Unbelievable DME

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

Unbelievable DME

Post by bwexler » Tue Aug 27, 2019 6:16 pm

I contacted my doctor by their private email system to request approval for a new Sleepweaver 3D mask, last Wednesday.
Yesterday I called the folks who must approve the transaction. They never got the request.
Contacted the doc again. It fell through the cracks, we'll get right on it.
Called the approval folks again. They now have the request and approve it before I hang up.
Yesterday and today I get robo calls from DME, do i want them to ship my order.
So I call and tell them what I want. They say there is no approval. I say yes there is. They put me on hold, come back and tell me the approval is for a full face mask, i want a nasal mask. The billing code is different.
Back to the approval folks. Ol, what code would they like, we don't have access to the codes. We get them from the doctor. We will call DME and find out what they need and take care of it..
Such a simple request made in detail. What a frustrating mess.

_________________
Mask: SleepWeaver 3D Soft Cloth Nasal CPAP Mask with Headgear
Additional Comments: AurCurve 10 ASV Also using Sleaplyhead 1.1, ResScan 6 and CMS50i

User avatar
LSAT
Posts: 13348
Joined: Sun Nov 16, 2008 10:11 am
Location: SE Wisconsin

Re: Unbelievable DME

Post by LSAT » Tue Aug 27, 2019 8:10 pm

CA must have a different system than others. Once my RX was on file with my DME, I can get any mask any time. The only time a new RX or doctors approval is needed is for a new machine.

User avatar
bwexler
Posts: 1582
Joined: Mon Nov 08, 2010 11:52 pm
Location: San Marcos, Ca. USA

Re: Unbelievable DME

Post by bwexler » Tue Aug 27, 2019 8:55 pm

When I order from CPAP. Com that's the way it works.
When I go to the insurance approved DME, about the only thing guaranteed is something will go wrong with the order.
This time around the only people who didn't foul things up was the folks who do the approval.

_________________
Mask: SleepWeaver 3D Soft Cloth Nasal CPAP Mask with Headgear
Additional Comments: AurCurve 10 ASV Also using Sleaplyhead 1.1, ResScan 6 and CMS50i

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NateS
Posts: 1716
Joined: Wed Dec 14, 2011 8:53 pm
Location: Kaatskill Mts-Washington Irving

Re: Unbelievable DME

Post by NateS » Tue Aug 27, 2019 8:59 pm

Key words on script:

Rx: "CPAP mask of patient's choice."
Signed: ______________, M.D.

_________________
Mask: DreamWear Nasal CPAP Mask with Headgear
Additional Comments: ResMed AirCurve 10 ASV; Dreamwear Nasal Mask Original; CPAPMax Pillow; ResScan & SleepyHead
Central sleep apnea AHI 62.6 pre-VPAP. Now 0 to 1.3
Present Rx: EPAP: 8; IPAPlo:11; IPAPHi: 23; PSMin: 3; PSMax: 15
"I've had a perfectly wonderful evening, but this wasn't it." —Groucho Marx