Are All DME's Bad?

Krelvin wrote:My recent experience was so far okay. There was an issue with the copay which I am still dealing with, but I can't say it was them yet. could simply be a mis-communication with the Insurance company on it. I will know for sure in a few days when the paperwork hits the system.

Well, it turned out to be the DME that was wrong. Turned out they didn't call the number on the back of my card or there was no record of them calling. Today I was told a refund check for the full co-pay was being sent. The insurance company had paid the claim in full so they were getting double paid.

Also clarified the number of rental periods before the unit is paid (10). This was in question since the Insurance Co said it could be up to 12 depending on the contract... not very useful when nobody can say what the contract was. Eventually, I got a hold of the Insurance company policy dept which looked it up...

It is funny for the DME to say they didn't know when I have them on tape saying that was their policy regardless of what my insurance was. Just reviewed the tape.

Never, ever only shop at only the DME your physician sends you to. They may be wonderful or horrible but how would you know which? You must go to them and at least three or four different ones if possible. Since there are so few machine manufacturers they will probably sell you a good machine. But, you will spend the rest of your life dealing with these people so you must find one that makes you happy. For those with only one DME available comparison shop on line, and call the customer service reps to see what authority they have to solve your problem.

lastlib wrote:Never, ever only shop at only the DME your physician sends you to. They may be wonderful or horrible but how would you know which? You must go to them and at least three or four different ones if possible. Since there are so few machine manufacturers they will probably sell you a good machine. But, you will spend the rest of your life dealing with these people so you must find one that makes you happy. For those with only one DME available comparison shop on line, and call the customer service reps to see what authority they have to solve your problem.

+1

That's why I've done almost all of my business with CPAP.COM since 2005.
I visited several local DME shops and made sure I got my prescription from the doctor......and uploaded it to CPAP.COM to place my order.


Den

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I'm on a high deductible plan that takes $3000 out of pocket before the family deduction is met and insurance actually pays. As a result, unless something really bad happens, I rarely exceed the deductible in any year. This means, I shop costs. Traditional DMEs like Apria mark up products as much as 3 to 4 times what I can pay for the same thing from online auction sites or independent suppliers.

For example, I called Apria tonight about CPAP replacement. The representative told me my 2008 Respironics RemStar M costs just over $2000 to replace. I said the machine is obsolete and asked for a quote on a current Resmet S10 Autoset.
"Well we don't have those in stock, but we can get the S9 for $2475".

I asked what they bill insurance for a new Mirage FX, and was quoted $188. These people are nuts! They actually have the nerve to charge at least 2X full retail. Meanwhile, online sites and sellers are offering significant discounts under retail. The traditional DME business model will break down as high deductible policies become more common, and couldn't exist if consumers actually researched costs.

Sleeprider wrote:I'm on a high deductible plan that takes $3000 out of pocket before the family deduction is met and insurance actually pays. As a result, unless something really bad happens, I rarely exceed the deductible in any year. This means, I shop costs. Traditional DMEs like Apria mark up products as much as 3 to 4 times what I can pay for the same thing from online auction sites or independent suppliers.

For example, I called Apria tonight about CPAP replacement. The representative told me my 2008 Respironics RemStar M costs just over $2000 to replace. I said the machine is obsolete and asked for a quote on a current Resmet S10 Autoset.
"Well we don't have those in stock, but we can get the S9 for $2475".

I asked what they bill insurance for a new Mirage FX, and was quoted $188. These people are nuts! They actually have the nerve to charge at least 2X full retail. Meanwhile, online sites and sellers are offering significant discounts under retail. The traditional DME business model will break down as high deductible policies become more common, and couldn't exist if consumers actually researched costs.

I also have a high deductible a whopping $4,000. The way mine works is prior to me reaching the deductible I pay out of pocket but I pay the amount the insurance company has contracted with the DEM. 10 months of payments of $52.76 plus an upfront payment of around $250. No where near the $2,475 you were quoted. As soon as our deductible was reached the insurance company started to pay.

Can you find a DEM who is willing to charge you the contracted amount and not the full retail amount?

I have a list of a half-dozen DME providers to contact. As suggested earlier, I'm sure I will pay the insurance discounted cost regardless of where I take my business. My point is that won't be Apria.

You'd probably be money ahead by buying from an online seller like CPAP.COM.

Or, even some place like secondwindcpap.com.

Den

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I honestly didn't know anything about the machines before I went in to get mine. I honestly don't even know if the machine I have is considered a good one or what y'all call a brick. The people there were very nice and seemed knowledgeable. But where he fitted me with the XS pillow pads y'all were the ones that explained the larger the better and while the smaller feel more natural, I sleep 100% better with your suggestions of the medium.

Does anyone have a good recommendation for a company in the Chicago area?

DME retail charges are pure fantasy. It's what they'd like to get paid, but insurers negotiate much lower prices. It's only the poor schlub who walks into the DME and is totally clueless who winds up paying full retail price. Don't be the poor schlub.

It really does depend on who you work with (the RT in that DME or sleep technician). But sometimes even good RT's are forced to be less than good by the companies they work for and their policies. I have friends that have worked in some DME companies that have terrible policies and make everyone work horrible hours (work very late, come in late to avoid overtime etc) and it creates an environment where even good RT's are forced to hurry with patient etc..I would look around. Usually smaller operations seem to be better.

Well, I had a good one for several years. While I didn't like their pricing, they were effective, responsive, and knowlegable. However, I retired in June and they advised me that since I now belong to Medicare that they can no longer provide any service. It appears they did not win the 'Medicare lottery' and are not a preferred provider for Medicare. They gave me the name of the local company that is, but I have not had any dealings with them yet. Time will tell if I am still happy with my DME. Fortunately I replaced my APAP just before retirement so I have a few years before I need to worry about a new machine. Masks and supplies I get from our sponsor.

Hummm, that brings a thought I hadn't considered. If my machine breaks down who fixes it, the old DME or the new?

I had a horrible experience with my doctor's sleep clinic staff. I made a big mistake by not educating myself ahead of time, I was a lamb being sent to slaughter. The sleep clinic was going to "handle everything for me." After the titration study I got a phone call from their staff telling me how much I had to pay up front and each month for a rental. When I asked a lot of questions about the price and what kind of machine it was, they immediately stuttered and said they'd call me back. They never did. I then had to try and educate myself on the whole matter. Unfortunately I didn't find this message board yet and I got discouraged with the run around I was given. I gave up. 18 months later a friend was hospitalized because of lung and heart issues which were worsened by not complying with the need for a Cpap machine. That woke me up!! I found this forum, bought my equipment online and with software and help here I have been 100% compliant for 9 months with an average AHI between 0 & 0.9. Sleep has become enjoyable and I have never felt better! BECOME YOUR OWN ADVOCATE!!

The problem is the overall system with brick-and-mortar DMEs: There is not enough competition to allow the market to reward the good DMEs or to punish the bad DMEs. There are some very, very good ones out there, but they aren't rewarded enough for their goodness, much as the bad ones aren't punished enough for their badness, which punishment should be quite severe for regularly sabotaging people's lifesaving PAP therapy.

IMO.

I noticed that ali baba sells a whole bunch of cpap machines. Some are obviously only available in bulk for resale and some are for sale by the piece. I do not recommend rushing out to buy one unless you are rich enough to be able to buy one that may be garbage, because I know of no one who has even seen these, let alone used them. But, we can hope that Chinese competition will lower prices and make the two major companies that are currently selling more competitive.