DME nightmare(S)

[123.Shawn T.W.]

WOW!

I sorry for any typo's in advance ... Hard to type on an iPhone, and even harder to go back and fix mistakes ...

Glad I have the afternoon off from driving!

I got a call from a DME (associated with sleep study) telling me that they got my Rx for a cpap and mask ... To make a really long story a tad shorter ... I told her that my Dr and i had ot talked about this yet ... That I wanted a particular machine ... I asked her if they carried ResMed products, she said no, I said well never mind ... She told me that they have Resperonics (sp?) I told her I wanted a S9 AutoSet, you would have thought that I had asked her to do something very unreasonable!! We don't just give out auto's, those are diagnostic machines, she said. And there a lot more expensive too! I told her, yes I know, and I also know because I checked with my ins co, and they pay you the same price for a bottom of the line $200 cpap as for a top of the line APAP! I pay my premium every week, I want the best for my health! Dr also prescribed me a nasel mask ... Without talking to me, he is out today, but ... Tomorrow we WILL talk!

I called over 40 DME's a few are to call me back, as some were busy and gonna check ... Some of the people were complete idiots! Tried to tell me that I could only get basic info of a ResMed, only leaks, and ahi ... but no details like the Devilbliss(sp), and furthermore I would have to take the disk out of the S9AutoSet, and send it to him to read even that data! I told him I could just as easily take out the disk, and put it in my computer and read everything he can ... He kept telling me that the Devilbliss is so much better ... But he could order me a s9 if I had a Rx for it ...

Anther guy called back and told me that Blue Cross would not give them enough money for the S9 AutoSet, it was not worth there while to order it ... It was a very expensive machine I was told! I told him yes, I know, I want the best for my health! I pay every week for my health insurance ... !

A lot of the people seemed to not really know what line they carried ...

Still waiting for a few call backs ... So far ... NOBODY in FOUR counties in South East Arizona has a S9AutoSet in stock!

I guess my therapy this afternoon is typing this all out on my iPhone!

Deep breath ...

[LoneStar]

See if your insurance company will reimburse you if you use an internet supplier. Our forum hosts, https://www.cpap.com, will supply an insurance form with your order if you ask for it.

And if your deductible is high, you'll probably save money ordering off the internet anyway.

Lisa

[flatag]

Wow, hearing your story make me appreciate my DME even more. Hang in there and don't settle for less.

[lazer]

........We don't just give out auto's, those are diagnostic machines, she said. ...

This! Wow and I'm clear out in Pennsylvania and my current DME said this exact thing although I won't slam on them too much as they have been gracious enough to let me hang on to this "loaner Apap" for like 3 months total or so until my Doctor gets me tested again for insurance qualification. There must be a universal "DME handbook" of bullshit to feed to patients.

[Pugsy]

Welcome to DME Hell. I know there are good ones out there but what you are experiencing seems to be what a lot of people experience much more often than the good experiences.
Stand your ground and someone will eventually want your business enough to give you the machine you want.
They make money on them....just not as much as they want.
It would help things greatly if your doctor would be specific and write the RX with machine make and model along with DAW but sometimes they get their panties all in a wad too.

Don't go into all the software and your viewing your reports unless you just want to wave a red flag in their face. I think they feel like their authority is somewhat challenged when we know how to do things only they are supposed to know.

[123.Shawn T.W.]

Unfortunately BCBS wants me to stay in there little network of preferred providers ... If I go out of network ... My deductible more than doubles, and then my co-pay is 40% compared to 20%!

I could buy a whole setup from cpap.com for less than what they want! (I just bought a S9AutoSet NEW from Craigslist for my wife delivered with H5i & ClimateLine for $525!

I've called my dr's office, to have him call as soon as he gets in tommoros morning ...

[123.Shawn T.W.]

I plan to explain to my Dr that the auto will help me actually USE the machine!

I'm VERY sensitive to changes in my sleep pattern, and I need every little bit of help I can get to make this work.

Heated humidifier
Heated hose
Ramp
EPR
Quiet
Mask fit feature
Adjustable pressure range as I sleep on my side, back, and stomach ...

I also want him to change the part of the prescription to "mask of patients choice" I don't want to be stuck with a particular style ...


Any other ideas I should add ... ?

[kaiasgram]

I and a lot of others feel for you, jeeza, over 40 phone calls?! I'm slowly moving in the direction of getting a BiPap and probably needing to sell my S9 Auto (only used 6 weeks now), but I don't know yet how long all of that will take (I'm having similar problems with sleep doc and DME -- even paying out of pocket for everything I keep hitting roadblocks). Since you are determined and you know what you're doing I have no doubt you'll get the machine you want, I'm just sorry you have to go through all this nonsense first.

BTW, you did pretty good with your typing given what your level of frustration must be!

[SleepDepraved2]

Unfortunately BCBS wants me to stay in there little network of preferred providers ... If I go out of network ... My deductible more than doubles, and then my co-pay is 40% compared to 20%!

I could buy a whole setup from cpap.com for less than what they want! (I just bought a S9AutoSet NEW from Craigslist for my wife delivered with H5i & ClimateLine for $525!

I've called my dr's office, to have him call as soon as he gets in tommoros morning ...

I have BCBS and they do restrict you to their SUPPORT partners. I was able to get a ResMed machine though, as long as you get the doctor to RX it.

[RandyJ]

As Pugsy said, if you get your doctor to write the prescription for the S9 Autoset with ClimateLine tubing - "No Substitutions" it will go a long way with the DME. They will want to accommodate your doctor in order to get repeat business (referrals) from him.

[123.Shawn T.W.]

Kaiasgram, You don't know the half of it!

But ... Since I'm stuck in Eugene, OR next load doesn't pick up till tomorrow at 13:00 ...

Last night I was driving through the back woods mountains of OR ... Got close to the maximum of hours I could legally drive, I didn't want to just park on the side of the road, so I ended up finding a nice spot about 100 feet off the road with a few trees between me and the road to just barely get my big truck into ... Nice little lake off on the side and everything! I figured I could get a nice quiet nights sleep, and I did!

Only problem as I was in the wilderness ... Not only did I have no cell phone reception ... But for some reason the satellite on my truck for email to my company also lost signal! Our hours of service are all logged on the computer, but I had no way to communicate to take me off duty for the night! (even though I sent the proper messages, they would not leave the outbox) I even took pictures to prove this!

This morning I started driving again (since I had over my required 10 hrs off) once my satellite connection got back up and working ... I got notice of FOUR different federal violations, and that I was to stop the truck until I made it right! I wasted over TWO hours getting that fixed!

Remember that where there are no toilets ... That the mesqueto's (sp?) still bite just as hard!

Then this next load is gonna take back over through the same boonies with none of our designated fuel stops ... I will have to go out of route to buy fuel ... My dispatch does not want to authorize this, so I will get wacked with a penalty from my Company! I only have 3/8 tank of fuel and 379 miles to next on route fuel stop ... I wonder what they will say if I run out of fuel?!!! I have about 75 gallons of fuel on, but I will be lucky to get 6 mpg as I have 44,000 pounds of metal to pick up tomorrow, and pull it up through the mountains, of course this does not figure the gallon per hour it burns at idle to keep me comfortable and my batteries charged to run my cooler and lights, phone charger, laptop ...

[Pugsy]

Aren't electronic logs a major pain in the butt? My husband just hates them.

[123.Shawn T.W.]

Aren't electronic logs a major pain in the butt? My husband just hates them.

When they work right there not too bad ... But ... Days like this! I told one of our log clerks I was ready to rip the Qualcomm (computer) out and through it out under the tires and run it over a few times! The tone of my voice got her attention, and then she started trying to make things right!

Some days I miss those paper logs ...

[Wonderbeastlett]

That is why I buy online. Cpap.com is amazing! Although my Rx says I need to use C-Flex, I have no insurance and couldn't afford a Machine that had C-Flex. Cpap.com doesn't hassle you on what you want or think is best. I bought what I could afford and that was that! I plan on making all my future purchases through them!

[123.Shawn T.W.]

One thing that burns me is that Brad from Lincare in Sierra Vista told me that he WOULD NOT order it because BCBS wouldn't pay enough! When I questioned him as to wether it was that BCBC would to cover that machine or not, he said that it was that they would not pay ENOUGH to make it worth his time.