Are Clinician Manuals Illegal

[rjjayrt]

I'm not sure of the percentages, I can only tell you how I do it. First of all, I don't even carry any basic machines, all of my machines are fully data capable. I only carry res med and Respironics machines. The reason for that is that the sleep docs in my area prefer those. I carry more masks than I know what to do with, I've never charged a patient for a mask because it didn't fit, wasn't comfortable or because it broke. All my sleep docs write there orders in a way that gives me the ability to fit the patient with the mask that fits best, is most comfortable or patient preference. I will admit I do not have a place to lay the patient down during fitting, it makes sense to do so, but I'm space limited. I do have an area that is exclusively for fitting. I have a written check list that I follow religously when setting up a patient. This list includes going over how to read a downloaded report (I give or download a patients machine at there request and supply then with a copy of the report). I explain the problems patients have had before them and give then solutions ahead of time. I go over every function of the machine and humidifier until they understand it. I provide them with my pager number so they can contact me at anytime they have a problem. We go over accessory replacement and cleaning procedures. I also ask them to come back or let me visit them at 1 month and 6 months to check on there progress (this is besides the regular downloads of there machines). This is the way I do it, In my own mind I expect that all RT/DME should be doing it this way, I know they don't. I bring this fact up every chance I get. Hand excepted...

[Patrick A]

How is the problem supposed to be addressed without those affected complaining to the PROPER agencies.

Just curious as to how patients are supposed to police the health care industry?

Who ARE the proper agencies?

You could be a big help if you would create a post which tells people how to handle the liars, the cheaters, the wretched jerks who are too lazy to do their jobs.

As it happens, I like the RT at my local Apria.

I loathe Apria. I end up tearing my hair out every time I have to order supplies. In fact, unless I can afford it out of pocket, I put off ordering supplies because dealing with Apria is so stressful.

viewtopic.php?f=1&t=47581&st=0&sk=t&sd=a is only one of several exchanges with Apria.

I have reported Apria to my insurance, Aetna. I have told them I intend to change DMEs and that I need information on reimbursement for out of pocket expenses. This has resulted in a fruitless and frustrating line of garbage that I must have a referral from my PCP in order to change DMEs.

viewtopic.php?f=1&t=47653&p=431347#p431347

Now, I'm asking: how would you procede to resolve these issues?

I have no clue. I just know that if I can afford it, I'll order from someone who fills my orders promptly and without giving me a run-around.

I reported Apria to my Insurance BC/BS FEHB They called the local Apria and got the same bovine excrement I am glad that I am not the only one that loathes APRIA RIPOFF

[rjjayrt]

The first place to start is with the insurance company. 2nd would be the accredidation agency the DME uses, all DME's who do medicare (which is most) are required to be accredited. 3rd would be the state board of pharmacy who regulates your DME

[jnk]

I'm not sure of the percentages, I can only tell you how I do it. First of all, I don't even carry any basic machines, all of my machines are fully data capable. I only carry res med and Respironics machines. The reason for that is that the sleep docs in my area prefer those. I carry more masks than I know what to do with, I've never charged a patient for a mask because it didn't fit, wasn't comfortable or because it broke. All my sleep docs write there orders in a way that gives me the ability to fit the patient with the mask that fits best, is most comfortable or patient preference. I will admit I do not have a place to lay the patient down during fitting, it makes sense to do so, but I'm space limited. I do have an area that is exclusively for fitting. I have a written check list that I follow religously when setting up a patient. This list includes going over how to read a downloaded report (I give or download a patients machine at there request and supply then with a copy of the report). I explain the problems patients have had before them and give then solutions ahead of time. I go over every function of the machine and humidifier until they understand it. I provide them with my pager number so they can contact me at anytime they have a problem. We go over accessory replacement and cleaning procedures. I also ask them to come back or let me visit them at 1 month and 6 months to check on there progress (this is besides the regular downloads of there machines). This is the way I do it, In my own mind I expect that all RT/DME should be doing it this way, I know they don't. I bring this fact up every chance I get. Hand excepted...

Thank you.

We need more posts like that one in these types of discussions, in my opinion.

Please keep sticking around even when we (I) get cranky. Such discussions are healthy here.

Just please continue to make allowances for what so many of us have experienced. It helps validate our pain. And we need that. Sorry if I came off more heated than I meant.

[Vigorous handshake. Hoping one day soon it will be a hug.]

jeff

[carbonman]

The first place to start is with the insurance company. 2nd would be the accredidation agency the DME uses, all DME's who do medicare (which is most) are required to be accredited. 3rd would be the state board of pharmacy who regulates your DME

Once I learned, through this group(Wulfman), what The Big A
was pulling on me, I cut them loose.
I will still get my allotted masks from them, but when
they screw it up, it won't be a big deal.
I have plenty of backup.

Patrick, I hear ya', but The Big A is not
worth the energy wasted railing against them.

I may or may not every go back to a DME for a machine.
The final large piece of my cpap therapy armada
is being delivered to my door today.

I think the best I can do is hang around here and
try to get the word to the OSA refugees as they
stagger in......so they can know what to do.
Education and self reliance is best course of action for this therapy.

[Slinky]

Thank you, rjjayrt. For the leads on where to file our complaints - and for your thick skin and patience as we vent our frustrations against the DME providers and provider RRTs we've encountered.

[jnk]

. . . here in San Diego, Mexifornia . . . .

Hey, Patrick, did you feel the quakes?

jeff

[-SWS]

Rjjayrt, you are a champion of both hearts and sleep--- warm and feisty as you may be.

Thanks for your input!

[GumbyCT]

I'm not sure of the percentages, I can only tell you how I do it. First of all, I don't even carry any basic machines, all of my machines are fully data capable. I only carry res med and Respironics machines. The reason for that is that the sleep docs in my area prefer those. I carry more masks than I know what to do with, I've never charged a patient for a mask because it didn't fit, wasn't comfortable or because it broke. All my sleep docs write there orders in a way that gives me the ability to fit the patient with the mask that fits best, is most comfortable or patient preference. I will admit I do not have a place to lay the patient down during fitting, it makes sense to do so, but I'm space limited. I do have an area that is exclusively for fitting. I have a written check list that I follow religously when setting up a patient. This list includes going over how to read a downloaded report (I give or download a patients machine at there request and supply then with a copy of the report). I explain the problems patients have had before them and give then solutions ahead of time. I go over every function of the machine and humidifier until they understand it. I provide them with my pager number so they can contact me at anytime they have a problem. We go over accessory replacement and cleaning procedures. I also ask them to come back or let me visit them at 1 month and 6 months to check on there progress (this is besides the regular downloads of there machines). This is the way I do it, In my own mind I expect that all RT/DME should be doing it this way, I know they don't. I bring this fact up every chance I get. Hand excepted...

I must be dreamin?

He's said all but how & where we can get hold of this leader in DME supplies.

I am all ears....where and how do we find you?

[Slinky]

I'm taking a guess, rjjayrt. Your business ONLY provides respiratory and xPAP services. You don't do the entire DME provider thing, you specialze. Am I right?

[Kiralynx]

The first place to start is with the insurance company. 2nd would be the accredidation agency the DME uses, all DME's who do medicare (which is most) are required to be accredited. 3rd would be the state board of pharmacy who regulates your DME

And how does one find these?

My insurance company I know.

I have no idea how to look up an accreditation agency for a DME.

And, I've been informed by my insurance that DMEs have nothing to do with pharmacies because a DME is a service provider and it's not like filling a medical prescription.

(I'm not intending to sound snappish here... just frustrated.)

[aka fuzzzy96]

i find it interesting that if it were illegal to posess a clinicians manual , then why is there one packed in each and every machine?????
if it's a contractual thing between the dme and the manufacturer, then why is there one packed in each and every machine?????

think about it. wouldn't the manufacturer send ONE copy of each model's manual to the dme and update as needed?

say as an example each manual costs $0.50 to print. selling a million units would be $500,000.00 in extra cost. some exec would be outta work!

i believe they are in there as a cya for the manufacturer since a lot of thier customers (dme's)don't have a clue and the corporate legal vultures want a first strike capability. (the best defense is a strong offense)

now on the same line of reasoning..........we are having a discussion on the legality of posessing a piece of paper with some printing on it. are the brittish coming??? are we in need of a form 1040 tea party????? lawyers and congress members (most of whom are lawyers) have got things out of hand .

IF" WE THE PEOPLE" can't tell if such a insignificant thing is legal or not then how are "WE THE PEOPLE" supposed to abide by these crazy laws?????? are we really free???

i can't afford a lawyer to tell me what is right and what is wrong and i suspect most of you can't either.

with that i step off the soap box.


happy new years all

[GumbyCT]

I have no idea how to look up an accreditation agency for a DME.

It may fall under the Dept. of Health. Certainly, your states Atty. General will know.

[elg5cats]

rjjayrt" I know its fashionable to beat up on RT's and DMEs but please consider that some of us try to do it right...

DME/RT's provide the material for fashionable beating up on RT's DME's. I professionally interface with Home Health Care and DME's on a regular basis for reasons unrelated to OSA but with providers who also market to my professional group as xPAP service experts. Yet my experience: DME #1 Stated I would have to fail CPAP before insurance would allow APAP and MD wouldn't prescribe APAP. DME #2 I would have to pay a mask and hose fee if I insisted on a APAP which then changed to an administrative fee of $200 beyond insurance and assigned copayment. DME #3 "insurance won't pay for it, you have to get xbrand and no APAP. DME #4 Carries my preferred brand only. Nice initial consult and ordered machine. No Show to appointment to pick up machine after I drove 45 minutes in frigid bad weather. When I called the 800#, I was told to call them back in 15 minutes. RT called and blamed me for his failure to be at appt..during blame made references to sick kid and daycare issues...adamantly blamed me for his NS.. I waited one hour in my car freezing while they "accommodated me" an hour late for my scheduled appointment. Arriving RT knew minimal about machine, set up no optional features, was frustrated her Holiday shopping was interrupted. When I called office manager to discuss the NS, she could have cared less, said a different RT would have to work with me. This RT called me and "B" me out making references to "office talk." Scheduled an appt 3 weeks later to "set up machine and educate." Called the office manager again only to be shamed for complaining, assured this RT would never behaved as she did. I cancelled the appt..then was sent paperwork to be completed to authorize billing insurance and "customer data." This DME is now over billing me and threatening me with collections if I don't continue to overpay. Facts: My insurance does not designate type of machine, only max DME coverage allowed. It's probably considered "double dipping" to charge me along side of billing insurance for in network providers as they agree to insurance payments for services. And likely motivation of limit my decision making is profit driven due to the max insurance reimbursement for DME without stipulations on Brand/Features of machine. I was clearly unwelcomed for having done my homework and was actively participating in my own decisions...I make the decision what car to buy, where I live, where I work and somehow I could be a decision maker for my APAP!!!!! DME's and RT's are not being bashed here, the typical method of "doing business" is simply being shared. The way to stop this "marketing, is to ensure "patients" receive excellent experiences to report.
Experience speak for itself.

[Patrick A]

. . . here in San Diego, Mexifornia . . . .

Hey, Patrick, did you feel the quakes?

jeff

Wow it made national news? The way people here were talking you would have thought Mexico had fallen of the map.