your therapy and periodically check in with you.

DMEs aren't perfect - BUT THEN AGAIN...why do people on here think that DMEs are responsible for YOUR health? They're simply not.

[BlackSpinner]

What's interesting though is that you're your doctor's customer - not the mask manufacturer, not the DME, etc.

No way. I am the DME's customer. My doctor just handed me a list of all the ones in town. My doctor doesn't care which brand I use as long as it is treating my OSA correctly. Just the same as I am my pharmacies customer. Doctor will chose the drugs for me but it is the pharmacist responsibility to make sure that what I am taking is the correct drug, the correct amount and will not clash with what else I am taking and I am the pharmacists customer. And just like with a pharmacy I will take my business elsewhere if I don't get the service I need.

Plus I am the customer of my provinces medical system - not my doctors.

[elg5cats]

please name names - your DME was obviously a jackass. The situation can be fixed. What's interesting though is that you're your doctor's customer - not the mask manufacturer, not the DME, etc. Internet retailers just throw stuff in a box and ship to you. Yeah, yeah, they provide phone support. Great. I want to see an internet retailer perform a mask fitting or read a data card. I'd like to see an internet retailer monitor your therapy and periodically check in with you.
DMEs aren't perfect - BUT THEN AGAIN...why do people on here think that DMEs are responsible for YOUR health. They're simply not.

Can you help me understand "why do people on here think that DME's are responsible for YOUR health. They're simply not?" It's very difficult for me not to believe a DME providing durable medical equipment is not responsible for the portion of health care involvement associated with the DME. If a DME is "ordered" to dispense a wheelchair and the wheel falls off, the patient falls out and suffers traumatic brain injury, is the DME not responsible for the health of the patient injured by the defective wheelchair.....if the DME dispenses a poorly operating or incorrectly programmed, or inefficiently mask for XPAP resulting in ineffective treatment, has the DME not demonstrated irresponsibility for patient health services.........I really don't understand the position, DME are not responsible for patient health? I am interested in your further explanation why DME is not responsible for patient's health. Will you clarify what DME's are responsible for? Thanks,

elg5cats

[Slinky]

Ozij, when I contacted Resmed about that local DME supplier Resmed made arrangements for Steri-Cycle to bring me my Recall replacement. I left the "services" of that DME supplier and have no idea if they still handle Resmeds or not. That was back in 2007. I haven't been near their office since.

I will say right around my "first anniversary" of CPAP use I did get a letter from that supplier telling me they would need a new script for my equipment. By then I had already "fired" them so I wrote them back a scorcher reminding them that, thank goodness, I was no longer one of their victims. I did get a phone call from a regional rep for the supplier asking for clarification on the problems I had had w/their "service" and so I brought up EVERY problem I had including the piddling little things. That was the last contact I've had w/them. And I'm perfectly happy for that to be the case.

I am NOT my doctor's "customer"!!!! He is MY employee! A skilled and educated employee in an area where I need his advice and expertise. "We" work as a team, w/mutual respect - or I dump him/her and get another who is a better "team player".

[BleepingBeauty]

please name names - your DME was obviously a jackass. The situation can be fixed. What's interesting though is that you're your doctor's customer - not the mask manufacturer, not the DME, etc.

The doctor should be concerned about your health too, but, as many have pointed out....it's YOU that has to become edumacated.

Internet retailers just throw stuff in a box and ship to you. Yeah, yeah, they provide phone support. Great. I want to see an internet retailer perform a mask fitting or read a data card. I'd like to see an internet retailer monitor your therapy and periodically check in with you.

Yeah, I'd like to see that too. From my B&M DME!

Re: fittings? I knew more about my mask than my RT did. No place to lay down, so I was sitting in a chair, as usual. I had to insist on being hooked up to a machine to test the mask's fit under pressure. (What a PITA I am, huh?)

Re: reading the data card? My DME read it exactly once, about three months after I started therapy, if memory serves.

Re: monitoring my therapy? My DME handed me an M Series Plus machine. What's there to monitor? (Now that I have the data-capable machine I wanted in the first place - same insurance code as the cheapie, but the DME insisted my insurance wouldn't cover the fancier model - I monitor my own therapy. Neither my DME nor my doctor is interested in my data.)

Re: checking in on the patient? My DME has called to "check in" on me exactly once, the morning after I began therapy. (I was really impressed by that at the time and thought, "Wow, now THAT'S customer service!" But since that was almost two years ago and there hasn't been another "checking in" call since...)

The real kicker is that they bill my insurance for all this "service." If only my insurance would allow me to buy my covered supplies online, they could save a ton of money. But the system is so messed up that they'd rather reward a crappy DME...

[dsm]

Howdy All,

Gil and leejgpt, thank you for posting. CPAPtalk operates as a free marketplace of ideas. We welcome yours.

Thank you to all CPAPtalkers who have contributed to this thread. Please keep in mind that posts like "I think X because of Y" is respectful and moves discussion forward, whereas "that point is a load of ****" leaves little room for intelligent rebuttal. The goal here is getting to see to the bottom of each position so that we can all read and judge for ourselves. This thread is a positive development and an important step.

From the DME and Manufacturer points of view I'm hearing "these are the things that must be done in order for good patient care to exist. We are professionals who can succeed in the right environment, let us set it up so that patients are well served. Resmed still sells on the internet but puts restrictions in place to promote patient care."

From the user point of view I'm hearing "the solution the DMEs and Manufacturers advocate is or has been harmful to my personal health and finances. I'm better off using the new system, but am being forced back into the old one. You may sell on the internet, but your restrictions are onerous."

Johnny

Johhny,

Great to see you taking a stand & this one was needed. This thread has great potential if our wilder emotions are kept under control.

Assuming we do have the visibility of some large companies I would like to throw in my 0.2 cents worth on issues dear to many of our hearts. ....

- The argument that on-line sellers won't provide as good a service as the walk-in bricks and mortar resellers, can be a compelling logical point but, from many peoples perspectives IT IS NOT BORNE OUT in the real world. We have too many repeat cases appearing here of both ignorant and poor treatment of people diagnosed with OSA etc: by their walk-in DME.

- The point made by JNK that reversed the position re Internet Seller vs Walk-in DME, was a clever & very valid one. Many here believe that cpap.com (via cpaptalk.com) provides a vastly more productive and useful user service to promote compliance than any brick and mortar DME that does NOT HAVE an online facility. Certaily, THIS online seller (cpap.com) can provide access to spares & to a wide range of help & thus support.

- There is a very good case that can be made that large numbers of walk-in resellers are failing in their duty of care when it comes to their own expertise of Cpap equipment and ability to provide useful and proper guidance to customers

- There is just as good evidence that many walk-in DMEs are treating the cpap opportunity as a 'high-margin' profit opportunity while working hand-in-hand with health insurance providers. Few people here (at cpaptalk) have anything good they can say about that relationship from their experiences with both parties.

- Many here will argue passionately & with some good basis, that the current supply & distribution of cpap technology when combined with the necessity to prove compliance, is a failed system that needs redesigning. Compliance info gathering as practiced by many walk-in DMEs is to obtain the bare minimum of what they need to maintain a sale & to pay little attention to the needs of the user. There is often overwhelming evidence (as we see in people who come here) that some walk-in DMEs care far more for meeting their compliance stats than for the patients. The issue here is that cpap therapy is a serious business that causes an enormous degree of stress and anxiety to the participants and any patient who comes to the conclusion that they are less important to the supplier than the suppliers need to provide minimal compliance stats to their insurance partner, is going to become hostile & can then believe the worst they want to about DMEs (we see that happening all the time here).


Summary:
What people are saying (some aggressively, some softly) is that in the minds of the 1000s of people who have participated here, this online seller is not worse than any walk-in DME they know. Some will argue that cpaptalk is vastly superior to any service that a walk-in DME could ever hope to offer.

Yes there are problems with some online sellers, just as there are with some walk-in DMEs.

These problems can be dealt with: if a cpap vendor is serious about improving the quality of the outlets (walk-in and on-line) then design and introduce a compliance model for an on-line reseller. Johnny Goodman has what may be the world's best model. Brand the compliance model and enforce it. This is done in business today from fast food outlets to retail stores (i.e. Allow setup of a store or outlet based on meeting defined standards of compliance to best practice for resale & supply of cpap related equipment).

We live in an Internet age, any vendor who tries to ignore that reality or deny it or work around it, will get burned. Internet business is every bit as viable as walk-in business & as proven over a period of many years, can set the high water benchmark for quality of support & help as here at cpaptalk.

DSM

[Froro]

Internet retailers just throw stuff in a box and ship to you. Yeah, yeah, they provide phone support. Great. I want to see an internet retailer perform a mask fitting or read a data card. I'd like to see an internet retailer monitor your therapy and periodically check in with you.

DMEs aren't perfect - BUT THEN AGAIN...why do people on here think that DMEs are responsible for YOUR health? They're simply not.

I want to meet/see a DME that ACTUALLY does a mask fitting. Mine didn't. I was shown a product to clean it with, that was it. Oh..they did show me how to change the filter...woohoo.
I want to see a DME call for follow up
I want to see a DME deal with a faulty piece of equipment within 14 days of receipt without having to have Resmed corporate get involved
I want to see a DME interested in more than just selling me the most expensive "full service" package and bilking both my insurance company and my tax dollars via our medical system by charging more than double (in my case nearly $1400 MORE than an internet provider). I have yet to see what this "full service entails as it took me contacting resmed to get a new replacement machine, and I have yet to get a single call from my DME

I want a DME who will support me with home software so I can monitor my own therapy. I want a DME who doesn't treat me like a five year old and tell me "most patients don't understand what those buttons do anyway".

Doctors are actually involved in someone's therapy with OSA?? Really?? wow....lord knows the specialist was with me for 5 minutes. Fortunately I have a fabulous famly doc who is well versed and works WITH me.

If my DME actually followed through with patient follow up, fitted me with a mask, took the time to teach me, and was involved, I would not have looked for help online. (and don't blame this on universal health care. Obviously US citizens under the private system have not had any better luck.)

It's all about the mighty dollar. BTW...my mechanic calls me to check in more often than my dme does and my van is worth less than my cpap equip!!
I, like other Canadians also want to know why we are being punished with higher priced machines. Why would companies block shipping to Canadians other than complaints from the DME's here that they are losing their incredibly escalated profit margins.

[Slinky]

Again, I'll have to don my kevlar vest and duck behind a brick wall.

Yeah, if I'm paying out of pocket and the local DME supplier is asking the same price as online I'll go w/the local supplier. Welllll .... UNLESS it was that local sheister outfit I was started with. I wouldn't buy from them again if the price were HALF the online price!!! Shaft me once, shame on you. Shaft me twice, shame on me.

The locals are closer and its easier to speak to someone in person than on the phone plus I prefer personal face to face contact when possible. I can be blunt and I can do better w/someone in person than on the phone if there are problems. I guess I am less abrasive when they can see me face to face. Or at least there is less chance for misunderstanding me and my attitude.

I live in a small somewhat rural town just a half hour drive from a good size town. I try to keep my business local to my small town as much as I can. I avoid the big chains as much as I can.

On the other hand, I feel a loyalty to cpap.com for providing this great cpaptalk.com forum. Since I have such good insurance coverage (thank God) I've not had much opportunity to show my appreciation financially - tho I have taken advantage of cpapauction.com a time or two. THANK YOU, cpap.com for that too!!