Good DME story

Well to be fair I am submitting a good DME story.

I started another thread this morning about problems with my card reader and this is the resolution. I packed up my CPAP and took it down to my DME at 1:00PM and told them how I could not get more than 1/2 hour of data for this morning off my card. They tried the card on their equipment and also tested the pressure of my unit since I complained it seemed to be excessive. Everything checked out OK but while I was waiting I told them I was waiting to hear from my sleep doctor for about two weeks and that I was sleeping terrible again since going back to CPAP after my 3 week trial with APAP.

While I was perusing the selections of masks they had in stock I heard them call the doctor's office and tell his secretary that they needed him to call them ASAP. They said he was with a patient but would call when done. About an hour later he called and talked to my RT and she explained the problems I was having going back to CPAP and that I thought I had done better during the 3 week APAP trial so she asked if I could switch over to APAP. After looking over my data the doctor OK'd the switch. I left with the same New APAP that I had for the 3 week trial and I also picked out a new mask to try and the RT also told me that if this mask didn't work I could come back in a few days and try the Hans Rudolph mask in a medium (I currently have a large) to see if the medium in a Hans would solve my leaks with a ff mask. She said if it didn't work they would just use it as a demo mask - no charge to me.

The owner and the RT (the RT came in on her own time) spent about 2 hours with me checking out my card, CPAP machine and fitting me with the new mask. The CPAP was swapped out for the APAP so I ended up with a new machine for one about 10 months old. Now I have to continue with the better numbers which I saw during my 3 week trial period.

I just wanted people to know there are some good DME's out there. Mine may not be the most knowledgable about some aspects of CPAP/APAP but they seem to really care about the people they treat. My hat is off to them.

Dale

Nice to hear about one of the 'good ones'!

wow, cool bro, good to here you finally got the apap to keep. which one is it, i've been off of the boards for about a week so i'm a little behind on all the current news.

It's the same one you have RedThunder94, it's the RemStar Auto. I got it right out of the box for my trial and the same unit was still sitting there when I went back so I took that one . I hung on to my original heated humidifier since it fit that model.

I have to say again they were great!

Dale

It's great to read that someone actually has been treated well by their DME. It is great news that you were able to get an APAP as well. .

Wow.. now that's service!

IMO, those are the people who have every right to charge $380 for a humidifier that CPAP.com sells for $180, or $1800 for a machine that sells for $700.

I sure wish we could clone your DME and send them all over the country to take care of the rest of us!

birdiebaby wrote: IMO, those are the people who have every right to charge $380 for a humidifier that CPAP.com sells for $180, or $1800 for a machine that sells for $700.

What? Are you smoking crack? There's no way I'd buy a machine from them for $1800 when I can get it from cpap.com for less than half the price. I don't care how good the service is.

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CPAPopedia Keywords Contained In This Post (Click For Definition): humidifier, cpap.com

cpapjack wrote:

birdiebaby wrote: IMO, those are the people who have every right to charge $380 for a humidifier that CPAP.com sells for $180, or $1800 for a machine that sells for $700.

What? Are you smoking crack? There's no way I'd buy a machine from them for $1800 when I can get it from cpap.com for less than half the price. I don't care how good the service is.

LOL... no crack here, but you might need a bit of Valium, Jack.

You must pay OOP. I don't, and my insurance dictates from whom I will receive my DME supplies. I get ZERO serivce. I resent that they charge those prices to my insurance (of which I pay a copayment). If I receceived that kind of service from my DME, I'd much more chipper when I fork over my credit card for my copayment.

birdiebaby wrote: LOL... no crack here, but you might need a bit of Valium, Jack.

You must pay OOP. I don't, and my insurance dictates from whom I will receive my DME supplies. I get ZERO serivce. I resent that they charge those prices to my insurance (of which I pay a copayment). If I receceived that kind of service from my DME, I'd much more chipper when I fork over my credit card for my copayment.

I'll take some if you got some.

Actually, I don't pay out of pocket. In fact, my insurance just happens to cover me 100%. That's a whole other story in istself. I get crappy service from my DME and I don't want them to get a penny more than they deserve, regardless if the insurance company is paying for it or not.

And regardless of how good the service is, nobody has the right or should charge someone $1800 for a $700 machine. That's just plain and simply morally wrong and highway robbery to say the least.

I'll take some if you got some.

Actually, I don't pay out of pocket. In fact, my insurance just happens to cover me 100%. That's a whole other story in istself. I get crappy service from my DME and I don't want them to get a penny more than they deserve, regardless if the insurance company is paying for it or not.

And regardless of how good the service is, nobody has the right or should charge someone $1800 for a $700 machine. That's just plain and simply morally wrong and highway robbery to say the least.

Oh... sorry.. I just gave away my last one!

We're on the same page, except that businesses who provide more service do deserve to charge more for that service. DMEs do provide a service by accepting the assignment of benefits to them.... dealing with the insurance company and waiting for reimbursment. They should also provide the high-quality of service that the original poster received. We should be able to try on a mask before our insurance has to buy it. The DME should be using the extra money to educate its workers, pay for more workers and provide services that would enhance our healthcare and increase compliance.

It's the $10 haircut vs. the $75 haircut. I prefer the $35 haircut myself, but I know that when I pay $75, I'm getting a good cut with lots of attention and service. And they have a right to charge it. Ultimately the market should determine whether or not the $75 is a justified charge, but in the case of the DME, Insurance pretty much eliminates the market influence in this area. And that, IMO, is the crux of the problem. Stockholders win. Patients lose.

Dale, you're a lucky guy!

birdiebaby,

I find it hard to believe that your insurance company wouldn't want to help you (and them collectively) save money.

Has your insurance company actually told you that they won't reimburse you your cost share for a cpap machine bought from other than a high price network DME? Just wondering.

If you want to see a shocker, go to, I think, PIMCO's web site and look at the chart that shows the escalation of medical care expenses as a per cent of GDP. It's scary.

Most insurance companies do not pay the high prices that DME do retail at as they have a contracted and much lower price that is predetermined long before you arrive at the DME. It does appear that the insurance companies do prefer to do business with "brick and mortar" DMEs as they give a certain buffer between the patient/insured and the insurance company in the event of wrong prescription/diagnosis and eventual litigation that would surely follow. This practice of the insurance companies is quite logical (from their perspective) and I believe not likely to change any time soon. I do not know just who does, in fact, pay those very high prices. I had a long discussion about this with my insurance company and they gave me a long list of DMEs who had signed agreements with them listing maximum payments for services/equipment. I do also believe that the "brick and mortar" DME is necessary to the newbie who otherwise might not get headed down the necessary CPAP path without the "hand holding" in the early stages of therapy. I only wish I had thought to or someone had told me to get online and make inquiries so I could have made better decisions immediately after sleep study results were given to me.
Of course, once the patient is educated to the "World of CPAP" and this forum is great at that, their elective dollars are best directed at our sponsor here.
Of course this all just IMHO. Have a good one!

Mike

My insurance carrier and Lincare have agreed to $ 1260.60 spread out over 12 payments for a cpap machine and heater that is about $ 550 on the web. This contracted price can hardly be described as "much lower." In addition, the carrying bag, hoses, filters, etc, which are included in the $ 550 price from web sellers are all billed out separately as one-time charges.

My insurance carrier told me that they would not reimburse me for an APAP paid for by myself even though it was 1/3 of their approved DME posted charges as they had an agreement to pay much must less than the posted DME rates. Seems as though different insurance companies handle this in a different manner. They made it clear it was not in my best interest for me to go outside their approved DME if in fact I expected them to pay...and I do have 100% coverage if I play by their rules. I do know that last year I had a gross billing of over $480,000 for my Quadruple Bypass, stents, and attendent tests, procedures, etc. At the end of the day, my insurance paid out a total of about $124,000 as their complete agreed and contracted obligation on these total charges...about 75% discount off the total bill. I think what we see sometimes is not the whole story.

Mike