Hope this helps on finding a DME

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
rise&shiner
Posts: 121
Joined: Thu Sep 24, 2009 4:45 pm
Location: sacramento,ca

Hope this helps on finding a DME

Post by rise&shiner » Mon Oct 19, 2009 12:13 pm

Navigating all of this has been a full time job for me for the past month if I had done these steps, I think I would not have run in to some of the frustrating problems that I have and am running into. So I hope that this helps someone out there.

These are things that I have learned along the way and after reading success stories and horror stories from others on this site. Note a lot of this is going to depend on whether the insurance you have is a PPO or HMO. If HMO such as Kaiser you are very limited to choice and how you can navigate the system unless you make this a full time job. It is a little easier to when you have a PPO but it still can be a long road.
1. Being proactive is not a choice it is a necessity.
When you find out that your are going to have a sleep study that is when the process begins.

2. Choose who you want to be " your sleep doctor" pulminolgist, ENT, neurologist or primary physician. Primary physician might not be the one you want to be responsible for you care for successful OSA treatment. Would you go just to your primary care physician if you have cancer or would you go to a Oncologist who specializes in cancer treatments?!

3. While waiting for your sleep study to be done, interview different DME's that are covered under your insurance. Researach OSA, equipment etc.

4. Also ask your physician if any of their patients with OSA would be willing to talk to you about their experience.

5. When shopping around for a DME make a list of questions that you feel are important to have you be successful.

What manufacturers do they carry and why. Don't accept their answer if it doesn't feel right for you.

6. Find out if they have RTS their staff and what kind of training they have and the average amount of time they have been with the company.

7. Call your insurance company and talk to a rep about how they choose which DMEs they use and how often do they send out update documentation to the DMEs so that they know if they have changed any of their policies procedures or brands.

8. What is their response time in giving you your equipment, return policy, trade ins etc.

9. If your physician writes a prescription for a specific cpap will they be able to get it for you even though it is not the brands that they usually carry? That goes for masks as well.
Ask if your insurance has a rental plan or straight buy contract with them. A lot of times insurance companies have both and leave it up to the DMEs to decide which way they want to go. 9. If you do not like the answers that you are given by the DME make sure you report them back to insurance company in writing. In some instances you might have to put in a grievance so the insurance company acts on it. Many times insurance companies do not know what brands there providers provide. Unless they work in the compliance or contract departments of the insurance companies.

10. Also call the manufacturer and tell them that you really want their equipment and are having a hard time finding a DME in your area that carries the equipment that will be covered under your insurance plan. They are very helpful, they want you business.

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Mask: Forma Full Face CPAP Mask with Headgear
Additional Comments: Masks also have used: mirage liberty, comfort full, quatro, comfort gel, F&P Hc431