CPAPtalk.com

Guest, if you are really interested to talk to CPAP users who have been successful, not so successful and are still struggling with compliance, do yourself a favor and register with a user name and stay on here. You will probably learn more than you ever did during your training.

It is imperative that DMEs have an assortment of masks for patients to try and be able to recognize when one might work better than another, and not just a nasal pillow versus a nasal mask or full face, but WHICH one of those styles. This could be easily done by sterilizing masks after a loan out, and I don't think anyone can make a decision if a mask will work for them or not by 10 minutes in the RTs office with the machine attached. They would need at least a few nights if not a week. Send them home with 3 or 4 masks and tell them to try them out one by one, give them an evaluation sheet to check off their complaints about a mask. Leaks, comfort, pressure areas, hair wearing off, can't sleep on side or stomach. these are all important issues in compliance. If sleep labs can sterilize masks between sleep studies and AWAKE America can sterilize them for redistribution to the underinsured and uninsured, then why can't DMEs?
I was told by my DME you couldn't sterilze them at all. I've discovered differently. Maybe she just wasn't an informed professional.

I realize you have a lot of clients/patients but it is really important to answer those call as SOON as possible. I've waited days and even weeks before I got a call back on what seemed to be a rather urgent question. This is the kind of thing that makes people dislike DMEs.

My current RT, same DME, told me that they couldn't order machines and masks from the manufacturer as cheaply as they are sold online. DUH! So why don't they buy online? Is it written in granite you HAVE to buy from the manufacturer? And if so, why aren't you getting a better break? I know many DMEs are part of a large network, with a headquarters. Wouldn't the HQ be able to get a bigger break for larger quantities and then redistribute them to their various offices?

I recently got an EOB from BC/BS on my first months rental back in Dec. It was denied because the DME did not submit a Drs letter of medical necessity. WHose fault was that? I mean, isn't this Standard Operating Procedure. What dummy didn't make sure all the required letters, etc were included with the claim? Was it the RT or someone else in the office? If this goes on a lot with all the equipment they sell, then I can see how they would lose money, too.

What it really all boils down to is good business. I've owned my own business and I know that one of the main priorities is Customer Satisfaction, and that will depend a lot on personalities of those dealing with the customers, their knowledge of the product and ability to apply what they know to give the customer the best service. It also depends on charging a reasonable amount for that service. This is how you make money. A satisfied customer will refer you to their friends, and they to their friends. An unsatisfied customer will leave you and go elsewhere, and they certainly aren't going to recommend you.

A good business will have their paperwork all in order, their inventory up to date, and know when to restock so there is no waiting period for customers wanting a certain item. I was told when I first went in they would have my PB 420E when I came back in two weeks with the Spirit for the compliance loaddown. When I went in about 3 weeks later (Christmas vacation), I was told it would be two more weeks, because they had just ordered it!!!! Was I mad? Damn right! Whose fault was that? Someone had dropped the ball, hadn't they?

seamaiden wrote:I have NH Cigna HMO. Their contracted price for the same machine is $750. Same state, same insurer but they pay $500 less per machine for their hmo clients. My dme was not happy when I switched out from cpap to apap.

Now that's really interesting. I wonder why they would have different negotiated prices (I'm on their "Open Access Plus" plan). Or does the HMO not require you to rent-to-own? And is that the amount paid to the DME, or the maximum allowed per year under the plan? (My Cigna will only pay $700 of the contract price, but that's because of my plan limits).

Either way, $750 seems more than a fair markup for the extra work they put into you as a customer (assuming they do), since the cpap.com price on the same machine I got is $545, which includes the hose (something the DME charged extra for).

And to the guest who is also a DME (and the other DMEs on here). Just by the fact that you're on this board and caring enough about your customers to keep abrest of the latest in treatment options puts you worlds above lots of DMEs. I agree, if you spend a lot of time fitting a customer, and letting them try mask after mask until they find the right one, you deserve to make some more money than cpap.com (wonderful folks, don't get me wrong, but there are things as an on-line retailer they simply can't offer that you can).

But just so you know, the reason the prevailing attitude on here is "DMEs are evil" is because far and away the more common story is DMEs who offer no choices, no options. Often times we've heard stories of people who were given a poor mask in the wrong size, and told that since it was now opened, they'd bought it. People who have spend less than 5 minutes total with their DME, and who then see that DME charging as an insurance-discounted rate 2-3 times what CPAP.COM can sell for...

The whole system is set up to ENCOURAGE price fixing and DISCOURAGE providing patients with the RIGHT options for them, if those right options are any more than base prices. This is not right, not right at all.

Liam, still not convinced that the DME supplying companies are not, on the whole, gouging prices badly.

I just went to Apria today to order an Ultra Mirage FF mask in standard medium. They told me they didn't have it, but they were at least considerate enough to offer me what they did happen to have on hand: either a small or large Mirage Series II FF mask. How typically accomodating! They didn't have my particular model or my size, but were big enough to offer me something different that would not fit. Glad they get extra money from my insurance company for their masks to offer that extra bundled service to the patient: that personal mask fitting we're all supposed to get.

I flat out rejected their utter nonsense and told them to order exactly what I had come to purchase. I'm not anti-medical-establishment, BTW. I'm just anti-kill-the-patient with incompatible therapy... Those morons!

My DME did not give me any choice of a mask. I was given a Respironics Comfort Select. The DME explained, it was the best most comfortable mask on the market, 90% of all CPAP users, use this mask.

I could not get my mask to stop leaking so I called the DME, asked if the mask could be the wrong size? I told it was the correct size, no other help or suggestions were offered.
I later discovered, my mask was too large. The DME did not return any of my phone messages that my mask was the wrong size.

Next I got a prescription for a Ultra Mirage Series 2 Full Face Mask. After I got home with my new mask, I discovered the factory seal had been broken and parts were missing, making it impossible to use the mask.
I called the DME and spoke to the same person who gave me the mask; she stated the parts I was missing are not included with the mask. I explained I had done a search on the Internet and the missing parts are included with the mask, the DME replaced the missing parts.

Turns out the DME had again provided me with the wrong size mask, and once again the DME did not return any of my phone messages that my mask was the wrong size.

And you see, based on the responses here, the sort of lacking customer service and blatent lies that GTOJim experienced seem to be in the majority.

My own DME rep has actually spent a reasonable amount of time trying to fit me correctly. From everything I hear, I'm EXTREMELY lucky in that respect.

(I did end up buying my ResMed swift from CPAP.COM instead of from her, because she told me flat out that A) It was a great mask, but B) they couldn't get enough of them from ResMed and it might be 3-4 months before she could get me one).

Liam, brain idling, lungs attempting to escape via violent coughing.

Liam1965 wrote: Now that's really interesting. I wonder why they would have different negotiated prices (I'm on their "Open Access Plus" plan). Or does the HMO not require you to rent-to-own? And is that the amount paid to the DME, or the maximum allowed per year under the plan? (My Cigna will only pay $700 of the contract price, but that's because of my plan limits).

My Cigna HMO has a $3500/year limit for durable medical equipment. They contract to pay the dme $750 for a cpap/apap machine (and the dme is not allowed to balance bill me). It does start as a rental arrangement and as soon as the paid rental fees accumulate to $750, the machine is owned by me. Apparently NH Cigna is more aggressive contracting cpap price limits in their HMO plans ($750) vs their Open Access Plan ($1250). NH dmes must hate to see us HMO clients coming.

I vowed to keep the lip zipped for LENT, but I simply cannot let the ''quote'' go by re DME's. Getting customer service in person, versus "buying online".


CPAP.COM has provided me personally with much better CS than my local DME ever did. She ran in/out, told me she knew nothing about the machine I badgered her to get for me, and actually had me reading out loud TO HER, how to set up the my 420E. She knew nothing. She had placed a phone call to the PB sales rep, that's as much as she knew~!

So as far as customer service, cpap.com has called me, asked ME questioned, followed up, followed thru, and I am very satisfied.

Would I buy online again? Yes! Would I deal with my "heavily doctor recommended" local DME. No thank you.

Back to zipping my lip.

Guest wrote:I happen to work for a DME company and have been for years. You would be amazed at what we actually get paid by insurance as stated in previous responses as well as the amount of effort we put in to our CPAP patients and their care. My responsibilities in an 40 hour work week consist of probably 30-35 hours of talking patients through problems and working with them on their CPAP therapy and maybe 5-10 hours of doing something that is acutually reimbursable. One thing people don't consider when buying online is that you will lose the patient care which good DME's (and believe me I do understand there are horrible companies out there) such as myself can provide. I will tell you there is nothing greater than to listen to a half hour story of how CPAP has changed someone's life which is why I do what I do but if you think about all the time your DME spends with you specifically, then multiply that times say 100 patients a week, it gets to be a lot of follow up and instruction that DME's get nothing for but the satifaction that CPAP patient will be sucessful. Also, one of the reply's mentioned not being able to try different masks and that is a huge area of loss for DME's but an essential part of CPAP therapy. So, this being said, as long as you have a good DME, we do a lot more than the insurance companies small allowable really covers. If your DME isn't meeting these expectations, speak to a representitve about it or change vendors. Your doctor may have a specific DME they prefer but the fact remains it is your care and there are certainly a lot of us out there that are willing to give you the attention as a patient you so deserve in dealing with your therapy.

Wow, I guess a lot of patients do have really poor DME companies. That is really too bad. I am the previous guest that works for DME (will be registered here soon!) and you are correct, customer service is everything! We are a smaller company unlike the seemingly repeated "problem" company Apria that keeps getting metioned. I am proud of the fact that I have never had a patient tell me they would rather buy online even though I have had the discussion with many that option. I am completely open and honest about pricing and still I have nearly all stay with me as they can stop in and see me face to face and we are local to pick up supplies if a mask breaks or even a machine needs to be switched out. I am VERY good at getting back to my patients and in all respect, there are C.S. rep's and therpists that have made such promises and do not. I am striving in our community at least to show people that there are DME's that care, you just see more referrals going to the "bigwigs" rather than those of us who have the ability to really offer quality care. I have at least 20-30 calls a day from all different patients, granted these are oxygen patients also, that I can identify by first name and voice recognition. They feel a sense of security knowing they have been dealing with me, the same person, for the last three years of their therapy with no problems. On a completely different note, the sterilzation of masks is something we do here in office and do provide as loaners which allows us to carry many different styles and methods of CPAP delivery. I will tell you that I personally look at each patient situation individually and have provided as many as 8 or 9 different masks to one patient alone! I am really dissapointed that this isn't the case with all DME's as that is a reasonable expectation when beginning therapy. I think it is very important to let your doctor or sleep lab know if you are dissatisfied with your DME as if they hear it enough, they may stop referring to them and you may save others a lot of grief. Until then..........hang in there and I am going to continue to do the best I can to represent DME's that are in this for the patients and not all for profit. That is not why we do what we do in the healthcare field if you are here for the right reasons. Thanks for listening and my heart goes out to those who have poor DME's, we're not all bad, I promise!