Need advice on how to make a complaint to Medicare about DME

[FoxNewsFan]

Has anyone made a complaint to Medicare about their DME? How did it go?

My DME, (which I liked), did not win the competitive bid for cpap supplies which went into effect last July 1. I went on this forum and the internet and picked out a new one. Right from the getgo I was not very happy. They seemed so disorganized but my old DME had already contacted them so I went with the flow.

I had been on my machine for more than 5 yrs. so I was entitled to a new machine according to Medicare guidelines. I sent them all the paperwork. They would ask for a document and I mailed it in by return mail. Then 2-3 wks. would go by and they would ask for another document. This went on so long that I had to go back to my doctor for new face-to-face notes. The notes had to be less than 6 months old. I finally got their OK at 6 months and 3 days so I needed to go back to my doctor again just due to their stalling.

I got the machine last Dec. and supplies last Jan. 21st. They called me April 24th and said I was due to order new supplies. I made my order. The next day they called me and said they needed 5 pieces of paperwork. The exact same pieces that I had supplied to them last Dec. I have not changed my primary or secondary ins., my address or anything else. I said that they must have misplaced my paperwork. They said, too bad, send it all in again.

Ed

[chunkyfrog]

How hard would it be to change to another DME?
Otherwise, call Medicare--click on my link below for the site.

[avi123]

As I understand it you need to contact your Medigap insurance to complain, and not Medicare. What arrangement do you have for your new CPAP, is it on rental basis and the new DME pays it?

[FoxNewsFan]

Chunk,
it would be very hard. I would have to start all over again with all the paperwork. Should I let them get away with very poor service. It's not in my DNA. I am paying for Medicare. It's not free. They take it out of my Social Security.

Avi,
I don't have medigap??? I am renting it from Medicare.

[LSAT]

Chunk,
it would be very hard. I would have to start all over again with all the paperwork. Should I let them get away with very poor service. It's not in my DNA. I am paying for Medicare. It's not free. They take it out of my Social Security.

Avi,
I don't have medigap??? I am renting it from Medicare.

Medicap is your Medicare Suppliment Insurance

[chunkyfrog]

Some outfits are so poorly run that I often make the choice to save myself before saving the world.
I know it seems selfish, but that's essentially what we are told on an airplane.
You can't help others until you help yourself---first!
Fixing the system can wait.

[FoxNewsFan]

Some outfits are so poorly run that I often make the choice to save myself before saving the world.
I know it seems selfish, but that's essentially what we are told on an airplane.
You can't help others until you help yourself---first!
Fixing the system can wait.

Chunk,
I see your point. I can afford to buy all the equipment and supplies without going through these terrible companies. But, two things- One, I paid for this my whole life. Should I just give up because of the incompetence of others? Second, what about all the older, less savvy people who depend on insurance to get there stuff? They must be giving up by the millions.

I often think that these companies must be run by absentee owners located in Manilla, Mumbai, Krasnodar or someplace else. I just don't understand their business model. They don't make any money unless they actually sell things to their customers. Yet, they make it so hard that I am tempted to give up. I used to own a small corporation. It thrived because I treated each customer like he or she was my grandma or grandpa. Before the age of social media, I made $3000 from one lady who tried to scam me out of $100. She and I both knew what she was doing but I let her get away with it. She became one of my biggest advocates and wound up bring me way over $100,000 in business. It's all common sense.

L- I have Medicare and a secondary, no Medigap. Are you under the impression that everyone has Medigap?

I am kinda disappointed in this forum which I hold in high regard because NO ONE has answered my original query.

[chunkyfrog]

Call Medicare. Didn't I say that already?

[happydaz]

Call Medicare and then call your secondary insurance company, which has been suggested to you several times. You will be doing us all a favor. Maybe when I'm on Medicare DME's will treat their customers the way they are supposed to be treated!

[msla]

Call Medicare and then call your secondary insurance company, which has been suggested to you several times. You will be doing us all a favor. Maybe when I'm on Medicare DME's will treat their customers the way they are supposed to be treated!

If the complaint is done in writing, you will have copies and the complaint can be cc'd to your 2 senators and representative. Sometimes the politicians will try to keep us happy by going to bat for the lowly voter.

[chronic]

Has anyone made a complaint to Medicare about their DME? How did it go?

My DME, (which I liked), did not win the competitive bid for cpap supplies which went into effect last July 1. I went on this forum and the internet and picked out a new one. Right from the getgo I was not very happy. They seemed so disorganized but my old DME had already contacted them so I went with the flow.

I had been on my machine for more than 5 yrs. so I was entitled to a new machine according to Medicare guidelines. I sent them all the paperwork. They would ask for a document and I mailed it in by return mail. Then 2-3 wks. would go by and they would ask for another document. This went on so long that I had to go back to my doctor for new face-to-face notes. The notes had to be less than 6 months old. I finally got their OK at 6 months and 3 days so I needed to go back to my doctor again just due to their stalling.

I got the machine last Dec. and supplies last Jan. 21st. They called me April 24th and said I was due to order new supplies. I made my order. The next day they called me and said they needed 5 pieces of paperwork. The exact same pieces that I had supplied to them last Dec. I have not changed my primary or secondary ins., my address or anything else. I said that they must have misplaced my paperwork. They said, too bad, send it all in again.

Ed

I would ditch those people in a heartbeat. I would contact a new dme and kind of interview them and then decide which one you want to use. I don't know what that competitive bidding stuff means. Just contact a new dme and see what they tell you.

[LSAT]

Some outfits are so poorly run that I often make the choice to save myself before saving the world.
I know it seems selfish, but that's essentially what we are told on an airplane.
You can't help others until you help yourself---first!
Fixing the system can wait.

Chunk,
I see your point. I can afford to buy all the equipment and supplies without going through these terrible companies. But, two things- One, I paid for this my whole life. Should I just give up because of the incompetence of others? Second, what about all the older, less savvy people who depend on insurance to get there stuff? They must be giving up by the millions.

I often think that these companies must be run by absentee owners located in Manilla, Mumbai, Krasnodar or someplace else. I just don't understand their business model. They don't make any money unless they actually sell things to their customers. Yet, they make it so hard that I am tempted to give up. I used to own a small corporation. It thrived because I treated each customer like he or she was my grandma or grandpa. Before the age of social media, I made $3000 from one lady who tried to scam me out of $100. She and I both knew what she was doing but I let her get away with it. She became one of my biggest advocates and wound up bring me way over $100,000 in business. It's all common sense.

L- I have Medicare and a secondary, no Medigap. Are you under the impression that everyone has Medigap?

I am kinda disappointed in this forum which I hold in high regard because NO ONE has answered my original query.

YES...you have Medigap just as most others with Medicare. You need to learn the terms before you speak.

n.noun...Medigap Definition
Private health insurance designed to supplement the coverage provided under governmental programs such as Medicare.

Your "secondary" is Medigap.

[sleeplessinaz]

Why can't you call Medicare and ask them? Some of us do not have or use Medicare so don't get angry at us if we can't answer your Medicare questions! Lol!

[chunkyfrog]

I do have Medicare; and some things are just plain ridiculous!
For example, if I want the "good" diabetes test strips, I have to buy them locally,
but I have to pay UP FRONT. Last couple times, my supplement reimbursed the pharmacy instead of ME.
"---Hey, didn't they already get paid?" At CVS, I had to send paperwork to their main office to get a check in about 2-3 weeks.
This time, at Wal Mart Pharmacy, they promised a refund Monday--in the store!
Say what you want about Wal Mart, they do have folks who get stuff done--and I was being a complete pill, too!
I wonder how many people are not getting a refund --who should.
There is no way (I) can let them all know that the "system" is allowing their pharmacy to passively double-bill.

[bwexler]

My approach is to start with the DME branch manager and work my way up. When I talked to the regional manager he went to bat for me and things improved some. The folks who work at the local branch, including the manager know me as do the folks at the call center and the warehouse facility.
Anytime I am unhappy with the service I ask for the manager and I either get what I want or a reasonable explanation of why not. Then we work on the solution, like go ahead and order what I asked for and let me know the progress until you have it for me.
It is amazing. The squeaky wheel really does get the grease.

I may not have helped the multitudes, but maybe I have moved the needle just a bit.