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Re: Kicked out Sleep Dr's Practice. Dme-Dr in with each other?..
Posted: Sun Nov 29, 2015 8:35 pm
by amenite
archangle wrote:but they can now claim that the original prescription has expired.
Just wondering what would happen if they tried to "doctor up" (pun intended) the original prescription by adding some verbiage to it like "void" or adding an expiration date that wasn't there originally. Check it over thoroughly. Question any discrepancies.
archangle wrote:There's also the trick that they can claim it isn't a "prescription," it's an "order," which may have slightly different rules.
In my case mine was written on a prescription blank. Seems to meet the definition of a prescription. And if it's suddenly an "order" isn't that technically a violation of the law requiring a prescription for this equipment? If a DME executed an order without a prescription wouldn't that be a potential legal problem for that DME? Just saying.
In any case, see if you can get the mask parts you want without a prescription and do that for the immediate term. Then you can sort out all this prescription stuff at your leisure. I don't waste time on medical office BS. I've encountered enough incompetence in medical offices to know their BS is not worth spending my time if I can avoid it.
Re: Kicked out Sleep Dr's Practice. Dme-Dr in with each other?..
Posted: Sun Nov 29, 2015 10:07 pm
by big_dave
metsfan302 wrote:A couple weeks ago I called the dr's office to ask them if they could send a prescription to Cpap.com for a mask, So I would have it on file so I could buy masks etc with cash as I wanted too.
There's an easy way for you to get a new mask without going through the prescription hassle. Go to cpap.com and order the AirFit™ P10 Nasal Pillow CPAP Mask Assembly Kit (mask without headgear), and the Headgear for AirFit™ P10 Nasal Pillow CPAP Mask, of course assuming that you want to stick with the P10. The price is the same, but a prescription is not required.
Edit: I'm not sure if you'll be able to get insurance reimbursement on a mask assembly kit.
Re: Kicked out Sleep Dr's Practice. Dme-Dr in with each other?..
Posted: Mon Nov 30, 2015 6:33 am
by Jay Aitchsee
amenite wrote:In my case mine was written on a prescription blank. Seems to meet the definition of a prescription. And if it's suddenly an "order" isn't that technically a violation of the law requiring a prescription for this equipment? If a DME executed an order without a prescription wouldn't that be a potential legal problem for that DME? Just saying.
Semantics, I think. A prescription
is a doctor's order. Though, I think most often a prescription is thought to refer to a drug. The FDA requires an oral or written "authorization" to dispense a restricted device.
Under the provision of Section 520(e) of the Amendments, the FDA is authorized to restrict the sale, distribution, or use of a device if there cannot otherwise be reasonable assurance of its safety and effectiveness. A restricted device can only be sold on oral or written authorization by a licensed practitioner or under conditions specified by regulation
Medicare requires a Physician Order. Note the use of the word prescription and clarification by using (order) in the requirement.
5.2.1 - Physician Orders (Rev. 242: Issued: 02-22-08; Effective/Implementation Dates: 03-01-08)
The supplier for all Durable Medical Equipment, Prosthetic, and Orthotic Supplies (DMEPOS) is required to keep on file a physician prescription (order). A supplier must have an order from the treating physician before dispensing any DMEPOS item to a beneficiary.
http://www.fda.gov/MedicalDevices/Devic ... 055910.htm
https://www.cms.gov/Regulations-and-Gui ... m83c05.pdf
Re: Kicked out Sleep Dr's Practice. Dme-Dr in with each other?..
Posted: Mon Nov 30, 2015 7:44 am
by ClassicsMom
One strategy for getting your script that worked for me was to simply ask for a hard copy of my script for myself in case of travel or in case I wanted any supplies. I did not ask doctor to send it anywhere. I just got the script which specified cpap 10 cm and necessary supplies.
of course, your doctor should be willing to send a script where you want but by getting a hard copy for yourself and sending it yourself via fax or email you can avoid any potential conflict. Also, keep in mind many doctors want to see you yearly and will not write script unless you are seen yearly- although I must confess our sleep doc does not require this but all of our other doctors do. I hope you get your script soon
Re: Kicked out Sleep Dr's Practice. Dme-Dr in with each other?..
Posted: Mon Nov 30, 2015 9:37 am
by chunkyfrog
Many have found that a dedicated sleep doctor is unnecessary if they have simple OSA.
Of course, your PCP needs to be OK with writing the needed scrips for your equipment and supples.
Some here have never seen a "sleep" doctor, and are happier for it.
If, however, you have central or mixed apnea, the sleep doc may be necessary.
--just not the one who's in cahoots with a supplier.
Re: Kicked out Sleep Dr's Practice. Dme-Dr in with each other?..
Posted: Mon Nov 30, 2015 11:46 am
by metsfan302
Yea I use to just have plain ole Obstructive, but now I have alot of centrals / complex (so the reports show), I have an appt for the 22nd with a new sleep dr
Re: Kicked out Sleep Dr's Practice. Dme-Dr in with each other?..
Posted: Mon Nov 30, 2015 11:50 am
by Too tall
The DME are ripping medicare off so bad that you can actually buy most stuff cheaper if you don't go thru insurance. Medicare pays a flat rate for things so the DME just charge away and let us pay the rest. (Medicare's fault here for ridiculous allowances). Shopping price with insurance is futile effort. There all the same. It's a monopoly.
Re: Kicked out Sleep Dr's Practice. Dme-Dr in with each other?..
Posted: Mon Nov 30, 2015 12:25 pm
by lindalam89
metsfan302 wrote:This is my orig sleep dr that sent me 3 years ago for a in lab sleep study and got me started on cpap. This is also the sleep dr who three weeks ago put in for another attended sleep study when my insurance rejected my family dr's request for a sleep study. The one my wife did not like the first time she met him and well I should of listened to my wife lol she thought he arrogant and he did not listen.
A couple weeks ago I called the dr's office to ask them if they could send a prescription to Cpap.com for a mask, So I would have it on file so I could buy masks etc with cash as I wanted too. I was told by the lady on the phone that I would have to wait to have a sleep study done before he would prescribe a mask. I informed her nicley that for the last 3 years i've been receiving supplies on a regular basis from the DME they referned me too. She then gets nasty - to a point were I will admit had me in tears. That they would/could only send a prescription to XYZ company (the one they sent me too). I explained that is untrue etc and I wanted them to send a mask prescription to cpap.com. She would not listen to me at all just continued being nasty. She then asked if I wanted to talk with the office manager, I did. 5mins pass, I am still just tore up at this point. She gets on and asks how can I help you - I first tell her that the woman I just spoke with was so nasty to me and if she treated people like that were I work she would not last long......... I explain the whole thing, that I am simply asking for a prescription for a mask, she says they could do that but the dr's not in it would be tomm - fine. I tell her I can fax her the request from cpap.com so the dr knows whats needed - she then goes I've never heard of that place, we can only send it to xyz company.... At this point I tell them nevermind forget I even asked and hung up.
Fast forward to yesterday.
I get in the mail a letter certified from my dr's office saying they are discontinuing out physician-patient relationship and there are 5 things listed, 1 being circled
Failure to follow medical advice
repeated failure to keep appts
Prescription Drug Abuse
Hostile/Abusive Behavior to Staff
Other
Circled is - Hostile/Abusive Behavior to Staff!
Wow, this so reminds me of the Sinfield Episode were Ellane tries to get Jerry and Kramer to get her medical file from the Dr's office as she was red flagged lol.
Also sent was a letter from my insurance telling me two things were denied
1. An Attended Sleep Study
2. CPAP Trial in a sleep lab (not sure what that is)
Approved is a at home sleep study, your doctor may request a home sleep study.......
I still have this Appt for a new sleep dr that i've had for three months - its Dec 22nd.
Ugg..... Sorry so long
Eric D.
That actually seems like the usual practice in some medical networks. I never got a nasty receptionist. But I heard stories of the whole staff telling patients that they cant get xyz covered, even if they said hey used to have xyz covered if spoken to the right people. It shouldnt be this way. Sometimes as another apnea patient friend of mine says, you really have to demand to talk to the manager to get things covered in the right place. But you did that and also got no where.
I wish I could offer some kind of advice. But you have my sympathy.
Re: Kicked out Sleep Dr's Practice. Dme-Dr in with each other?..
Posted: Mon Nov 30, 2015 3:31 pm
by Air Jordan
Oh, my.
Re: Kicked out Sleep Dr's Practice. Dme-Dr in with each other?..
Posted: Mon Nov 30, 2015 3:34 pm
by Susie Kay
Air Jordan wrote:Oh, my.
If you are just getting started, don't let this thread scare you. Some people have no negotiating skills and no charm. You should do fine.
Re: Kicked out Sleep Dr's Practice. Dme-Dr in with each other?..
Posted: Mon Nov 30, 2015 4:08 pm
by chunkyfrog
Generally most of us can get what we need just by asking. Sometimes repeatedly,
--but as long as you avoid profanity. Or Apria. Or an HMO. THOSE DO NOT NEGOTIATE.
Otherwise, tears can even help sometimes.
Re: Kicked out Sleep Dr's Practice. Dme-Dr in with each other?..
Posted: Mon Nov 30, 2015 5:05 pm
by amenite
Susie Kay wrote:... Some people have no negotiating skills and no charm.
Yea, like the office manager in my last doctor's office. Negotiated and charmed herself right out of a paying customer.
Re: Kicked out Sleep Dr's Practice. Dme-Dr in with each other?..
Posted: Mon Nov 30, 2015 6:29 pm
by klv329
What an ordeal. My second doctor fired me 5 or so years ago after a couple of machines (drowned an M series respironics and the tank had a ton of hours) and a couple of sleep studies. He never said why but his wife wouldn't book an appointment, and I finally asked if it was time to find a new doctor and she said yes, it's time for a new doctor. The reason, well, I assume because I sat there for two hours after the appointment time listening to him gab with his staff and finally walked out and went back to work. Two hours was long enough for me.
Re: Kicked out Sleep Dr's Practice. Dme-Dr in with each other?..
Posted: Mon Nov 30, 2015 7:48 pm
by Ricochet
My .02 is have a lawyer write the letter and send it to them.
Coming from a lawyer will get there notice
Just my 02
Re: Kicked out Sleep Dr's Practice. Dme-Dr in with each other?..
Posted: Mon Nov 30, 2015 9:23 pm
by metsfan302
Susie Kay wrote:Air Jordan wrote:Oh, my.
If you are just getting started, don't let this thread scare you. Some people have no negotiating skills and no charm. You should do fine.
Was that toward me? Just wondering