Is there a way to get a DME (Lincare) to order non formulary

And the kicker is, the longer you hang onto the used machine, the harder it will be to get them to take it back.

I returned the used machine this morning to Lincare

Go to another Lincare office. All of Lincare offices will have your order on file. ***Take your new order to Lincare (another office) and see what they can do.

cpap82 wrote:The new DME wouldn't accept the Rx written from my NP and now they are saying they aren't in my network, but they are.

Shouldn't you call your insurance company and report this to them?

ChicagoGranny wrote:

cpap82 wrote:The new DME wouldn't accept the Rx written from my NP and now they are saying they aren't in my network, but they are.

Shouldn't you call your insurance company and report this to them?

I just got off the phone with them. Insurance is stating they are in network and called the DME. DME said they are going to call their local, regional and district managers to discuss with them.

cpap82 wrote:call their local, regional and district managers

Holy crap. Tooooooo many layers of management. Or ...

... the person you spoke to is lying.

cpap82 wrote:

ChicagoGranny wrote:

cpap82 wrote:The new DME wouldn't accept the Rx written from my NP and now they are saying they aren't in my network, but they are.

Shouldn't you call your insurance company and report this to them?

I just got off the phone with them. Insurance is stating they are in network and called the DME. DME said they are going to call their local, regional and district managers to discuss with them.

You have my sympathy. You didn't just get crap. You got a shower of it!

ChicagoGranny wrote:

cpap82 wrote:The new DME wouldn't accept the Rx written from my NP and now they are saying they aren't in my network, but they are.

Shouldn't you call your insurance company and report this to them?

Did they say why they wouldn't accept it? Was it because it was not a Detailed Written Order (DWO)?
What is the name of this DME?

Can you afford to just buy a cpap off craigslist? Or someone on here? If so, I would first pursuit that then report all of them the dme's & the doc to the state licensing authorities. At least call them and seek their advise.

But do start the clock by requesting a copy of your records to include the DWO from the 1st DME and the doc - in writing - either deliver it personally recording or by certified mail.

Time to keep a journal if you haven't yet started - start with a clean notebook.

Out of curiosity what state do you live in?

Pap-Daddy wrote:

ChicagoGranny wrote:

cpap82 wrote:The new DME wouldn't accept the Rx written from my NP and now they are saying they aren't in my network, but they are.

Shouldn't you call your insurance company and report this to them?

Did they say why they wouldn't accept it? Was it because it was not a Detailed Written Order (DWO)?

They said they wouldn't accept it because it wasn't written from my sleep doctor. The Rx my NP wrote for me today has this info:

- my name and d.o.b.
-Dx number
- Resmed Airsense 10 AutoSet For Her CPAP Machine with HumidAir Heated Humidifier
- Pressure Setting 5 to 20 cmH2O
- Mask to fit
- All Necessary Supplies
- Dispense as written
-NP's signature

Pap-Daddy wrote:What is the name of this DME?

Express Medical Supplies but they also go by Aerocare

Pap-Daddy wrote:Can you afford to just buy a cpap off craigslist? Or someone on here?

Honestly, I've already met my deductible so my insurance should pay 100%. So, I'm trying to avoid paying out of pocket.

Pap-Daddy wrote:If so, I would first pursuit that then report all of them the dme's & the doc to the state licensing authorities. At least call them and seek their advise. But do start the clock by requesting a copy of your records to include the DWO from the 1st DME and the doc - in writing - either deliver it personally recording or by certified mail.

Time to keep a journal if you haven't yet started - start with a clean notebook.

I'm going to the medical records dept. in the morning. However, I just checked my voicemail and there was a message from someone in that dept., saying they found the original Rx and faxed it to the new DME (Express Medical), but they also said the Rx has Lincare written on the top of it. So now I'm wondering if Express Medical will accept it. I'm still going to clinic in the a.m. because I want a copy of the Rx and my sleep study for my records.

Pap-Daddy wrote:Out of curiosity what state do you live in?

Texas.

SewTired wrote:

cpap82 wrote:

ChicagoGranny wrote:

cpap82 wrote:The new DME wouldn't accept the Rx written from my NP and now they are saying they aren't in my network, but they are.

Shouldn't you call your insurance company and report this to them?

I just got off the phone with them. Insurance is stating they are in network and called the DME. DME said they are going to call their local, regional and district managers to discuss with them.

You have my sympathy. You didn't just get crap. You got a shower of it!

Thanks. the funny thing is, I use another DME for my diabetic supplies and I didn't have to lift a finger. All they asked me when I initially called was my doctor's name. They got all the info they needed from my doctor's office. This was 2 years ago and to this day, Ive never had a problem. I'm set up for ongoing care with them so once every 6 weeks I get an automated call asking me to press 1 to release my order or 2 to cancel my order.

So, I expected this cpap order to be similar.

Sweetheart, I just want to reach through this screen and give you a big hug! I am so sorry that you are having problems. Don't let this put a damper on your attitude about cpap. You've got bunches of us waiting to hear about how you get this resolved. Hang in there! And if you want a little laugh, read the thread about the guy who wants to write a cpap book! We are cheering for you!

cpap82 wrote: Pap-Daddy wrote:
Can you afford to just buy a cpap off craigslist? Or someone on here?

Honestly, I've already met my deductible so my insurance should pay 100%. So, I'm trying to avoid paying out of pocket.

I fully understand that. Consider that everyone on cpap sooner or later needs or wants a backup cpap and insurance just won't pay for that. The DME will normally say it's covered by warranty or we will get you a replacement, Then things happen on a long holiday weekend and then it takes two weeks (or more) for the DME to get things straightened out. With the problems you are having I wouldn't risk it with these guys. Hence, thought it might be wise to buy a cpap now while pursuing your insurance claims. Should you decide to go that way it is wise to have both machines the same make & model if possible. Easy for supplies and how to operate, etc. Or some get a cpap that will work on 12v battery of which the Respironics is much much easier to do that with.

It just seems getting the insurance on boards is also quite a hassle.

Hey whether it's craigslist, someone on this forum or keep in mind that cpap dot com is in TX, so I don't get it wrong I will let someone else who knows say where. They are pretty easy to work with on the script too.

Pap-Daddy wrote:Pap-Daddy

Your posts in this thread make no sense. The girls are doing fine without you. Quit trying to bungle it up worse than it already is and leave the women to take care of it. You are just taking wild stabs at things. Bye.

Chevie wrote:

Pap-Daddy wrote:Pap-Daddy

Your posts in this thread make no sense. The girls are doing fine without you. Quit trying to bungle it up worse than it already is and leave the women to take care of it. You are just taking wild stabs at things. Bye.

it seems you are the one who is lost and not helpful to anyone

Chevie wrote:

Pap-Daddy wrote:Pap-Daddy

Your posts in this thread make no sense. The girls are doing fine without you. Quit trying to bungle it up worse than it already is and leave the women to take care of it. You are just taking wild stabs at things. Bye.

If you knew what you were talking about and weren't so insecure you maybe would be helping maybe? Instead all you ever do is make negative comments, that's it, that is your whole persona here. Maybe you aren't getting enough attention at home?