DME Anti-Defamation League
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rested gal
- Posts: 12881
- Joined: Thu Sep 09, 2004 10:14 pm
- Location: Tennessee
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rested gal
- Posts: 12881
- Joined: Thu Sep 09, 2004 10:14 pm
- Location: Tennessee
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Selena (but really Julie)
DME's - ADL
Ok, ok! I just didn't want to dare say he was spoofing in case he wasn't - one gets jumped all over on forums for being 'rude' or whatever all the time, and I don't like offending people I'm glad you all know him and picked up on it quickly ?
Look again, RG. Considering what he's been driving today,rested gal wrote:If you're talkin' about the red and green striped saucer out in the driveway...the one held together with duct tape...yeah, that's mine!!! Hey, you aren't the one who sideswiped it, are you?!!Ric wrote:(excuse me, is that your saucer parked in the driveway?)
I'ld say he's the one who plain swiped it.O.
_________________
| Mask: AirFit™ P10 Nasal Pillow CPAP Mask with Headgear |
| Additional Comments: Machine: Resmed AirSense10 for Her with Climateline heated hose ; alternating masks. |
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brasshopper
- Posts: 169
- Joined: Thu Apr 27, 2006 9:26 pm
- Contact:
I just dealt with a DME ,...
,,,and the first thing I asked them was, "Please fax me the form, and I will get it filled out by the doctor. Please fax it to me and I will get it filled out properly."
They refused, basically insulting my ethics. Don't worry, We will get it faxed to the doctor on the day of your appointment and we will get it all filled out for you.
So, 10 days after my appointment, they had no form that they could use and they suggested that I was impeding the process. But nothing at all would have been done had I not gotten interceded at every step. They had done nothing to ramrod the forms through the doctor. They were not even able to get the doctor to admit that they had gotten their faxed forms until I interceeded. At that point they invited me out of the process even though my insistence and rudeness (not to them) was the only thing that advanced the process.
Think I should admit to them that I went to the doctor's office after they asked me to butt out and sat there until the doctor's staff showed me the latest form? Think I should admit that it was screwed up the same way it was the day before when the DME refused it because it was, basically, a confusing form?
Think I should admit that all the writing on the form that they finally said was acceptable was mine? (except for where the doctor initialed my changes after I fixed the form?)
Think that they would have saved me 10 days had they sent me the form in the first place and let me bring it to the doctor and tell him how to fill it out?
Maybe not - the CPAP is finally on the way, and I would not want to rub it in anyone's face. But the way I get other forms filled out by my doctor is that the insurance (or whoever) mails them to me and then I take them to the doctor,
I can't understand why a CPAP is so special that the DME can't know that I helped the doctor with the form.
They refused, basically insulting my ethics. Don't worry, We will get it faxed to the doctor on the day of your appointment and we will get it all filled out for you.
So, 10 days after my appointment, they had no form that they could use and they suggested that I was impeding the process. But nothing at all would have been done had I not gotten interceded at every step. They had done nothing to ramrod the forms through the doctor. They were not even able to get the doctor to admit that they had gotten their faxed forms until I interceeded. At that point they invited me out of the process even though my insistence and rudeness (not to them) was the only thing that advanced the process.
Think I should admit to them that I went to the doctor's office after they asked me to butt out and sat there until the doctor's staff showed me the latest form? Think I should admit that it was screwed up the same way it was the day before when the DME refused it because it was, basically, a confusing form?
Think I should admit that all the writing on the form that they finally said was acceptable was mine? (except for where the doctor initialed my changes after I fixed the form?)
Think that they would have saved me 10 days had they sent me the form in the first place and let me bring it to the doctor and tell him how to fill it out?
Maybe not - the CPAP is finally on the way, and I would not want to rub it in anyone's face. But the way I get other forms filled out by my doctor is that the insurance (or whoever) mails them to me and then I take them to the doctor,
I can't understand why a CPAP is so special that the DME can't know that I helped the doctor with the form.
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rested gal
- Posts: 12881
- Joined: Thu Sep 09, 2004 10:14 pm
- Location: Tennessee
Re: I just dealt with a DME ,...
It's not. The people you're having to deal with at that particular DME place just think they, themselves, are.brasshopper wrote:I can't understand why a CPAP is so special that the DME can't know that I helped the doctor with the form.
Amazin', ain't it...
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path2others
- Posts: 32
- Joined: Thu Apr 06, 2006 10:38 pm
- Location: Cleveland, OH Area
... the flip side of faxes...
In my case cpapforseniors had to teach the doctor's office how to use the fax machine. The person at the office was putting the wrong side into the fax machine and the DME was recieving blank sheets of paper. I quess it can work both ways.
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3isles to lazy to sign in
Here's some problems the DMEs deal with:
1. Insurance or medical groups pay a rental fee for equipment. What are DMEs to do with equipment that is used? It is rental equipment, just like the movies you rent from Blockbuster. That's because of the insurance companies, not the DMEs. We'd much rather sell give a new machine to each patient. How many of you complain that you didn't get a new movie for rent at Blockbuster? If Blockbuster gave out a new movie for every movie rental, they'd be out of business very quickly. Same goes for DMEs.
2. Many insurance companies or medical groups only pay for the cheapest equipment. $40 for a CPAP mask is not unusual. The medical group doesn't care if the mask is uncomfortable. The comfort classic is what is paid for and that is what should be delivered. The same goes for humidifiers. We contract with one major medical group that won't pay for a heated humidifier. That's not the DMEs fault. They only pay for a cool humidifier.
3. In general, many patients refuse to pay an upcharge. For example, we'd gladly give someone a better mask, such as a Swift if the patient would pay the difference in what we pay for the mask. The same goes for machines. Very few patients take us up on it. They could end up with a Swift mask and Remstar Plus with C-flex for about a $120. It's a little frustrating when the patient chooses the least expensive insurance they can but then expects the most expensive equipment available.
4. You guys say DMEs are ignorant and many are but so are a lot of patients and doctors. The ENT Dr I saw didn't know anything about auto-CPAPs or the data they're capable of downloading. Why does this matter? Because if the Dr explains to the patient that they should pay a little out of pocket for a better machine, the patient understands what they need when we go go their home. It's not us trying to sell them something when we arrive. Of all the Drs we deal with, there is only one that insists patients get an S8 Elite so he can track their progress. That is horrible medical care. How many MDs prescribe BP medication and then never follow up with the patient?
5. DMEs are heavily regulated. Competative bidding is coming to healthcare and DMEs are the first to get hit with it. Competative bidding, in short is the government asking DMEs to bid for Medicare's business. End result will be less reimbursment which will equal less service and less expensive equipment to patients. All DMEs will also have to be accredited through an organization such as Joint Commission. That's not cheap but I do think it's a good thing.
6. Many referral sources insist that a Respiratory Therapist (RTs) set-up CPAP machines. RTs are in high demand and demand a good salary. I'm sorry but setting up a CPAP machine does not require an RT. All they do is set the pressure, deliver a mask and leave. What a waste of money the DMEs have to absorb. I know more about CPAPs where I work than the RTs do.
7. Insurance companies are great at not paying for equipment or not paying on time. Getting paid in May for equipment delivered in February kills cash flow.
8. Patients often want to try on different masks. Masks cost money and are for SINGLE PATIENT USE! Once someone breaths on it, it's not safe to have someone else breath on it. I know some companies and sleep labs do but they shouldn't. How do you know the patient before you didn't just come down with the flu, has TB, or any other disease? I know I wouldn't even consider putting a used mask on my face. All we can do is show the different mask and help the patient make a decision.
I can understand where you guys are coming from though. There are a lot of poor DMEs out there but there are also a lot of good ones. Where I work, our yearly revenue is over $20,000,000 per year but our net-profit is less than zero. Why? We can't pass on the cost of doing business like most companies do. Higher gas prices, labor costs, workers comp, health insurance costs all have to be absorbed by the DMEs. Medicare and insurance companies don't pay us more because our cost go up. Many of our patients steal our equipment. The insurance stops paying the rental fee for whatever reason and the patient is gone.
This is crazy but here's what was recently passed. Oxygen Concentrators will be capped at 36 months by Medicare. What does this mean? The patient owns the equipment at 36 months. Why is this totally stupid? First, O2 Concentrators don't last forever and require regular maintenance. Many patients won't know there concentrators aren't working and will die as a result. That will save Medicare a lot of money but it's not good for the patient. Oxygen is a prescription drug. How is the government going to stop the sale of this drug when O2 Concentrators start being sold on the open market? What if the patient doesn't have the money to maintain their O2 Concentrator? They will end up in the hospital. The hospital won't be able to discharge them without oxygen. Since the patient will now own the equipment but doesn't have the money to repair it, Medicare won't pay for another machine. I wonder how much that hospital stay will cost the government? Keep in mind, most people on oxygen are elderly on a fixed income.
Where I work, the S8 Compact is our standard machine and the Swift is the main mask we put out. We do often lose money on the Swift but it keeps our referral sources and patients happy. Those two pieces of equipment works great for 90% of our patients.
Peraonally, I think it's criminal that insurance companies charge so much for premiums and then turn around and work as hard as they can to pay as little as possible for our health care.
In summary, dealing with insurance companies is a real pain! If you don't think so, try doing it on your own.
1. Insurance or medical groups pay a rental fee for equipment. What are DMEs to do with equipment that is used? It is rental equipment, just like the movies you rent from Blockbuster. That's because of the insurance companies, not the DMEs. We'd much rather sell give a new machine to each patient. How many of you complain that you didn't get a new movie for rent at Blockbuster? If Blockbuster gave out a new movie for every movie rental, they'd be out of business very quickly. Same goes for DMEs.
2. Many insurance companies or medical groups only pay for the cheapest equipment. $40 for a CPAP mask is not unusual. The medical group doesn't care if the mask is uncomfortable. The comfort classic is what is paid for and that is what should be delivered. The same goes for humidifiers. We contract with one major medical group that won't pay for a heated humidifier. That's not the DMEs fault. They only pay for a cool humidifier.
3. In general, many patients refuse to pay an upcharge. For example, we'd gladly give someone a better mask, such as a Swift if the patient would pay the difference in what we pay for the mask. The same goes for machines. Very few patients take us up on it. They could end up with a Swift mask and Remstar Plus with C-flex for about a $120. It's a little frustrating when the patient chooses the least expensive insurance they can but then expects the most expensive equipment available.
4. You guys say DMEs are ignorant and many are but so are a lot of patients and doctors. The ENT Dr I saw didn't know anything about auto-CPAPs or the data they're capable of downloading. Why does this matter? Because if the Dr explains to the patient that they should pay a little out of pocket for a better machine, the patient understands what they need when we go go their home. It's not us trying to sell them something when we arrive. Of all the Drs we deal with, there is only one that insists patients get an S8 Elite so he can track their progress. That is horrible medical care. How many MDs prescribe BP medication and then never follow up with the patient?
5. DMEs are heavily regulated. Competative bidding is coming to healthcare and DMEs are the first to get hit with it. Competative bidding, in short is the government asking DMEs to bid for Medicare's business. End result will be less reimbursment which will equal less service and less expensive equipment to patients. All DMEs will also have to be accredited through an organization such as Joint Commission. That's not cheap but I do think it's a good thing.
6. Many referral sources insist that a Respiratory Therapist (RTs) set-up CPAP machines. RTs are in high demand and demand a good salary. I'm sorry but setting up a CPAP machine does not require an RT. All they do is set the pressure, deliver a mask and leave. What a waste of money the DMEs have to absorb. I know more about CPAPs where I work than the RTs do.
7. Insurance companies are great at not paying for equipment or not paying on time. Getting paid in May for equipment delivered in February kills cash flow.
8. Patients often want to try on different masks. Masks cost money and are for SINGLE PATIENT USE! Once someone breaths on it, it's not safe to have someone else breath on it. I know some companies and sleep labs do but they shouldn't. How do you know the patient before you didn't just come down with the flu, has TB, or any other disease? I know I wouldn't even consider putting a used mask on my face. All we can do is show the different mask and help the patient make a decision.
I can understand where you guys are coming from though. There are a lot of poor DMEs out there but there are also a lot of good ones. Where I work, our yearly revenue is over $20,000,000 per year but our net-profit is less than zero. Why? We can't pass on the cost of doing business like most companies do. Higher gas prices, labor costs, workers comp, health insurance costs all have to be absorbed by the DMEs. Medicare and insurance companies don't pay us more because our cost go up. Many of our patients steal our equipment. The insurance stops paying the rental fee for whatever reason and the patient is gone.
This is crazy but here's what was recently passed. Oxygen Concentrators will be capped at 36 months by Medicare. What does this mean? The patient owns the equipment at 36 months. Why is this totally stupid? First, O2 Concentrators don't last forever and require regular maintenance. Many patients won't know there concentrators aren't working and will die as a result. That will save Medicare a lot of money but it's not good for the patient. Oxygen is a prescription drug. How is the government going to stop the sale of this drug when O2 Concentrators start being sold on the open market? What if the patient doesn't have the money to maintain their O2 Concentrator? They will end up in the hospital. The hospital won't be able to discharge them without oxygen. Since the patient will now own the equipment but doesn't have the money to repair it, Medicare won't pay for another machine. I wonder how much that hospital stay will cost the government? Keep in mind, most people on oxygen are elderly on a fixed income.
Where I work, the S8 Compact is our standard machine and the Swift is the main mask we put out. We do often lose money on the Swift but it keeps our referral sources and patients happy. Those two pieces of equipment works great for 90% of our patients.
Peraonally, I think it's criminal that insurance companies charge so much for premiums and then turn around and work as hard as they can to pay as little as possible for our health care.
In summary, dealing with insurance companies is a real pain! If you don't think so, try doing it on your own.
DME guy writes:
..."For example, we'd gladly give someone a better mask, such as a Swift if the patient would pay the difference in what we pay for the mask. The same goes for machines. Very few patients take us up on it. They could end up with a Swift mask and Remstar Plus with C-flex for about a $120. "
$120 for a machine and mask upgrade? That is not even close to what many people have said they would have to pay for an upgrade from a DME. Many times the "upgrade" charge costs more than they could buy the equipment for on-line.
And the cry-me-a-river DME only gets $40 for a mask from the insurance company? Then why does the poor ignorant person that is not aware of on-line sources get hammered for $300 for a mask if they want to buy an extra one? Actually, that is an issue I have with the entire medical industry. Insurance underpays the "billing charge" and the person that for some reason could not afford insurance in the first place is the only one paying the over-inflated "billing price" for services.
..."For example, we'd gladly give someone a better mask, such as a Swift if the patient would pay the difference in what we pay for the mask. The same goes for machines. Very few patients take us up on it. They could end up with a Swift mask and Remstar Plus with C-flex for about a $120. "
$120 for a machine and mask upgrade? That is not even close to what many people have said they would have to pay for an upgrade from a DME. Many times the "upgrade" charge costs more than they could buy the equipment for on-line.
And the cry-me-a-river DME only gets $40 for a mask from the insurance company? Then why does the poor ignorant person that is not aware of on-line sources get hammered for $300 for a mask if they want to buy an extra one? Actually, that is an issue I have with the entire medical industry. Insurance underpays the "billing charge" and the person that for some reason could not afford insurance in the first place is the only one paying the over-inflated "billing price" for services.
Remember:
What you read above is only one data point based on one person's opinion.
I am not a doctor, nor do I even play one on TV.
Your mileage may vary.
Follow ANY advice or opinions at your own risk.
Not everything you read is true.
What you read above is only one data point based on one person's opinion.
I am not a doctor, nor do I even play one on TV.
Your mileage may vary.
Follow ANY advice or opinions at your own risk.
Not everything you read is true.
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wolftracker
- Posts: 315
- Joined: Sun May 14, 2006 8:20 am
CL2 mask
I asked my DME for a CL2 mask, they told me it would take 2 weeks to
arrive and the insurance company would be charged $160.
I purchased one from CPAP.com for $98 including shipping and it
arrived in 3 days.
I am still waiting for the DME to deliver the mask I asked them for.
160 is a hefty charge when I am sure CPAP.COM is not losing money
on all their mask sales.
Wolf
arrive and the insurance company would be charged $160.
I purchased one from CPAP.com for $98 including shipping and it
arrived in 3 days.
I am still waiting for the DME to deliver the mask I asked them for.
160 is a hefty charge when I am sure CPAP.COM is not losing money
on all their mask sales.
Wolf
DME_guy, thanks for sharing your perspective. I agree there are good honest hard-working DMEs that care about their clients and do everything to advocate for the patient and help them get all the right equipment the first time around. You don't find us ranting on about those, generally. But we should. Too bad there are so many "evil" DMEs out there giving the rest a bad rep. I can understand there are LOTS of ways to lose money in this business. It's unfortunate that all these wonderful toys aren't absolutely FREE to everybody, and the only task at hand would be to carefully match each individual to the best equipment and configuration to suit the need. But that would be a different planet, different galaxy different era.DME_Guy wrote:I can understand where you guys are coming from though. There are a lot of poor DMEs out there but there are also a lot of good ones.
Your contributions to this dialogue are an asset to the forum. I would hope we can ask you "DME" type questions from time to time, I know you have much to contribute. I also appreciate that you are forthright and speak "on record" and are not pretentious about what you have to say, (unlike some DME Joes who blow in here anonymously for the unmistakable purpose of disrupting the dialogue and telling us to turn off our computers, our minds, and just put our fates in the hands of the "breathing authorities" who always know best). I hope you can also understand where we are coming from. I guess you already said that.
I hope you stay tuned.
-Ric
He who dies with the most masks wins.
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NightHawkeye
- Posts: 2431
- Joined: Thu Dec 29, 2005 11:55 am
- Location: Iowa - The Hawkeye State
DME_Guy, I commend you again for taking the time to detail the perspective DMEs work from. This knowledge increases understanding for all of us, and it is always better to look at reality than putting on blinders. Hopefully, it will help some to learn how to conduct more satisfactory transactions with their DME's.
Please also remember that many folks here have reported being very satisfied with service provided to them by local DMEs, and continue to do business with their local DME's, despite having the obvious knowledge and capability to conduct their transactions online.
Regards,
Bill
Please also remember that many folks here have reported being very satisfied with service provided to them by local DMEs, and continue to do business with their local DME's, despite having the obvious knowledge and capability to conduct their transactions online.
Regards,
Bill
DME_Guy,
I also echo what Ric and Bill said. There are many "issues" that we have all had to deal with, so it's nice to get a perspective from you. I think we all realize that you folks have more than just CPAP equipment in your inventory, too.
Stick around.
Thanks,
Den
I also echo what Ric and Bill said. There are many "issues" that we have all had to deal with, so it's nice to get a perspective from you. I think we all realize that you folks have more than just CPAP equipment in your inventory, too.
Stick around.
Thanks,
Den
(5) REMstar Autos w/C-Flex & (6) REMstar Pro 2 CPAPs w/C-Flex - Pressure Setting = 14 cm.
"Passover" Humidification - ResMed Ultra Mirage FF - Encore Pro w/Card Reader & MyEncore software - Chiroflow pillow
User since 05/14/05
"Passover" Humidification - ResMed Ultra Mirage FF - Encore Pro w/Card Reader & MyEncore software - Chiroflow pillow
User since 05/14/05