DME's, Insurance, Dr's and Me!

Well I can add to the growing groan we all exhibit with regard to DME's. My expeirnece today was a few hrs wasted on the phone, one with the dr. recommended DME, and the other a local company that'd I rather do business with. Anyhew......the dr. recommended place, could not NO WAY, never ever, GET THE GOODKNIGHT 20E. They wanted to ''rent'' me the Resmed Spirit.
Local place said FORGET THAT ONE, and wanted to put me into a F&P 220. The resmed spirit was auto, the F&P HC 22o was not. So we tango'd around with numerous phone calls. I went back to Dr. place #1, and said I want the GOOKNIGHT (sounding like a broken record). Anyway, between phone calls, they ''suddenly were speaking to the medical director'' and may be ''able to find me one and get it thru my insurance"...after all "insurance only says rent a CPAP" and nothing about brand.

I call back local outfit #2, and said thanks for your recommendation but want to stick to the GK 420E yadda yadda yadda. well, they think they ''can'' get it. But that my insurance told her, that my dr. would have to call the insurance back and re-certify a change in vendors.

So I'm thinking, no ins. company is going to give a good @@$% about where I get the machine, so long as I have the scrip. Which I do have a copy of. The physicians' office was hesitant to fax me same. Vendor had NO PROBLEM (remember they are selling)..

But I'm selling too, my time and newly acquired CPAP.com knowledge and I want the one I want...

I also slipped in there, that I may ''buy'' it outright rather than play the insurance game, so guess they'll all be calling me tomorrow. I told each one,
whomever gets to me first, GETS IT!

so I've learned to sit tight, stay focused, stick to one's guns and any other trite expression to GET WHAT YOU WANT, and have THESE DME"S, Work for me, and not vice versa. I will become their nightmare.

Good thing it's snowing they can all go home early and not hear from me anymore today! haha.

So what do you all think of my story?

Way to "stick to your guns" Gail,

Seems like the Doc left the make and model up to you so keep after them. Have you been able to get prices from the DME's to compare your out of pocket with them to buying outright online? You may even be able to buy online and submit to your insurance yourself. That's what I did (check with the insurance company first though).

You bring back memories for me. I had a few of those days "on the phone" with the local DME's before I decided to by from cpap.com.

Muck is what the DME's were flinging my way today. I did check with my ins. (and so did the 2 DME's).....My out of pocket is high, as I am self insured,so have hi deduct/out of pock. so for me, it's not so much what they'll cover, and pretty much what they will NOT PAY for. I also have 70/30, so I'm stuck with a lot of the costs. I can't even get started on insurance..been there done that. Suffice to say I said if my ins. won't/can't, I will pay myself. Well that got the two DME's, salivating, so I'm taking bets on who calls me tomorrow morning. Too bad I'm not near the lottery tix counter I'd be a winning bettor on getting a phone call tomorrow.

wading thru the muck! wrote:Way to "stick to your guns" Gail,

Seems like the Doc left the make and model up to you so keep after them. Have you been able to get prices from the DME's to compare your out of pocket with them to buying outright online? You may even be able to buy online and submit to your insurance yourself. That's what I did (check with the insurance company first though).

You bring back memories for me. I had a few of those days "on the phone" with the local DME's before I decided to by from cpap.com.

Gailzee, The PB 420E with all the trimmings is 799 (420E cpap, humidifier, software, cable), . maskabout another 100. Delivered. Ask your DME if he will match that...LOL https://www.cpap.com

Cheers,

Chris

Don't worry I'm ready for him. haha. I told both of them, whomever gets to me what I want first, gets my order. I think I surprised them, as they both went on and on pushing the ''one we most recommend''. I thanked them, took the info down as if I'm going to say GO AHEAD, and then I dropped the b-bomb I still want the 420 E, check into it. The first DME said the first go-round, we can't, won't, never have sold that one. Can't get it! Well once I told her that I had called a second place, et. al, well, another phone call to me was< ""well you'll never believe this, we just got another request for the 420E, and I'm clearing it with the medical director". Now do they think I'm that stupid? haha.........It even makes me chuckle, if I don't find them transparent, I'd get too angry over wasting my own time. taking things into perspective! See what tomorrow brings!

chrisp wrote:Gailzee, The PB 420E with all the trimmings is 799 (420E cpap, humidifier, software, cable), . maskabout another 100. Delivered. Ask your DME if he will match that...LOL https://www.cpap.com

Cheers,

Chris

Sorry to hear such a horror story, I suppose I am more blessed than I knew.
I have not had any issues with the DME or insurance - I am not self insured and the insurance has been great with paying what I need.

My first CPAP, the DME made the decision of what I needed, this time, 5 yrs. later I asked my ENT to write to prescription to be " as what the patient preference was " he did so, and I got my fabulous C-Flex along with the mask I preferred...I use Apria; I know many here have not had success with Apria, but I have had all along, I guess it is people too--their attitude of the day.

Anywho, good luck and hang in there, it all will come together,
Yawn, hope you don't lose too much sleep over this...

Apnatic
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