DME Anti-Defamation League

Snork,

You are right on with your comment on insurance vs no insurance. My son broke his leg a couple of years ago. The hospital bill was $999 (not the follow up, just the hospital and their staff that night). The "negotiated bill" that our insurance paid was about $256.

Now, if I had no insurance the collection people would be coming after me for $999. I ask the same question as you. Why should it cost one person $256 for a broken leg and an uninsured person $999? What is the real cost. Bill it.

On top of that I paid my copay at the door $75 (I got a small discount for cash that night so I figured why not?). Then my insurance company tried to bill me for the copay again. If I didn't catch that one I would have paid $150 and they would have paid $106.

At this point I figure the insurance is soley for the purpose of paying less overall, not for any benefits collected.


___________


Sorry DME guy, I fail to see the reasonableness of a $120 upgrade when I am already being charged $1450 for an APAP and humidifier that is available retail for $725 (no mask included here). There is no way even with the price of RT's that I cost $700 even including your overhead etc to service. I am driving to the DME and staying for as little time as possible. Maybe some people do cost that kind of mark up but they need to be billed seperately for RT time, or masks tried or something. I just want my machine, and to walk out the door. Unfortunately I am not allowed to use my insurance any place else.

As for the RT needed to set up CPAP. You are so correct on that one. It is far from rocket science. In fact it is harder to program my VCR to tape the correct channel than to set up a CPAP. Most likely CYA from lawsuits which is a lot of what drives regulations in this country.

As to the regulating O2 as a drug. I am of the opinion that WAY too much in this country is regulated. O2 should be non prescription, CPAP also, tyl with codine, cough syrup with codine...... Look where we are going. Now you won't even be able to buy Antihistamine (Dimatapp type) without going to the counter since the gov't is so worried that we are going to make cryastal meth. Something has to give or any personal choice and freedom will be gone.

These type of regulations are not going to stop the criminals, just make our (regular people) lives more miserable. I use every opportunity to tell my congressman and senator what I think, but sometimes I think it is useless. I for one don't want to be protected from myself. I like to think that I have a brain and can use it to do what is best for me.

Thanks guys. I am most definately sticking around. I'm mainly here as a fellow user and that's why I've joined this site. I have learned much more than I thought I would from all of you.

I've been in the health care industry for almost 20 years and have managed private Drs offices, large medical centers, and of course DME. The one constant I've observed through the years is the insurance companies making large profits at the expense of patient care. Not enough of the money gets passed down to the providers of care.

I hope nobody took my post as argumentative. I was merely stating a different point of view. Like aall professions, there are bad and good companies whether it's the local car dealer or the hamburger joint down the street. In no way am I saying all DMEs are ethical and strive to do a good job - but many do.

I do hope that sleep apnea gets the attention and education from the medical field it deserves. IMO, auto-titrating machines and heated humidifiers should be standard.

DME_Guy wrote:IMO, auto-titrating machines and heated humidifiers should be standard.

YEAAAAAAAYYH !!!

I am wondering if a serious cost-analysis has been done LATELY, CPAP vs. APAP? Considering the cost of repeat sleep studies, repeat titration studies, multiple service calls (by non-inexpensive R.T.s) for the mere purpose of setting the pressure, and benefits gained by the end-user, including work/productivity, etc. My intuition suggests that APAP as a standard issue might actually be the least expensive choice overall. I could be wrong, but I would like to see a serious cost analysis across a representative cross-section of the target population.



(did this thread start out as a mikemoran humor column? heh! thanks mike! look what you started )

[quote="Wulfman"]DME_Guy,

I also echo what Ric and Bill said. There are many "issues" that we have all had to deal with, so it's nice to get a perspective from you. I think we all realize that you folks have more than just CPAP equipment in your inventory, too.

Stick around.

Thanks,

Den

Ric,

(did this thread start out as a mikemoran humor column? heh! thanks mike! look what you started )

MIKE's column was marvelous, but as a "Roving Reporter" and the local Evil-DME locator, I think my "Breaking News" entries were fodder for Mike's post.
We roving reporters need to keep up our credit, else we'll lose our bylines, ha ha.

I WELCOME DME_GUY's perspective and invaluable information, especially since he is also a XPAP user.

True about Auto CPAP being standard equipment. Wouldn't the manufacturing costs also then go down(and ours, and that of Insurance Companies), if only one model is needed to satisfy most?

Offerocker wrote:Ric, We roving reporters need to keep up our credit, else we'll lose our bylines, ha ha.

Rocker,

I think you meant to say "Mike's column was marvelous", (giving credit where credit is due).

I think even mikemoran would agree that the "Roving Reporter" series was inspirational, if not indeed INSPIRED! I predict the "RR" thread will pop up for YEARS, and I hope it does! The theme certainly resonates with this audience. DME-bashing will continue as long as there are evil greedy DME's that richly deserve the notoriety. As you pointed out there are good DMEs, they probably deserve their own thread, I haven't thought of one yet. (Put your mind to it! )

For what it's worth, there is a whispered thread circulating offline and by PMs that contain the recurring motif:

OFFROCKER RAWKS !!!

There, you've earned it, that is our equivalent of a Pulitzer! And your series has provided many hours of ROTFLMAO if not in fact improved breathing and lower AHIs!

As for APAP becoming standard, one could only hope. Yes it would lower manufacturing costs. That it might lower the PRICE... ROTFLMAO !!! (it didn't work for the Nonin pulse oximeter, as they still own the algorithm and all the patents, and the price hasn't budged. still sells for $200+ even though it costs maybe a dollar or two to make/package/distribute) I doubt the prices will drop significantly unless the technology becomes functionally obsolete or the patents expire. (Is anybody watching?) That's one nice thing about filing early, they also expire early. .

Ric I stand corrected, and message has been corrected. THANK YOU!

In fact, everyone on this Forum is M A R V E L O U S ! ! !

Thanks for the compliment; I'm sure there will be more from me anyway...calling insurance company in a.m. then FAXing (so that Office Manager sees it) kind message to Evil-DME letting them know there is a problem with their outdated machine...and, oh, by the way...I have a RX for a different kind (updated, of course). HOPEFULLY there just could be a (hoke, choke) compromise? I hope they know what that word means...that's why I'm FAXing it - to give 'em time to look it up in the dictionary, har har.

Well, off to saw a few (lower) limbs from a blue spruce (needles gone, so no griping, anyone). I'll be thinking of my favorite "you-know-who" meanwhile.

DME_GUY QUOTE:"The one constant I've observed through the years is the insurance companies making large profits at the expense of patient care. Not enough of the money gets passed down to the providers of care. " UNQUOTE

I totally agree. Many people put the blame of High cost health care on the shoulders of the providers/Doctor's, and yes, SOME, of them have played a part in the past... but currently, it's the INSURANCE COMPANIES who are making billions of dollars.

I also agree it's at the expense of the patient.

All of the examples cited on this forum alone, just concerning the CPAP machines and the monkey business the Insurance companies play, is just one example. Multipy it by thousands.

They are a HUGE lobby group with the politicians and wine and dine them non-stop to get their way.

It does not make sense... they buy dinner and a movie for someone else, and end up screwing "US" !

Tim

Offerocker wrote:Ric,
MIKE's column was marvelous, but as a "Roving Reporter" and the local Evil-DME locator, I think my "Breaking News" entries were fodder for Mike's post.
We roving reporters need to keep up our credit, else we'll lose our bylines, ha ha.

And which posteriorly displaced poster do you think I was rebutting LOL

Yes you provided the fodder and i aapreciate your posts tremedously. I find it kind of amazing how this post took off. Since writing it I have been contacted by numerous trade associations to see if what I did to DMEs I could do to them. I will have to make sure I F/U them.

MIKEMORAN WROTE:

And which posteriorly displaced poster do you think I was rebutting LOL

So, I'm insecure! That's the only part of your post that I took seriously!

Since writing it I have been contacted by numerous trade associations to see if what I did to DMEs I could do to them. I will have to make sure I F/U them

I wish that were true, Mike - you'd be inundated with our list of suggestions!