what benefits does a DME give?

xiola · Post by **xiola** » Thu Oct 22, 2009 1:01 pm

I've been reading through the forums, and was wondering...

if i have the means to buy the equipment myself...is there any reason I should use a DME?

From my very limited experience - it seems like i'm just adding another layer of complexity to this and another person interrfering in business that should be between me and the dr?

But, does having a DME available for things like equipment exchange/returns/repairs something I'm not seeing the value of yet (because I haven't started using this yet, because the DME doesn't have a data capable machine in stock and had to grudgingly order one for me) ?

I guess... someone to show me how to use it, get the right fit for the headgear, etc? is that something the sleep clinic would help me with?

carbonman · Post by **carbonman** » Thu Oct 22, 2009 1:16 pm

xiola wrote: because the DME doesn't have a data capable machine in stock and had to grudgingly order one for me) ?

I think you answered your own question.

We will teach you and you will learn how
to take care of your therapy.

cinco777 · Post by **cinco777** » Thu Oct 22, 2009 1:17 pm

A Good B&M DME would do everything on your wish list. However, most are not worth the trouble (my experience and that of close relatives & friends would put the percentage over 90%). Many forum members, me included, have succeeded with our sleep therapy without any contact or involvement with a local DME (one that you can visit). However, to succeed w/o a DME (or helpful Dr.), you need to read and make informed decisions/changes based on the helpful information and answers on this forum.

If you can find a Good DME, use them. But don't ever use a DME that lies to you, overcharges you because they can, takes forever to deliver, screws up your RXs and order(s), and so on. You get the message: Good ones - stay awhile. Bad ones - run away quickly. Just be aware that Good ones are rare and that you can succeed without them, as long as you make use of all the helpful advice, recommendations, and answers available from the experienced, skilled, talented, and most importantly, caring, members you will find here on CPAPTalk.

jnk · Post by **jnk** » Thu Oct 22, 2009 1:18 pm

xiola wrote:I've been reading through the forums, and was wondering...

if i have the means to buy the equipment myself...is there any reason I should use a DME?

From my very limited experience - it seems like i'm just adding another layer of complexity to this and another person interrfering in business that should be between me and the dr?

But, does having a DME available for things like equipment exchange/returns/repairs something I'm not seeing the value of yet (because I haven't started using this yet, because the DME doesn't have a data capable machine in stock and had to grudgingly order one for me) ?

I guess... someone to show me how to use it, get the right fit for the headgear, etc? is that something the sleep clinic would help me with?

If getting reimbursement from insurance is not an issue for you, I don't know how you could do better than using cpap.com as your personal online DME. They provide a lot of information on their site, are helpful over the phone, have a provision for mask insurance in case you can't get a particular mask to work for you, and they sponsor this board.

I have had success with them, as have many others who post here.

jeff

Autopapdude · Post by **Autopapdude** » Thu Oct 22, 2009 1:25 pm

Honestly, for anybody who has experience in xpap therapy and has software? I'd have to say NONE, unless you have great insurance that covers data capable equipment, and good masks.

xiola · Post by **xiola** » Thu Oct 22, 2009 1:58 pm

well I thought about it, and I think I want to use a DME because i want this to count towards my deductible. But if it weren't for that, I'd probaby order online.

But I called my ins, got other provider names, called another provider and talked to them and..

WOW what a difference. the lady was nice, answered all of my questions, very helpful. I called my clinic and asked that I switch providers, they said they would send the info over right away for me.

Hopefully take 2 will be a more positive experience.

Wulfman · Post by **Wulfman** » Thu Oct 22, 2009 2:11 pm

xiola wrote:well I thought about it, and I think I want to use a DME because i want this to count towards my deductible. But if it weren't for that, I'd probaby order online.

But I called my ins, got other provider names, called another provider and talked to them and..

WOW what a difference. the lady was nice, answered all of my questions, very helpful. I called my clinic and asked that I switch providers, they said they would send the info over right away for me.

Hopefully take 2 will be a more positive experience.

When is your insurances' fiscal year up? If it's the end of December, they're going to "ding" you again starting in January for the deductible if you're on a monthly payment plan with the DME. And, depending on what your deductible is, it could make your equipment alot more expensive. There's a reason why these payment plans run for 10 months or more.......it's a huge benefit for the insurance provider because it reduces THEIR payments and it's great for the DME because it stretches out their income.

I've never dealt with a brick & mortar DME. I purchased all of my equipment from CPAP.COM and my insurance provider reimbursed me for 80% of it when I billed them.

Den

timbalionguy · Post by **timbalionguy** » Thu Oct 22, 2009 2:43 pm

What are the advantages of a DME?

Aggravation
Frustration
Misdirection
Delays
Overcharges
Humiliation

I am so glad I went the online route. I didn't need a person to explain to me how to set up the machine or use the mask. I was able, using the tools on this site's parent site, CPAP.com to make informed mask decisions. (I have tried just two and both work for me.) Their reviews on machines had me pretty much convinced from day one which was the right machine. My particular case has not been easy to treat, yet is not (yet) to the point of needing a BiPAP or servo ventilator. Reading the many experiences here has taught me what to watch out for, and how to deal with less than optimal results. And as I learn, I try to help others, like you!

jnk · Post by **jnk** » Thu Oct 22, 2009 2:56 pm

timbalionguy wrote:What are the advantages of a DME?

. . . Misdirection . . .

I'm trying hard to think of the other word for that, but it just isn't coming to mind!

I forget the exact joke, but the punch line is, "When their lips are moving."

DannyPh · Post by **DannyPh** » Thu Oct 22, 2009 3:01 pm

Well. Six of one and Half a dozen of the other. I have a Wonderful DME that has been nothing but Helpful. Supplies and Mask etc. sent via mail in a timely manner and they have been nothing but Helpful and Polite each time I contact them. But there are rotten Apples iin every Barrel. Guess I just chose the right Barrel ! Best of luck .

SnoozyWoozyCat · Post by **SnoozyWoozyCat** » Thu Oct 22, 2009 5:03 pm

I have BCBS and called the insurance company to ask about purchasing online and the one thing that convinced me to use a DME provider is that if I purchase online, my insurance considers this charge as out of network and my benefit coverage would be reduced and I would have to meet a separate deductible. So that kind of made the decision for me!

mattman · Post by **mattman** » Thu Oct 22, 2009 5:04 pm

lol! Well, you certainly asked a question guaranteed to get a long list of responses here!

Speaking as a former DME guy who is a strong advocate of being able to both shop online AND use brick and mortar places as well, here is what I can tell you from a long personal experience (Both as a cpap user and a dme guy)

IF you are the sort to want to micromanage your healthcare and your cpap treatment in particular AND you are comfortable doing a lot of research and enjoy really studying up and becoming an expert on cpap treatment then a DME company will really not have a lot of benefits to you.

Basically, when using a local DME company you should be getting a local company who can work with you to get you setup and running without you having to be the expert. Obviously a LOT of people are coming here because they did not get effective treatment from a local DME so yes - there are a great deal of angry and hurt feelings from users here over the service they got at a local DME company. I firmly believe this is the exception and not the norm so if you want to give it a try don't be afraid to do so.

Look at what it will cost you. As already mentioned - we are approaching year end so factor that into your insurance company thoughts.

Insurance companies set the prices through local DME companies. Due to the nature of billing an insurance company, the massive amount of paperwork and documentation as well as the huge amount of regulation that goes on - using an insurance company will nearly always result in significantly higher total costs (Not neccessarily cost to you, total cost) than buying cash online.

Especially if you are nervous and unsure about how to move forward or if it seems much too daunting (And for some it is. Not all, but some) or if you just don't want to be bothered with learning all this stuff - then by all means a local DME can be an excellent partner in getting you taken care of.

It all comes down to what YOU are comfortable with and where you see yourself in the role.

Feel free to ask any other questions. Yes I love my local DME but I also strongly believe people should have a choice.

mattman

telly · Post by **telly** » Sun Oct 25, 2009 10:01 am

I don't have insurance right now and normally avoid DMEs like the plague. However, both my machines were on the blink and a wonderful DME called SomniHealth in Alameda, CA fixed me right up. My machines were fixed at no charge! Also, they guys were really cool and looked at the readout from my software and made suggestions. There was a respiratory technician on staff and he deduced that I am still "mouth breathing" and gave me steps to help get out of the habit.

So, not all DMEs are bad, IMHO.

rubymom · Post by **rubymom** » Sun Oct 25, 2009 12:31 pm

I don't know that I'd be so harsh. My DME got me started and I needed to switch out machines and masks. Now that I'm six months in, I'd feel OK going it alone but that's with the software that I have and this forum to help.

Wulfman · Post by **Wulfman** » Sun Oct 25, 2009 1:37 pm

I did some searching this morning on some billing practices that may or may not be allowable by DMEs.
There seems to be a contradiction in billing for mask parts in a couple of the links.
Draw your own conclusions.

Den

http://homecaremag.com/mag/add_revenue_ ... ompliance/

http://www.billmyhealthinsurance.com/me ... hines.aspx

http://stanford.wellsphere.com/asthma-a ... heme/19560

"Does your DME Company send you CPAP supplies at regular intervals (say every 3 months) without asking if you need them? If you answered yes, you are a victim of Medicare fraud. This is a common practice of the national companies and is very wasteful of our limited health care resources."

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