Run around with DME - which of us is crazy?

deleted - duplicate post

sleepycarol wrote:She stated that a SMART CPAP is one with c-flex and a ramp feature and my setting would have to stay a 10 as the "range of 8 -12" meant that my number was 10 -- NO discussing it that is final. I asked why not just write 10 on the prescription and with that I am told that they put a range down and you get the middle number.

sleepycarol wrote:She stated that oh you don't want a bipap as that is only for people that are nearing death.

Stupid. Pathetic. What a sorry excuse of a so-called health care professional.

sleepycarol my heart goes out to you.

Is it against some law to let us know who this devious DME is? At least give some clues? So others may avoid keeping them in business!!

Also what state are you in?
I am in CT, where by law they have to provide you, when you request your prescription and/or sleep study. Not just read it to you. You should be able to get a copy from either your sleep lab, Dr., or the mysterious DME. After all it is about YOU, your personal info, right? Do NOT be bashful.

I thought the Dr.'s order were to be followed and not deviated from? If there is a change the Dr. has to write an new script?

Imagine going to the pharmacy where the pharmacist says "oh the doc doesn't know what s/he's doing? I'll just substitute this for that?"

That is why these people are sposed to have a state license.

If what you are saying IS true - you are doing others a grave disservice by NOT filing a complaint with your state licensing agency. And standing on a pedestal to warn others who will be harmed if this problem is not corrected.

Good Luck,
GumbyCT

your doctor prescribed an autopap with the range of 8 cm to 12 cm. The machine you have only delivers 1 pressure they appearently stuck it in the middle at 10 cm.

Your doctor should revise your script to "A-Flex" then they have no option but to supply you with the machine your doctor prescribed.

OR!! You can take the cheapo machine you got back and set it on the counter, then you fail CPAP, they will give you a Bipap which now costs twice as much.

You sell the Bipap on craigslist or other place for $700-$800 and buy the AFlex machine with proceeds and pocket the rest

Make money off them bastards I say!

I am going to call the doctor first thing in the morning and see if she can spell it out (hopefully the DME CAN read -- but wouldn't bet on it ) on a new script. If that fails I will call the sleep lab and speak with the doctor there. I am pretty sure my family doctor will write the script though as she is really good to work with .

I appreciate everyone's encouragement as this can be a very frustrating journey and one that you ALL have contributed to my wanting to make this work!! I can see where many of you have benefitted on making it work and I know it is just finding the equipment that will work for me.

May you have a good nights sleep!!

Good luck Monday, SleepyCarol. Please do keep us informed of how things go for you. Just for spite I would want a copy of that original equipment order (script) FROM THE DME. (AND from the doctor - to compare). They "have" to give you a copy as it is part of your medical records and HIPAA gives you that legal right. But w/school just starting I suppose its really not worth that hassle. It would be interesting tho to hear how this DME supplier's RT tries to worm her way out of this one. Hopefully, she will be fired. She certainly deserves to be! Be sure that those higher up the food chain at this DME supplier's is made aware of her attitude and her careless disregard for your health and welfare in ignoring your doctor's order and providing you w/a lesser machine at the wrong pressure!!

Carol, when you ask your doctor to write a new Rx for a specific machine, I'd ask her to write it this way:

Respironics REMstar Auto A-Flex M series
8 - 12 cm H2O
A-flex 2
No ramp
Heated humidification

The DME might decide to let you keep the integrated heated humidifier you already have for your Plus machine. Any M series machine's heated humidifier will work with another M series machine.

For anyone interested I live in Sedalia, Missouri and as far as I know we only have two DME's here. The one I chose is not affiliated with our local hospital. My biggest mistake!! I should have went with the one affiliated with the hospital. After I get this straightened out -- believe me I will make the switch.

rested gal wrote:Carol, when you ask your doctor to write a new Rx for a specific machine, I'd ask her to write it this way:

Respironics REMstar Auto A-Flex M series
8 - 12 cm H2O
A-flex 2
No ramp
Heated humidification

The DME might decide to let you keep the integrated heated humidifier you already have for your Plus machine. Any M series machine's heated humidifier will work with another M series machine.

And:
Mask of patient's choice

Slinky wrote:

rested gal wrote:Carol, when you ask your doctor to write a new Rx for a specific machine, I'd ask her to write it this way:

Respironics REMstar Auto A-Flex M series
8 - 12 cm H2O
A-flex 2
No ramp
Heated humidification

The DME might decide to let you keep the integrated heated humidifier you already have for your Plus machine. Any M series machine's heated humidifier will work with another M series machine.

And:
Mask of patient's choice

AND:

Mask of patient's choice: Full Kit

I was told to have them write "full kit" on the script by a wonderful RT who works at a local hospital sleep lab near here. He said he always tells patients to do this. It helps to be able to switch pillows, gaskets, etc. if things don't seem to fit quite right.

You might want to check with the hospital sleep lab and see if they will do free mask fittings. That way you have more choices to try.

If your Dr's script stated 8-12 cmH2O than the DME made a substitution of a Dr's order. Probably without the DR consent. I came to a DME from a Dr office and nothing infuriated me more than a DME changing a Dr order to benefit them. If I was your Dr I would be very upset that an RT at a DME is changing my script. I know that the Dr I worked for was. We had to turn the particular DME into medicare and to the board of healing arts to have their procedure changed. It is illegal to change a Dr order without consent. Which is why DME's get bent out of shape when patients request a APAP in place of a CPAP and don't have a script. It works both ways. I am sure that your insurance company wouldbe interested in knowing that they are paying a DME for equipment that is not what your physician perscribed. I know that I work for a "DME" but there are good ones and bad ones. Now that I have ranted please don't be turning over all your RT's and DME's in to Medicare and the Board of Healing arts. Please give them a chance to fix the situation, even though they screwed it up in the first place. A healthcare persons liscense is their livelyhood. Give them a chance to save it. Everyone has good and bad days. Some people have days that border on ethical and not ethical. I know that a lot of people here are ready to jump on DME's as bad. Give new one's a chance. I know that it puts me on the offensive from the get go. I don't like helping people that accuse me of trying to screw them over before I have even opened my mouth. That is not fair. There are good DME's and bad DME's just like there are good patients and bad patients. Now that I have ranted for a while, please forgive me. People here are not used to DME rants. Sorry.

Hey, KansasRT, I think we can all understand how difficult it must be to see your profession branded so badly here, even tho it is much too often deserved. We might not say it enough but we DO APPRECIATE the good DME suppliers and their GOOD RTs such as yourself. And we do appreciate you.

rested gal wrote:Carol, when you ask your doctor to write a new Rx for a specific machine, I'd ask her to write it this way:

Respironics REMstar Auto A-Flex M series
8 - 12 cm H2O
A-flex 2
No ramp
Heated humidification

The DME might decide to let you keep the integrated heated humidifier you already have for your Plus machine. Any M series machine's heated humidifier will work with another M series machine.

Sorry, but I disagree with the "No Ramp" inclusion, that makes NO sense whatsoever, Ramp and when to use it is personal choice. Even if it is enabled the patient has the option of selecting if they want to use it or not. By specifying it on the script you preclude the patient from ever being able to use it (if they want to follow the rules and not program it themselves).

The point is Ramp has a very useful purpose it only impacts the first 45 minutes of therapy (if it is even used) and we have seen many benefit from using it. It is even a more useful feature for a newbie patient trying to get used to this therapy in falling asleep.

I would ask that the "Auto:Ramp" be enabled, then the patient can decide for themselves weather or not if they want to use it. It doesn't work until you push the button.

I'm inclined to agree w/SnoreDog. Even w/my low pressure I appreciated the Ramp feature the first week or so. And after that I appreciated the option of being able to turn it off if I so wanted to do so.

Color me red-faced. I didn't notice the No Ramp in the suggested script.

sleepycarol, and any others who have similar problems, when you have the energy, report that unethical DME to JCAHO, the organization that monitors healthcare safety. If you don't report them, the same RT may keep harming other patients. The first message you submitted (with a little editing) would be fine for your JCAHO report.

Find the JCAHO link in the light bulb/Our Collective Wisdom, the safety article at cpaptalk-articles/CPAP-safety-incidents.html
Scroll down to the end of the article for the JCAHO link.

If JCAHO doesn't cover that DME (and even if it does), report this unethical and harmful treatment to the DME's regional manager or president, telling them you've filed a complaint with JCAHO to get their attention. Remember, it's not just for you, it's to help other patients from being harmed.

I speak from experience. An RT at a large national DME set up my machine and prescription wrong, too. They had no procedures to detect their error. If not for this forum, I wouldn't have found that out, and might well be dead by now because of congestive heart failure caused by inadequately treated OSA due to RT incompetence and the DMEs lack of a standard of care.