DME problems

Hi there --

I'm a first time poster but I am having a lot of problems and need help. I'm in Virginia. I've had a CPAP for 4-5 years and have always used Roberts Home Medical for my DME. They were good when I first got the machine, but they are a pain in the butt about ordering supplies. I've had it with them. I wrote them a letter listing my complaints -- chiefly that they never call me back, and I never get my supplies on time. I sent the letter to the local branch and the home office -- NOT ONE WORD from either and that was over a week ago. I'm done.

I called the pulmonary clinic who handles my prescriptions and asked if there was anywhere else in town to use. They told me two other names but that Roberts was the best one. They emailed someone over there and I got a response that time -- but I don't know the contact info for the person who got it done. I have needed nasal cushions for my Swift FX for several weeks now and my mask is leaking like crazy and I can't get anyone to call me or order it -- and I went in at one point in person and placed the order! Nothing. No masks for me.

First, what do I need to do to switch my DME? (I also have trouble getting the pulmonary clinic to help me understand. I felt like when I did talk to them, they were bigtime buddies with Roberts and I wasn't getting an honest helpful answer. Or else maybe the other two places, American Homepatient and Lincare, really really are worse. Tough to imagine!) I'm a professional - I feel like I should understand how all of this works, but I find it nothing but confusing. Help!

Second, I have Aetna insurance and the local university is my pulmonary care clinic. Can I use someplace online to order supplies and have them bill my insurance? Will the university clinic work with an online DME provider? If so, which one would you all recommend?

Third, all I want is a tank that comes apart that I can clean in the dishwasher. I keep asking Roberts about this and always get told they don't carry it. I also asked about upgrading my machine to the newest model - I have a friend who did and he likes it so much better -- but they also told me that they couldn't do that -- were no longer allowed to? -- unless the machine is no longer working. True or no? Is it worth upgrading?

Thanks for any advice you have -- especially about changing DMEs. I'm at my wit's end and I'm sleeping horribly with a really leaky mask.

Do you have a reason to believe you can't just walk into any other dealer and shop there? And why not ask your insce. co if they have a problem with online dealers (much, much cheaper than brick + mortar places) such as Cpap.com that hosts this forum and where we shop a lot (they really have the most variety and best prices of any others)? You're a free agent unless you signed for a rent-to-own machine and have not yet paid it off. Or am I missing something?

It's quite possible your clinic, etc. gets a kickback from the DME there, and it's been known to happen to others, but you should have no problem going to whomever you want to get your supplies.

I'd start with getting a list of in network DME providers from your insurance co.. Call a few of them and see what kind of response you get to your questions. That's what I did. I called Lincare and Apria since both were in network for my insurance. After talking to both, I ended up picking Lincare.

Considering BCBS's high deductible, I used our host for the better part of two years.
I spent less in a year than my ridiculous deductible.

Step 1: call your insurance company and get a list of providers and ask if they will honour online purchases (they probably won't but if enough people ask....) Also ask about replacement of machines - there are different rules on that but for most it is 5 years.

Step 2 : list in hand call all the places and interview them. If you are allowed a new machine get a list of machines you want (the newest data capable machines) and ask about them. You will learn a lot about DME's from the answers. Treat the whole thing like you are going to buy a used car from a shady dealer.

Step 3: get a copy of your prescription in your hand - you have the right to have it - you will need it to order online.

chunkyfrog wrote:Considering BCBS's high deductible, I used our host for the better part of two years.
I spent less in a year than my ridiculous deductible.

I came across the same situation given that now due to Obamacare my deductable is $300. I paid $80 from our forum sponsor for the mask I wanted. Buying it from the local DME would have been $212.50.

It never hurts to shop around and to run the numbers.

I just recently had a big problem with my DME. I called the insurance complaint to make a complaint. They told me that others were complaining also and they would handle it. I made it clear that I wanted a new DME. The next day I had a new DME and an appointment to go get a fitting for new headgear. Let your insurance handle it. Best luck with your problem.

Laura

Hey Jesse,

I had terrible problems with American Home Patient as well. For this reason, I looked up medical supplies in my home town and saw that one was fairly close to my house. I called them and they took my BC/BS insurance.

Now, a simply thirty second phone when I need anything, they ship it, and it's on my front doorstep in two days.

Maybe use the Yellow pages or if you prefer, search for 'medical supplies in xxxxxxx' on your computer to see if there is a company you prefer. The first time I utilized my new DME. I actually drove there so I could see what it looked like. I wanted them to look legitimate and not rinky-dink.

On my first visit, they asked if they could help. They called BC/BS on the spot and all has been well since!

Bad DME's are soooo frustrating. They are very condescending and act like you are taking up their precious time.

I wish you well,
TheWino

I honestly love Lincare's supply ordering options. email reminder and order from the email link what I want. When I switched (also from Roberts) I did the autoship initially. It was too many supplies compared to what I was receiving from Roberts. All the local office needed was my sleep studies, prescription, demographics. I went into Lincare for my initial appointment to ensure I knew I was going to receive the correct supplies and to see if there were any new masks. It was well worth my time and has been a blessing ever since. Hope you find what something that works well for you too!

My current DME is a family business who chose to accept assignment from Medicare,
---Which Apria does not do here. I can pick up all my supplies at the local office--
No worrying if the local punks are following the UPS truck.

Go to Aetna.com and register. You can find providers on this site. Or you can call the number on the back of your insurance card and they will help you.
Here in Texas there are over 15 providers.