whoa, did I ever upset my DME

I dont get it? FYI Im not a DME. If I were I'd just say.

Guest wrote:yeah, it's pretty easy to figure out what comes in the bag. Go here: http://www.mrl.respironics.com and type the number 1026346 in the Keyword box. Then click on the returned link, then click on the URL beside the PREVIEW word. (No need to add to cart).

I wish you'd just go ahead and log in with your user name.
I'm serious when I say that it's GOOD to have knowledgeable DMEs hang out here on the forum and share information. And, I do appreciate your presence here......as long as you can handle a little teasing, too.

Along the lines of what rested gal was saying, the new users don't know what to expect when they're transitioning into this therapy and unless they find their way to the forum, and wouldn't know the difference if or how badly they're getting ripped off. And, in my opinion, it's as much about DME education as it is CPAP user education.

Take care.

Den

Guest wrote:I dont get it? FYI Im not a DME. If I were I'd just say.

Soooooo......are you a company rep?

Den

are you?

Guest wrote:are you?

Nope!

But, if I WAS, I'd be trying to make some changes in the way some things are done.

Den

Well the Lincare (or is that Lynn doesn't give a flying leap) I went to will bill every damn piece in the box/sack that they can. They would bill for the plastic sack if they could get away with it. It doesn't matter how many pillows or cradle cushions, they will bill for each one separately.

I got a Swift and they only sent one pillow and told me to get all that were in the box they would bill for 3 even though I had not gotten the first Swift from them. They billed for a mask, a nasal pillow, and headgear. At that stage this was no copay for me as this was near the end of the year and I had reached my max out of pocket.

I talked to the billing office (head guy for the region), talked to the District Manager, and talked to the Corporate Office patient complaints person about it too and nothing was resolved. It was all part of an ongoing billing problem.

Oh I was promised another nasal pillow by the District Manager (size I needed) and I am sure glad I never tried to hold my breath for it cause that was almost 3 years ago. They didn't say that they wouldn't bill for it, but since I never got it, that part didn't matter. It was about then I elected to buy OOP and forget all the insurance racket as the headaches fighting Lincare was overwhelming.

We see horror stories and some of us have them ourselves. We can try to educate the newbies on some of the worst cases we see so they can be better prepared when they deal with their local DME's.

I have my former DME providing the blower & humidifier, but my new DME provides the mask, etc. Point is you have no obligation to use the one DME for everything. I have Medicare as you do, and I don't get any grief from the former - in fact haven't needed to talk with them for months.

Something to consider.

PS: Forgot to mention to interview the prospective new DME's asking about your experience and how they would handle it.

Hi nobody - Perhaps Medicare will start me over with another DME. Is the best way to call Medicare? II had an uncomfortable feeling about spending a whole year fighting over every pourchase. Life with sleep apnea is stressful enough without adding to it. Jan

NeurosurgeryNP wrote:I guess I am blessed to have an awesome DME wo really cares after reading all of these stories.

Ditto and Amen to that! I read these stories and want to kiss my RT every time I see her. I get my new machine tomorrow, she doesn't HAVE to swap mine out, but said she will since I prefer the ResMed.

Slinky - Thanks for your post, it brought a lot of questions to my mind. Medicare was effective November 2008. I received my Elite, mask, & humidifier on December 31, 2008. I just got a statement from Medicare regarding what they paid, and the balance. I have a secondary ins. from my former POE, so I don't know yet what I will owe. No, I haven't signed up with mymedicare.gov. What is the benefit of it?

I really want to leave the DME. Is anyone successful in doing that, do I have a contract with them? I signed for my equipment when I got it. And if I can get free of them, what happens to my equipment? Is there a benefit, in keeping the equipment with them and getting another DME for my supplies? Would another DME accept me?

I went to another supplier, asking if they had equipment that could be tried on. They brought out a 5 or so masks and said they had some kind of a cleaning system that sanitized each mask after it was tried on. Is this normal for a DME, and is there a way to clean each mask?

I have more questions than answers, but with the help from the members, I am beginning to know what questions to ask. Thanks again Jan.

Jan, I thought I gave you some clear advice. If you don't ask the DME exactly what I said, how in the world would anyone act on it? If Medicare doesn't have the reason from the DME as to why you were not given the full OptiLife bag, then what action could possibly take place to remedy the situation?

This stuff isn't that hard. Maybe you haven't read what I said.

DMEs ARE permitted to bill for separate items on a new patient. They are permitted to bill for a CPAP E0601, Nasal Interface, A7034, Headgear, A7035 as well as replacement cushions/masks that happen to come in the bag. There is nothing wrong with this. The issue at hand is why you weren't given everything you should have been given out of the OptiLife bag.

Yes, there is an approved way to clean a mask. Every DME should let you try on as many masks as necessary. They should understand that if you continue to use your equipment, you represent an annuity in replacement items.

I think there is also a question on "which" bag the DME had in stock. If I look here - I took off the coding numbers

http://optilife.respironics.com/Parts.aspx

I see 3 different "bags" with mask, headgear, and assorted pillows/cushions.

OptiLife Mask with Headgear and Pillows Cushions
Sizes: P, S, M, L Pillows Cushions 1036800

OptiLife Mask with Headgear and pillows cushions and CradleCushions
Sizes: P,S,M Pillows Cushions S,M CradleCushions 1036801

OptiLife Mask with Headgear and Pillows Cushions and CradleCushions
Sizes: M,L Pillows Cushions M, L, LN CradleCushions 1036802

Well Guest, I had to read your post several times trying to decipher what seemed like a mixed message to me. I'm not a mind reader, and decided to consider your post as well meant advice. However, I did get the impression that the subject of DME's is a sensitive subject either for you, or to you. Sorry about that. I am new to the whole business of sleep apnea, and I didn't enjoy my DME experience. If I can, I want to find one like some that have been described here.

In my previous life, (before apnea) I spent considerable time defusing & neogeotating with hostile individuals. It was stressful. Professionally, I attempted to have each situtation be resolved on as much of win-win as I could. By using a little psycho babble & agreeing to a part of their arguement, many left feeling satisfied they had won. I repeat, It was very stressful. I want to buy my apnea supplies with a simple win-win for me and the business. Thanks anyway. j

Hi Sharkbait, I agree with you. Do you know if I can switch a DME after getting your basis equipment? That visit was just about as pleasant as having a jolt of rain come down the hose and startle an unsuspecting person awake. Not the worst thing in life, but not too pleasant too. Thanks for your support. J.

Guest, I hadn't read your second post, when I responded to the first one. I get you now, some DME's are difficult to deal with and if they have questionable business practices, someone needs to confront them. Until I get over being fatigued & sleep deprived, I don't have the energy to be that person. However, if I can't change DME's and if they continue the hardnosed tactics, then I agree with you I have no choice.

That particular DME is the Home Office of a large multi-division home care organization. I have heard about their V.P through friends. He was formerly with another home care group in another part of the State, and was hired to update the apnea part of their company. The V.P. brought the therapist with him. J