A Miracle has Occurred in my Life

Babette · Post by **Babette** » Fri Jul 20, 2007 4:02 pm

Suppose I should update this.

Last Friday, being the 13th and potentially a crappy day anyway, I moseyed into the Demon DME and returned my cpap machine. HH and all. Idiot Tony did not know how to do a return. I was counting on that, that's why I turned in the HH as well, with the swapped out leaky chamber that I got from another forum member... heh heh heh....

Apparently he did KNOW I was going to return the machine - the Insurance must have put a world of hurt on them to get them to take it back after our little phone fight. But he kept making phone calls to "corporate" and demanding I give him a scrip from my doc stating I was cancelling therapy....

I stood there politely for about 15 minutes of his blithering, then firmly told him that he could sort that out on HIS TIME, not MINE, and would he please sign my receipt? I finally got it signed, and left.

Promptly faxed it to insurance and doc, assuring them I HAD NOT QUIT THERAPY, but returned machine DUE TO POOR CUSTOMER SERVICE.

Haven't heard a peep since. Am worried that I haven't seen a revised billing from Insurance, but am hopeful it will be resolved, and the APAP will eventually be reimbursed.

Can't shake this sense of anxiety though. Wish I could feel it was REALLY OVER AND DONE WITH!

GOOD LUCK TO ALL! BE FIRM! BE STRONG! CARRY A BIG STICK! AND A PACK OF CIGARETTES FOR AFTERWARDS!!!!
B.

gasp · Post by **gasp** » Sat Jul 21, 2007 9:08 am

[quote="Babette"]Suppose I should update this.

Last Friday, being the 13th and potentially a crappy day anyway, I moseyed into the Demon DME and returned my cpap machine. HH and all. Idiot Tony did not know how to do a return. I was counting on that, that's why I turned in the HH as well, with the swapped out leaky chamber that I got from another forum member... heh heh heh....

Apparently he did KNOW I was going to return the machine - the Insurance must have put a world of hurt on them to get them to take it back after our little phone fight. But he kept making phone calls to "corporate" and demanding I give him a scrip from my doc stating I was cancelling therapy....

I stood there politely for about 15 minutes of his blithering, then firmly told him that he could sort that out on HIS TIME, not MINE, and would he please sign my receipt? I finally got it signed, and left.

Promptly faxed it to insurance and doc, assuring them I HAD NOT QUIT THERAPY, but returned machine DUE TO POOR CUSTOMER SERVICE.

Haven't heard a peep since. Am worried that I haven't seen a revised billing from Insurance, but am hopeful it will be resolved, and the APAP will eventually be reimbursed.

Can't shake this sense of anxiety though. Wish I could feel it was REALLY OVER AND DONE WITH!

GOOD LUCK TO ALL! BE FIRM! BE STRONG! CARRY A BIG STICK! AND A PACK OF CIGARETTES FOR AFTERWARDS!!!!
B.

Babette · Post by **Babette** » Sat Jul 21, 2007 10:08 am

Gasp, that was the problem. I was under the impression it was a rental contract, but the DME billed my insurance for 2 months rental and full purchase price within a 30 day period. GRRRR......

And the Insurance paid it all. Double GRRRRR.....

So, I'm just going to wait awhile longer and if I get really anxious, I'll call the Insurance and demand a statement.

The Insurance did call me last week and tell me they'd convinced the provider to convert back to a rental agreement and take the machine back.

Cheers,
B.

gasp · Post by **gasp** » Sat Jul 21, 2007 10:44 am

[quote="Babette"]Gasp, that was the problem. I was under the impression it was a rental contract, but the DME billed my insurance for 2 months rental and full purchase price within a 30 day period. GRRRR......

And the Insurance paid it all. Double GRRRRR.....

So, I'm just going to wait awhile longer and if I get really anxious, I'll call the Insurance and demand a statement.

The Insurance did call me last week and tell me they'd convinced the provider to convert back to a rental agreement and take the machine back.

Cheers,
B.

itchysmom · Post by **itchysmom** » Sat Jul 21, 2007 11:12 am

Babette, your story sounds identical to mine. I returned all my stuff before signing up with the new DME though.

I got a receipt stating "unhappy with service" or something to that effect.

The case manager at my insurance company is PO'd at me, stating "For God sake, its only a piece of equipment"....I assured her that it was more than that and promptly called my HR department to complain about her rude treatment. This was not the first nasty interaction I'd had with her regarding cpap. Since my employer is self insured, the insurance administrators work for them.

I am looking forward to getting my auto on Monday.

I would do as the previous poster stated and fax the receipt to your insurance company as a follow-up for their fraud investigation.

Babette · Post by **Babette** » Sat Jul 21, 2007 11:28 am

I did. I faxed the receipts - both mine and their's - to both the Insurance company and the doctor, within an hour of doing the return.

I had to have the new machine before returning the old machine. And I dawdled about returning it, because I was unsure about the messages I was getting from the insurance company, and wanted confirmation from the GOOD customer service rep who helped me, as opposed to the numerous morons I'd talked to. I had to wait a week to get her to return my phone call. Still worth it. She's the only one there that can follow up and get things done right.

Cheers,
B.

Nazareth · Post by **Nazareth** » Sat Jul 21, 2007 1:52 pm

[[I said yes, and then said, "Could I... could I please... May I please, ma'am, have an auto-titrating machine?" She said yes. Just like that. No questions asked. ]]

I want the name of your Doc, and I want ot drop my doc like a hot potato- Can we switch docs? lol, glad you found a good one- Hang onto her!!! She sounds really nice.

Babette · Post by **Babette** » Sat Jul 21, 2007 7:58 pm

Dr. Kimberly Mebust, Neurologist, and Medical Director of the Multicare Sleep Center, Tacoma, WA. Offices in Tacoma, and Puyallup, WA. Very nice lady, indeed!

I also want to brag that I had great service at Multicare's Sleep Center downtown across from TG. I've heard that their Good Samaritan sleep lab is even more posh, with en suite bathrooms. I didn't really mind going down the hall to the potty. I have to be unhooked ANYWAY, so what the hey? Wasn't like I could just get up and pee when I wanted... I suppose I could have requested a cath, but...

The downtown lab all had Sleep Number beds, which was nifty, since I'd never tried one. My first study, I played with the settings, and really couldn't tell the difference. The next one, I just left it at 45 and it was fine. I don't think I'd spring for one of those, but it was fun to test out.

Cheers,
B.

socknitster · Post by **socknitster** » Sun Jul 22, 2007 9:06 am

I just recently found out that the sleep center I had my study at isn't certified! If my son goes for one he is going to the certified one.

The one I used had two rooms that shared a bathroom. Yuck. There was an older gentleman in the other room. The only other person in the whole place was a slightly built sleep-tech, female. I was very uncomfortable with the arrangement. There weren't any locks on the doors that I noticed.

Good for you for taking back that machine and staying strong. I hope it resolves itself and they don't take your insurance for any more money and that they will reimburse you like they should.

Jen

Babette · Post by **Babette** » Sun Oct 21, 2007 1:04 pm

Final update to this thread - FINALLY GOT MY REIMBURSEMENT CHECK! They paid me nearly 100% - for some reason they quibbled over some small charges, but the initial claim was approx $750 (for machine, HH, and a replacement hose), and they paid me approx $733. Interesting that they paid the fraud DME 100% and they quibbled with me... sigh...

I was getting worried, so Monday I called the insurance to check on the claim. THEY COULDN'T FIND IT! I said I'd call back with my copy of the claim in front of me, then, of course, I couldn't find it in the mess.. sigh... Then Wednesday the check came in the mail. Weird.

So, the check is deposited, and now that THAT is done, I'm ready to buy a mask. It's October, the time the original DME told me I could get a replacement mask, so it's time to test drive that process again.

And the insurance DID get the fraudulent DME to refund them the money they'd fraudulently charged. I was amazed about that. They refunded the money, and re-charged for rental instead of purchase, which the insurance paid. We are DONE!

If you live in Western Washington State - DO NOT USE BLUE MOUNTAIN MEDICAL AS YOUR DME!

And that's all I have to say about that. (Forrest Gump)

Cheers,
Babs

DreamStalker · Post by **DreamStalker** » Sun Oct 21, 2007 1:07 pm

Congrats! ... you can get yourself two masks ... Holloween is up in a week or so.

Organplayer · Post by **Organplayer** » Sun Oct 21, 2007 5:09 pm

Way to go Babette. Story with a happy ending. Would not want to meet you in a dark alley... on the other hand, may be I would.

See you in Lower Alabama in Nov.

From Upper Alabama,
Kevin

j.a.taylor · Post by **j.a.taylor** » Sun Oct 21, 2007 5:17 pm

BrianRT wrote:OMG...I believe that's in the Book of Revelations as a sign of the Apocalypse

Or it's a sign that Babs has found PARADISE (no Babette, not pair-a-dice).

Congratulations.

May your sleep now progress to better and better levels.

Pam · Post by **Pam** » Sun Oct 21, 2007 5:41 pm

W T G
(way to go)

Thats great news

sleepycarol · Post by **sleepycarol** » Sun Oct 21, 2007 5:43 pm

Glad things worked out for you!! We have to be our own advocates -- if we aren't no one else will!!

Mask	Humidifier

Additional Comments: Pursleep, Padacheek, Regenesis™ Pillow, Neti Pot, Travel Buddy hose hanger