Re: Is there a way to get a DME (Lincare) to order non formulary
Posted: Wed Jul 06, 2016 3:39 pm
And the kicker is, the longer you hang onto the used machine, the harder it will be to get them to take it back.
A Forum For All Things CPAP
https://www.cpaptalk.com/
Shouldn't you call your insurance company and report this to them?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.
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.ChicagoGranny wrote:Shouldn't you call your insurance company and report this to them?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.
Holy crap. Tooooooo many layers of management. Or ...cpap82 wrote:call their local, regional and district managers
You have my sympathy. You didn't just get crap. You got a shower of it!cpap82 wrote: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.ChicagoGranny wrote:Shouldn't you call your insurance company and report this to them?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.
Did they say why they wouldn't accept it? Was it because it was not a Detailed Written Order (DWO)?ChicagoGranny wrote:Shouldn't you call your insurance company and report this to them?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.
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:Pap-Daddy wrote:Did they say why they wouldn't accept it? Was it because it was not a Detailed Written Order (DWO)?ChicagoGranny wrote:Shouldn't you call your insurance company and report this to them?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.
Express Medical Supplies but they also go by AerocarePap-Daddy wrote:What is the name of this DME?
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:Can you afford to just buy a cpap off craigslist? Or someone on here?
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: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.
Pap-Daddy wrote:Out of curiosity what state do you live in?
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.SewTired wrote:You have my sympathy. You didn't just get crap. You got a shower of it!cpap82 wrote: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.ChicagoGranny wrote:Shouldn't you call your insurance company and report this to them?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.
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.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.
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.Pap-Daddy wrote:Pap-Daddy
it seems you are the one who is lost and not helpful to anyoneChevie wrote: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.Pap-Daddy wrote:Pap-Daddy
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?Chevie wrote: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.Pap-Daddy wrote:Pap-Daddy