What your insurer and DME know

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
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bwexler
Posts: 1582
Joined: Mon Nov 08, 2010 11:52 pm
Location: San Marcos, Ca. USA

Re: What your insurer and DME know

Post by bwexler » Thu May 10, 2018 10:12 am

I have seen a Sleep Doctor 4 times in 7.5 years.
I have had 2 in lab overnights.
When I got my original S9, I picked up my results in the parking lot of the lab as I was driving out of town.
When I arrived in San Diego I called a GP who was a friend. He wrote me a prescription and sent to the DME where he got his XPAP and supplies. They were great. They handed me my stuff that same day.
I spent a lot of time with this group and learned to manage my own care.
The DME may have checked my machine for compliance once.

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D.H.
Posts: 3532
Joined: Sun Sep 04, 2016 7:07 pm

Re: What your insurer and DME know

Post by D.H. » Thu May 10, 2018 10:15 am

prodigyplace wrote:
Thu May 10, 2018 8:44 am
TASmart wrote:
Thu May 10, 2018 8:40 am
OH yeah forgot to add, the surveillance by the insurer ends after compliance has been demonstrated, after that they don't give an ants fart.
Are you sure they do not continue monitoring to insure you need your CPAP supplies?
I think my insurance in New York is doing this.

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Lucyhere
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Re: What your insurer and DME know

Post by Lucyhere » Thu May 10, 2018 10:25 am

I got my machine back in 2008 from essentially a mom and pop DME. When they were knocked out of the ball park a few years ago I started using Versus Health Care. I never had problem one with either DME. I see my doctor once a year because I choose to, not because I have to. Actually, I didn't see my doctor last year because I had a bad cold and cancelled my appointment. I still ordered and received cpap supplies from Versus with no problem. I know people here in CA who have sleep apnea and use different DMEs. They don't have problems either. The complaints about DMEs are endless. I don't understand how it could be so different from state to state. And, as far as doctors are concerned, it's not fun when they "probe", but that's what they get paid for. That's my choice... no one is making me go to a doctor. Heck, at this point in my life, I don't care who knows what about any aspect of my medical care. The group of doctors I see can look on a computer screen and immediately see what any doctor in the group had to say, along with test results and what meds I take. Personally, I think that's a good thing.
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LSAT
Posts: 13345
Joined: Sun Nov 16, 2008 10:11 am
Location: SE Wisconsin

Re: What your insurer and DME know

Post by LSAT » Thu May 10, 2018 10:38 am

I had a prescription from my PCP when I got my last machine in 2014....I have had no other prescription and I get my supplies whenever I need them with no questions asked. Nobody monitors my data.

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Goofproof
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Joined: Mon Dec 05, 2005 3:16 pm
Location: Central Indiana, USA

Re: What your insurer and DME know

Post by Goofproof » Thu May 10, 2018 11:17 am

TASmart wrote:
Thu May 10, 2018 8:40 am
Whenever I go to the Dr. office they record weight, BP, ask what is going on in my life. peer into orifices and remove body fluids. Sometimes they even do anal probes not to mention genital groping. Hell, I would think I have been abducted by aliens or something to do with UFOs. Then they record all this and report it my insurance CO, and since my insurance is government paid, they, by extension, report all of my health data to "the government". Pills too! Why the pharmacist even has to council me before I get pills. Who do you suppose he reports that conversation to? And that nasty insurance company that is actually paying for the equipment, oh the horrors that they keep track of my use of the equipment as a condition of paying for it, rather than me being able to get xPAp and sell it on the street. Where will the horrors end? ANAL PROBING! OMG

OH yeah forgot to add, the surveillance by the insurer ends after compliance has been demonstrated, after that they don't give an ants fart.

The difference between Doctor probing and Alien abduction probing, Aliens return you to your home after. Doctors, make you come back later, for another round, and you have to provide your own transportation. Jim

Then there's that bill thing....
Use data to optimize your xPAP treatment!

"The art of medicine consists in amusing the patient while nature cures the disease." Voltaire

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palerider
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Joined: Wed Dec 16, 2009 5:43 pm
Location: Dallas(ish).

Re: What your insurer and DME know

Post by palerider » Thu May 10, 2018 12:25 pm

. wrote:
Thu May 10, 2018 2:50 am
chunkyfrog wrote:
Wed May 09, 2018 7:42 pm
What everybody already knows when . "discovers" it!
At least they are learning unlike Palerider who just tends to criticize without providing useful “correct” information.

Learning is to be commended. Just being critical should be minimized.
If they already know it, they aren't learning.

Perhaps you should try learning.

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