Yet another DME story to add to the pile...

[JohnBob]

My DME was quite frank and honest with me...he said he could not compete with the internet...he had overhead for his office, diagnostic equipment (software to download reports from CPAP machines, etc.) and he makes house calls for some patients (he runs a respiratory therapy busines, NOT a general DME provider) and also provided service on machines. He did not take it personally at all when I told him I would check to see which route cost me the least. He also said my insurance paid the same amount regardless of which machine I get...so with the exception of the stupid/dishonest DMEs, I lay the blame on the insurance companies for not being responsive enough to tier claims dependent on what is medically necessary.

[Comteplating]

...Personally, I didn't go through a local DME and purchased all of my equipment from CPAP.COM, so I haven't had any bad experiences. My reasons were primarily cost-related.

Wulfman,

I'm comtemplating going thru the same route (i.e. buy my equipment from a third party like CPAP.COM)... would you mind sharing what was the steps you had to take to get it done? Once you buy how do you get it set up according to the docs specifications if you skipped the DME (aren't they supposed to be the ones setting it up for you? plz, plz, share...

Thanks.

[Wulfman]

...Personally, I didn't go through a local DME and purchased all of my equipment from CPAP.COM, so I haven't had any bad experiences. My reasons were primarily cost-related.

Wulfman,

I'm comtemplating going thru the same route (i.e. buy my equipment from a third party like CPAP.COM)... would you mind sharing what was the steps you had to take to get it done? Once you buy how do you get it set up according to the docs specifications if you skipped the DME (aren't they supposed to be the ones setting it up for you? plz, plz, share...

Thanks.

Well, actually, the DME in my case WAS CPAP.COM. I uploaded a scanned copy of my prescription to them and they set up my machine accordingly and shipped it to me. I then submitted an invoice (from ME) to my insurance provider and was reimbursed at the in-network rate of 80%.
It was VERY simple. I read the manuals when I got it, attached the humidifier, hose and mask....checked out the C-Flex and RAMP settings, filled the humidifier with water and started getting some much-needed sleep.

I actually had more problems with getting my sleep doctor's office getting a copy of my sleep study sent to my insurance provider for review than anything else. Somebody "dropped the ball" and that delayed things by another week or more.
Initially, I had contacted my insurance provider to pre-approve the sleep study, and then to make sure that they would reimburse me for my out-of-pocket purchase of the equipment. This part CAN be crucial in making sure that everything gets covered. Talk to your insurance provider!
On the other hand, I was prepared to purchase all of my equipment out-of-pocket if necessary....to be able to get what I wanted. After checking the local prices and doing the math, I figured I was going to be money ahead by going the way I did. On top of that, the local DMEs were proposing equipment that was not as technologically advanced as what I bought from CPAP.COM.
I also wanted to make sure that I could purchase the software to monitor my therapy. It was not paid for by my insurance....but that was OK....it's been worth it.

Hope that answered your questions.

Best wishes,

Den