Ridiculous DME Behavior (is this common?)

anonymoe · Post by **anonymoe** » Wed Jul 13, 2011 11:55 am

I just got my first 6 month mask cushion replacement from my DME. They sent me the wrong cushion, which you know, I understand. People make mistakes. I had started with a Quattro FX but quickly switched to a Swift FX (I still have the Quattro FX) for daily use.

They sent me a Mirage Micro (at least, that's what I think it is based on checking images on CPAP.com). It's in a small ziplock bag with "Large" written on the bag with marker. I called them to tell them I'm on the Swift FX and that I got the wrong cushion, they told me just to pitch the one I received in error.

So here's what the DME is doing... when they get in a new mask that contains multiple cushion sizes they break the set apart and keep the cushions the patient doesn't need. They then send those out as replacement cushions... and I'm sure they also help people out with "freebies" when they are trying to find a mask that works. The invoice they sent me for the replacement cushion lists a "retail" price of $75, although I'm sure the insurance company pays less than that.

So a part that they claim is worth $75 should be thrown away because it's not worth it to ship back to them.

This seems fishy to me. Should I insist on replacement pillows in the original manufacturer packaging? Is this kind of part swapping common with DMEs? Does it break any laws/rules?

cowlypso · Post by **cowlypso** » Wed Jul 13, 2011 11:58 am

It's incredibly common. Not really illegal, but a bit unethical.

chunkyfrog · Post by **chunkyfrog** » Wed Jul 13, 2011 12:06 pm

If you have a choice of DME's with your insurance, it would probably be good to shop around.
We switched providers, and I have ordered equipment from cpap.com (our hosts--my dime) when our
insurance schedule did not allow what I needed --now!

Mary Z · Post by **Mary Z** » Wed Jul 13, 2011 1:46 pm

Tell the DME what you want- a factory packaged replacement cushion. Talk to the manager if necessary. If they can't accomodate you I would go shopping for a new supplier.

HerbyPeg · Post by **HerbyPeg** » Wed Jul 13, 2011 4:38 pm

The consumer who received the original package paid for all the parts in full. The second consumer (and maybe the third if asking for different sizes) will also pay for those parts at the highest price allowed for that item. You and your insurance company are paying too much.

AmIawake · Post by **AmIawake** » Wed Jul 13, 2011 6:26 pm

Excerpt from 21CFR801.1 CFR=Code of Federal Regulations= US law

Subpart A--General Labeling Provisions
Sec. 801.1 Medical devices; name and place of business of manufacturer, packer or distributor.
(a) The label of a device in package form shall specify conspicuously the name and place of business of the manufacturer, packer, or distributor.

xpap is a medical device, which is why you are required to have a prescription in the USA.

Ask the DME where the required label went to.

codinqueen · Post by **codinqueen** » Thu Jul 14, 2011 8:46 am

DONT throw the wrong piece away!!! Go to the thread about "The Great Pillow Exchange" and exchange it for what you need! It might take awhile, but be persistent, and eventually you will have a cushion to spare that only cost you postage to send the "wrong" piece to a fellow hosehead who needs it, while he/she will send the piece you need. And yes, the DMEs commonly do this, so be sure when you qualify for a new mask to tell them you want ALL of the sizes in the package, not just your size they have on file- tell them you experiment with the different sizes, if they want to know. Then you will have more to swap! Some hoseheads can actually use two different sizes of nasal pillows, you might be one of them!

archangle · Post by **archangle** » Thu Jul 14, 2011 12:04 pm

Some masks get shipped with multiple sizes of cushions, some don't. Also just because the part you order has multiple sizes doesn't mean the DME doesn't get a single size package.

However, I'm sure many DMEs do split up packages this way.

xenablue · Post by **xenablue** » Thu Jul 14, 2011 12:20 pm

When I get replacement pillows for my FX or Lite, I get only the size requested and the charge is something like $17 each, which is billed to the insurance. Sounds like your DME is charging everyone (and/or their insurance) for the whole set, so effectively receiving triple the $$$$. Sad.. no wonder insurances premiums are sky high!

xena

GumbyCT · Post by **GumbyCT** » Thu Jul 14, 2011 12:56 pm

anonymoe wrote:This seems fishy to me. Should I insist on replacement pillows in the original manufacturer packaging? Is this kind of part swapping common with DMEs? Does it break any laws/rules?

It is not only fishy and unethical it is unsanitary. I would spend my waking moments talking with my insurance about this. Find out who else you can buy from that is in your network.

Do not return this part. I would file a complaint with the Insurance Commission and the licensing authority in your state so this practice does NOT happen to the next person.

I have received many wrong parts and wrong sizes for wrong masks but never (yet anyway) a part repackaged in a zip lock baggie. In fact, I complain when I received nasal pillows which were opened. The excuse I got from the VA lady was 'maybe' they were checking which size it was. Well shouldn't a 30yr RN know these parts come in "clear" plastic sealed bags which clearly indicate what it is and what size the part is? So maybe they weren't checking the size.

In any case, all parts should be in unopened, original manufacturers packaging, period. And should include ALL sizes if that is they way they are sold. Check cpap.com if unsure what should be included.

If I were you, I would not be doing business with this DME again. If you do, you are reinforcing a bad business practice.

Vader · Post by **Vader** » Fri Jul 15, 2011 9:06 am

GumbyCT wrote:
anonymoe wrote:This seems fishy to me. Should I insist on replacement pillows in the original manufacturer packaging? Is this kind of part swapping common with DMEs? Does it break any laws/rules?

It is not only fishy and unethical it is unsanitary. I would spend my waking moments talking with my insurance about this. Find out who else you can buy from that is in your network.

Do not return this part. I would file a complaint with the Insurance Commission and the licensing authority in your state so this practice does NOT happen to the next person.

I have received many wrong parts and wrong sizes for wrong masks but never (yet anyway) a part repackaged in a zip lock baggie. In fact, I complain when I received nasal pillows which were opened. The excuse I got from the VA lady was 'maybe' they were checking which size it was. Well shouldn't a 30yr RN know these parts come in "clear" plastic sealed bags which clearly indicate what it is and what size the part is? So maybe they weren't checking the size.

In any case, all parts should be in unopened, original manufacturers packaging, period. And should include ALL sizes if that is they way they are sold. Check cpap.com if unsure what should be included.

If I were you, I would not be doing business with this DME again. If you do, you are reinforcing a bad business practice.

What Gumby said.

Yeah, I agree. This practice by your dme is really unacceptable. A dme that I used to work with pulled something similar and I reported them.
They don't do that no more!

Ridiculous DME Behavior (is this common?)

Ridiculous DME Behavior (is this common?)

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