A Tale of Two DMEs

[Lady Marian]

It was the best of service. It was the worst of service.

My husband started on CPAP several months ago. We knew next to nothing about the whole affair, so we naively accepted a ResMed Escape from the first DME we went to. When we went to get it, the RT showed my husband one nasal pillow mask, and that's what we came home with. My husband has been very satisfied with his therapy and is feeling much better, but he isn't as data and detail oriented as I am when it comes to health care. The best thing that RT did, in my opinion, was to inform me that if I was getting up several times each night to urinate, I wasn't waking up because of my bladder, but probably because of OSA. That put ME on the path to diagnosis, which started at the end of October and eventually led to the other DME (story below). I must mention, also, that every bill submitted by this first DME to date has been denied by our secondary insurance because they are not receiving primary insurance EOB information from the provider as they should. I have called local, regional, and national level billing offices every month in hopes of sorting this out. It seems to be resolved this time, but that's what I've said after every phone call, so you can take that conclusion with a grain of salt. (the first two re-submitted bills have subsequently been paid, and we have paid very, very little out of pocket, so I'm cautiously optimistic)

Given the quality of supplies, service, and paperwork management we experienced with DME #1, when it came time for me to get a machine, I did a bit more homework. (enter cpaptalk.com -- many thanks to all who have helped me, either knowingly or unknowingly) I found that one other local DME is a preferred provider for my primary insurance. I spoke with an RT there a couple of weeks ago, and have somehow lived through the excruciatingly slow process of titration study, report, script, and insurance clearance. Yesterday afternoon, the long awaited appointment finally occurred.

DME #2: We entered the office and before I had finished introducing myself to the receptionist, the RT was out in the lobby to greet and welcome us. In his office, he had set out a Respironics machine and humidifier (the PR one, I think... he said it was their newest model). I mentioned that I'd had a specific machine in mind, and before I could finish saying ResMed S8 Autoset II, he had one sitting before me. (my script was identical to my husband's... CPAP and mask ... no details other than pressure setting) Next, we moved into the CPAP room, where he had me try at least 6 or 8 different masks. I settled on one that I'd successfully slept with for part of my titration study. He patiently answered question after question. He showed me how to access the clinician menu. He offered to download and print data from my card as often as I wish -- even multiple times per week so I can get the detailed graphs. He gave me the clinician manual. He gave me advice on how I might be able to get my husband's machine upgraded within my insurance company's restrictions, even if it has to be done with DME #1.

In the short time I've been lurking around this forum, I've seen many opinions expressed about doctors, techs, RTs, DMEs and other providers. I wanted to share my story because I think it encompasses many of the situations, frustrations, and joys that have been relayed by others. I hope it might be helpful to someone in the same way that many of your stories have been helpful to me.

Oh, PS: I almost forgot. My first night's data: leak rate 0.0, AHI 2.0, AI 0.0, HI 2.0 so I couldn't be happier. I understand that if anything, ResMed's algorithm over-reports hypopnias, so the AHI could easily be interpreted as even lower than that.

PPS: I'm still remembering the mantra that one night does not a trend make, so naturally, I'll keep an eye on the therapy as it progresses.

[Gerryk]

Congrats and welcome aboard. At least we know neighter of you will be complaining to the other about ones mask blowing in the others face.

Sounds like you had a fantastice experience with DME #2 and have a new DME for both of you.

Gerry

[sleepycarol]

Good for you learning and getting what you need!!

Some don't care what machine they have etc.

My son-in-law had a sleep study last week. They were here tonight and I told him if he indeed needed to go back for a titration study to let me know. I showed him my machines (I recently purchased a Resmed S8 Vantage in like new condition from cpapauction) and own an M series Auto. He was lamenting that of course it will be after the first of the year before he hears anything and then his deductible will start all over. I explained the differences in the machines, why it is to his benefit to get a data capable machine, etc. He says he will ask plenty of questions, and of course I will recommend he come here for help as well. His mom has sleep apnea and is not interested in any aspect of her treatment. Joe said she has complained "it isn't working" like she thought. Duhhhh -- she doesn't care about the data so what can she expect.

So I am proud that you have taken the bull by the horns and are advocating for you and your spouses health!!

[Slinky]

Wow, LadyMarion!!! CONGRATULATIONS. IF only every new xPAP patient could be so fortunate as you!!! Goshes, sounds like you found rjjayrt's DME provider shop!!!!

[Scarlet834]

Another Tale of Two DMEs (or rather, more about my own DME #2)

I am in the middle of transitioning to Apria; been through all the hoops, no choice. Pleasant, apparently efficient phone service so far, and one of the agents advised me to have my existing CPAP model added to my script to ensure I get the continuity of equipment I'm looking for (even though I was doing that anyway). So no concrete complaints for now.

I will say this, however: before I asked questions about my existing REMstar Pro I was told I'd be getting a REMstar M series. Now that it's on my script, the Pro model has to be special ordered. Reading between the lines it's clear to me that a newbie off the street is not going to walk away with a data-capable machine.

I'm so grateful to have started elsewhere because I did, indeed, originally accept whatever the first DME suggested. Now that I know more what I'm doing I will probably do fine, but if worst comes to worst I can consider an insurance change at the end of 2010.

[KatieW]

Welcome Lady Marian! I enjoyed your tale of 2 DME's. Glad you've got a good one! I know they exist, I just haven't met one yet.