SaltLakeJan wrote:My question now, is there a way to determine if your DME is charging you correctly? And if you are buying a bag from DME, are you getting all what he paid for in the bag? And what is fair to both parties?
Will be interested to hear the results of your reporting an incompetent DME.
Jan,
Since I don't know how the various DMEs pay for the stuff, I'm not sure what would be fair. If they buy the individual pieces and assemble it as a kit for their convenience, then they could be justified in billing for each individual piece, I think. Although that would be somewhat unfair to some patients, since they would be charged for parts / sizes / whatever that they will never use. In my bookstore analogy, though, publishers often assemble boxed sets which they price at a significant discount from purchasing the individual books. If CPAP companies do something similar, then the DME would not, in my opinion, be justified in charging by the piece for a pre-assembled kit. I do think that having multiple sizes in a kit allows the patient to experiment with different sizes to find the best fit.
For instance, I was sized with a medium simple cushion for my CL2 headgear. It came with small and medium simple cushions and small and medium nasal pillows. So I was able to try all of them and find out what sizes / models worked or didn't. (As it turned out, I ended up with something else entirely, the direct seal for the same mask, which I didn't even know existed umtil I was reading threads here.) The CL2's packaged with simple seals and nasal pillows or simple seals and direct seals, but not nasal pillows and direct seals. Go figure.
As for what happened with the incompetent DME, I ordered a new direct seal for my mask. (It's three months, I was due, and I could tell the seal was becoming worn.) The DME told me it would take 2-3 weeks to come in as it was a special order. It was ordered by the DME, sent from Respironics to the DME's main warehouse, then sent from the warehouse to the local office, who tossed it in a plain manila envelope and UPSed it to me.
It arrived with the seal pulled off the attachment, and the shaping wires twisted beyond correction. The CPAP supplies people said I had to speak with the local office. I called the local office, and they insisted I had to talk to CPAP supplies. I re-called CPAP supplies, and was told it had to come through the local office, and in any case, it would be another 2-3 weeks before they could get one in because Respironics did not allow them to keep Direct Seals in their warehouse. I said that was unreasonable, and they told me that if I had a problem with it, I should complain to Respironics.
I called the local DME office to complain again, and this time was told that I would have to ship or bring the damaged seal to them before they would order another one. So I made a trip, 25 miles each way, across a toll bridge, to deliver the damaged seal. They glanced at it, and said they would order a new one, and then were going to take the damaged seal. I requested a receipt for the returned seal. They got all confused, and said they didn't do return receipts. I said I wasn't going to hand it to them without a receipt, because my insurance had already paid for it, and I didn't intend to hand it over with no proof of its return.
This brought the office manager into it. He gave me the damaged seal, and said they would order one (it could not be quick ordered for some reason), and if he needed the damaged seal back, he would send me a padded envelope with return postage. I was again told that the problem with stocking was due to Respironics rules.
So I came home and posted an email to Respironics, explaining, in short form, what was going on, and stating that I did not know who was at fault here, Respironics, or the DME, but that it was unacceptable customer service.
I shortly had an email from Respironics agreeing that it was not acceptable customer service, with a phone number to call to give more information. I called and gave additional details. The following day, I heard from the local Respironics representative, who was going to meet with the branch manager to see what was going on.
In the meantime, I located a #4 Direct Seal for my Comfortlite 2 mask with a local DME who is not, regrettably, covered by my insurance. I placed an out-of-pocket telephone order late on Thursday, 12 February 2009. It was hand-delivered by this local DME on Monday, 16 February. I was significantly impressed and pleased by the level of service provided by Access Respiratory Homecare (504-456-9355).
I have also obtained a list of other DMEs in the New Orleans area which are covered by my insurance (Aetna), and will be checking to see which ones have Respironics products readily available. I let the delinquent DME know this.
The Respiratory Tech at the DME, Donna, was excellent in terms of selecting the correct machine for my complex sleep apnea. However, I have not been impressed with the company's supplies division. Interestingly, I had a phone call yesterday (17 February) from Donna, who said that my new insurance-covered direct seal will be hand-delivered today -- a little more than a week after I was obliged to show them the damaged seal, which demonstrates that they can obtain the direct seals in under 2-3 weeks if suitably motivated.
At least now I have a back-up seal. Oh yes -- about that "not allowed to have direct seals in the ware house" business... CPAP.COM has them in stock, and I could have had one within 2 days. I just didn't have anything else I needed to make up the $100 order which gets free shipping, so in this one instance, it was less expensive to get it locally. However, under most circumstances, CPAP.COM would have been significantly less expensive. Mebbe I should find out what the insurance will reimburse for out-of-pocket CPAP purchases....
I will say that Respironics customer service, in this instance, was excellent. We'll see how the DME does in three months when I'm due to replace my mask.