Problems with Supplier

Hello All

New CPAP owner/user here. I have a question regarding problems with my CPAP supplier. Pretty long story but I want to give the details of my problem.

I was prescribed a CPAP 2.5 months ago after a sleep study. My doctor sent the prescription to the medical supplier. I waited for 2.5 weeks and never had a call from them to setup/fit the machine.

After numerous failed attempts to contact them, I asked my doctor to transfer the prescription to the only other supplier in town.

After waiting over a week for the second supplier to contact me I finally had a appointment for the setup/fitting. When I arrived at the appointment I was informed that they do not keep machines in stock and mine had not been delivered yet. They said they tried to contact me but couldn't reach me. I had not received a call from them. I just let it be and assumed it was a phone tag issue.

A week later they contact me saying the machine had arrived and setup a new appointment. When I arrive for the second appointment I was told the person in charge of the setup/fitting wasn't in the office and that they tried to contact me. So another appointment was setup for a home fitting.

The day of the home fitting the supplier calls me and asks that I come into the office for the fitting to "make it easier on them". I refused as I had already been stood up twice by them. She agreed to go forward with the home visit.

Fast forward to the afternoon and she is 1.5 hours late for the appointment, with no call to inform me. I have the machine setup and fitted. I was told they have a 30 day return policy for the mask and if I need different type/size after using it a week or so to drop by the store to pick up a different one.

I have been using the machine for a little over week now and feel the mask is to small and causing some discomfort. Besides the mask causing slight discomfort the CPAP had been a god send!! I have had zero issues wearing the mask and have wore it 7+ hours each night!

Today I make the 30 minute drive to the store to try different mask sizes and styles. When I arrive and speak to the receptionist she acts odd and says she needs to call her boss, the one who does the setup/fitting. After her phone call she tells me that she cannot change the mask. And that I would have to make a appointment to come in for a new fitting with her boss. To say the least I was not happy!! I refused to make another appointment with them just so they can not uphold it.

So now my question. Can I contact my insurance and tell them I don't want the machine now? Will I be charged for the rental or full cost, which is 5 times what the machine cost online. Should I explain the situation to my insurance? I have no desire to give the supplier my business. But there isn't another store within an hour and half of me. If I can return it I will ask my doctor for the prescription and order the machine online for much cheaper without the hassle of the store.

I don't see a good future dealing with my local supplier after the issues mentioned above. And the worst part is the person who does the setup/fitting is the owner!! So the business does not have a great customer service foundation if the owner is causing the issues.

I'm super new to this and hope someone here has had similar issues returning machines and can give some insight to how they handled it.

Sorry for the novel!!

Thanks

Ken

I agree..Call your insurance. Tell them and your doctor of your experience. If they agree to cancel the transaction, you can get a top of the line machine for under $900. If you purchase from cpap.com the sponsor of this message board, they have free return insurance on their masks. Be sure to tell the DME "boss" why you are doing this.

First of all- welcome. Call the Dr. and get a copy of your prescription to have for yourself. That way, you can email it to whatever supplier you want. It is not a "one supplier use" kind of prescription. As many different DME's as you want can have it on file. Heck, I think 3 online DME's and 2 local DME suppliers have my prescription because I sent it tBuo them. You can order from as many different places as you want. www.cpap.com is a good place to deal with, good customer service.
As far as taking back your machine, what make and model did you get? If it was me, I would figure out the cost online and through my insurance co. I would want the cost of the machine to apply to my deductible if possible, it is such a big expense. Figure out what you will be paying through insurance and from an online place and do the math. I got my machine through insurance, but my other supplies I get online from www.cpap.com because they have the 30 return mask policy, which is great.
Good luck.

Thanks for the replies!! I have already talked to the doctor and I'm picking up my prescription tomorrow. The machine I have is the 3b Medical Luna with Humidifier. It's seems to be a decent machine. It can be purchased online with the humidifier for $320. The supplier told me the cost through them was $1400 plus $400 for the humidifier. Which is a HUGE markup. I'm calling my insurance tomorrow to discuss the issue with them. And I didn't know the insurance would possibly let me count the cash buy of the machine towards my deductible. I will have to talk to them about this. Again. Thanks for the responses!!

Ken

I am not familiar with the Luna machines. Is it AUTO and does it supply you with full data? If it does not, you may want to see if you can return it for one that does those things. Others on here will be able to help with that info. The 2 newest and most recommended machines are the Resmed Airsense 10 Autoset and the Phillips Dreamstation AUTO. You may want to look at those.
When I order from online, my insurance covers it as OUT of network.
Do you know what model of Luna you have? There are different ones.

KennyS83 wrote: ↑

Wed Jun 13, 2018 7:55 pm

Thanks for the replies!! I have already talked to the doctor and I'm picking up my prescription tomorrow. The machine I have is the 3b Medical Luna with Humidifier. It's seems to be a decent machine. It can be purchased online with the humidifier for $320. The supplier told me the cost through them was $1400 plus $400 for the humidifier. Which is a HUGE markup. I'm calling my insurance tomorrow to discuss the issue with them. And I didn't know the insurance would possibly let me count the cash buy of the machine towards my deductible. I will have to talk to them about this. Again. Thanks for the responses!!

Ken

If you are determined to go with the Luna, get the Auto model which will likely cost more than $320. At $320 you are getting the basic model. This is a Medical device that should serve you for 5+ years...get the best one you can afford. I have never seen anyone on this board with the Luna, so you will not get much machine support here.

There is limited data available on the Luna or the Luna Auto.
You have to use the icode thing...no software that I know of to see anything else.
Not sure if the AHI it shows will give a breakdown into event categories or not.

They gave you the cheapest machine they could so that they could have the highest profit margin because insurance companies pay by HCPCS billing codes and not by brand or model.

It is NOT compatible with SleepyHead software.

If your AHI is nice and low and leaks are minimal and you are sleeping good and feeling good you may not care that your data is limited but if you have problems you won't have any detailed data to evaluate to look for potential causes of any problems you might have.

Check with your insurance company as to how much of that billed amount will get applied to your deductible. It most likely won't be the entire amount but instead the allowed amount which is what they would actually pay for the machine (any machine).
It's very rare for an insurance company to allow that much for a cpap machine. Usually they knock it down and allow much less and the difference gets written off by the DME.
It's the allowed amount that gets applied to any deductible a person might have. Not the pie in the sky billed amount.

I'd say don't cut off your nose to spite your face and make an appointment for a fitting. DMEs are not allowed to issue masks without a fitting and unless they have someone who is available all the time, you have to make an appointment. You will run into this every where else. It's annoying as heck. Apria, Lincare and other larger DMEs have a high turnover so they are often short handed of appropriate personnel. Mom and Pop shops are the only places I've know where you could just walk in and buy (provided you have prescription and are paying cash).

Your other option, of course, is just to buy online, but then you pay 100% (but fewer hassles).

Just got a chance to read the newer replies. I have been out of town for a few days. The machine I have is Luna Auto CPAP Model E-20A-H-O (H60) with the Humidifier attachment. As far as th setting and data go it has a few listed but I'm not familiar with what theyean or do.

Mode - Auto
RampP - 4.0
MinAPAP - 6.0
MaxAPAP - 20.0
MaxRamp - 30

30 day data (had unit for 2.5 weeks)

Compliance - 7H
P95 - 8.5 cmH2O
P Mean - 7.0 cmH2O
AHI - 0.8
SNI - 1.8
Leak - 3.3 LPM

I still haven't got a straight answer from my insurance about the issue, but I have been out of town. The problem with setting up an appointment is I have been stood up multiple times by them already. And I specifically asked if I could drop by to exchange the mask and I was told "yes". But if I don't hear anything from the insurance by Tuesday I will go ahead andake an appointment because that will be right before the 30 days for the exchange.

I do sleepuch better with the machine and I'm beginning to feel better in the morning and waking up easier. But the mask seems to leak and make a annoying sound that wakes my wife and myself up at least twice a night. I have to readjust the fit each time. I'm also not sure if the harness is the correct one for sleeping on my side which could be causing the mask to leak.

So hopefully I hear from the insurance and if not I will give them another go.

I do appreciate all the feedback as I'm just learning what owning and using the CPAP entails.


Edit - I did try to scan the QR code from the machine but it's just a series of letters and numbers that are meaningless without the proper software I assume.