Against Medical Advice?!?!

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
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Slinky
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Re: Against Medical Advice?!?!

Post by Slinky » Wed Jul 08, 2009 8:17 pm

Eh, I would scratch out AMA and write in returning due to inferior equipment, not what I wanted, bought elsewhere and sign right below my notation.

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Gerald
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Re: Against Medical Advice?!?!

Post by Gerald » Wed Jul 08, 2009 8:38 pm

Elg5cats seems to have some good points......and if it were me, I'd do what she says.

That aside, I had a thought.......Might you simply amend the AMA statement....by writing on it what you want the insurance company to know? You can write a "story" in the margins.....and if they send it to the insurance company, your statement of compliance goes with it.

Get a copy of it before you go out the door,,,,,and that way, they can't "photoshop" you.

Gerald

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elg5cats
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Re: Against Medical Advice?!?!

Post by elg5cats » Wed Jul 08, 2009 9:18 pm

Slinky wrote:Eh, I would scratch out AMA and write in returning due to inferior equipment, not what I wanted, bought elsewhere and sign right below my notation.

Although I greatly love Slinky's humor. I strongly encourage you not to make any written marks, comments , or signatures on the DME AMA forms. Offer to sign an acknowledgement of returned equipment that says NOTHING else other than stating DME acknowledges equipment (identifying specific equipment) was returned........no other verbiage....if they don't have it don't sign their documents. If possible take someone along with you when you drop off the equipment and place equipment in the hands of a representative of the DME..Again, I would not write anything on their documents, period. Can make life easier should you have to present your case to insurance..........I still think there is more bark than bite here, but I would treat DME comments seriously.

elg5cats

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Ruby Vee
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Re: Against Medical Advice?!?!

Post by Ruby Vee » Thu Jul 09, 2009 12:41 am

elg5cats wrote:
klockemy wrote:
I return the machine to her, that I am going to HAVE to sign an AMA (against medical advice) form to return the machine. I am not going against medical advice.

Kevin,
I strongly suggest you DO NOT sign a AMA notice..........Once you refuse the DME may note you returned machine and refused to sign the AMA forms. Sometimes when patient's leave medical care...diagnostics or treatment...before "discharge" from the physican, insurance will refuse to pay and ALL COSTS ARE BILLED to the patient. Many of us will have signed an agreement not to leave the sleep study until it is completed/or understanding insurance may not pay if sleep study was left before completion......this is an AMA agreement...insuring payment to sleep clinic. This DME is likely attempting to secure their cost/profits from the machine at your expense. If you refuse to sign, you maintain easier ability to challenge being charged by appeal. Call you insurance and without identifying yourself ask what if there is an AMA policy for home health care or DME. Your physican would not be able to reasonably say you left treatment since you have your own machine and are compliant...until this is resolved just print copies of your compliance data. If needed, you can show you have maintained "compliance" beyond the DME return. I suspect this all is an empty threat, but best to be proactive.

elg5cats
I agree! DO NOT SIGN an AMA notice. If you do, you may find yourself responsible for all costs related to your sleep apnea from now on.

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klockemy
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Re: Against Medical Advice?!?!

Post by klockemy » Thu Jul 09, 2009 5:18 am

Thanks for all the advice. I am returning the machine this afternoon. I will let you know how it goes.

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klockemy
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Re: Against Medical Advice?!?!

Post by klockemy » Thu Jul 09, 2009 8:59 am

I haven't returned the machine yet, but wanted to let you know what my insurance company said about this:

"We pay claims based off medical necessity. If you need it, then we will pay it according to your schedule of benefits. Each claim is evaluated independant of the next one. First off, the DME shouldn't send us an AMA because we don't need it. Second, we don't care about an AMA, because each claim has no relation from the next one. Basically, it sounds like the DME is trying to cover themselves from legal liability in the instance that you aren't continuing your therapy on your own or you do something wrong and something bad happens."

m4k4evr

Re: Against Medical Advice?!?!

Post by m4k4evr » Thu Jul 09, 2009 9:42 am

the ama is ONLY to protect the dme company. it goes absolutely nowhere but in your chart so that you or the doctor can't come back on them later. DME company's have to protect themselves from any law suit. it's just a cya. Truly not a big deal.

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2flamingos
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Re: Against Medical Advice?!?!

Post by 2flamingos » Thu Jul 09, 2009 12:09 pm

Kevin -

regardless of what your insurance company "said" (did you get it in writing?), I would NOT sign the AMA statement. I remember a previous thread (don't remember who) where the person returned the machine and refused the sign the AMA. After some discussion (I seem to remember argueing and maybe some shouting) with the manager, a comprimise was reached - they signed a statement simply saying they had returned the machine.

If it were me - I would go the same route - that is, after all, all you are doing. You are not doing anything that is against medical advice - you are still on therapy.

Don't let them bully you! Good Luck!

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BleepingBeauty
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Re: Against Medical Advice?!?!

Post by BleepingBeauty » Thu Jul 09, 2009 1:26 pm

2flamingos wrote:I remember a previous thread (don't remember who) where the person returned the machine and refused the sign the AMA. After some discussion (I seem to remember argueing and maybe some shouting) with the manager, a comprimise was reached - they signed a statement simply saying they had returned the machine.
I remember that, too, 2. I believe it was Catnap's experience. I'm sure the thread(s) can be found with a search of her posts.
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klockemy
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Re: Against Medical Advice?!?!

Post by klockemy » Thu Jul 09, 2009 1:31 pm

Well, I turned in my machine. I signed a receipt for return and a liability release form. The only reference to 'against medical advice' was the title. There was nothing else in the form that indicated that I was going against doctor's orders. I just struck-through the title, had her and I initial it and I signed the liability release. I faxed the form to my insurance company and again they reiterated that they don't care and if they were presented with the same form from the DME, the would still continue to cover my CPAP supplies according to my schedule of benefits.

Thank you all for your advice. I really hope that someone else doesn't go through this where they have a full blown AMA they are presented with.

Kevin

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jdm2857
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Re: Against Medical Advice?!?!

Post by jdm2857 » Thu Jul 09, 2009 1:32 pm

In general, it's good advice to refrain from signing statements that are not true.

Kevin --

Glad to hear that things went well. And you're now officially rid of that DME.
jeff

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klockemy
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Re: Against Medical Advice?!?!

Post by klockemy » Thu Jul 09, 2009 1:38 pm

jdm2857 wrote:In general, it's good advice to refrain from signing statements that are not true.

Kevin --

Glad to hear that things went well. And you're now officially rid of that DME.
Thanks. I guess cpap.com is my official DME now. Now I have to learn the whole buy/reimbursement process. (couldn't be any worse that all the hoops I had to jump through to turn the machine in)

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jdm2857
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Re: Against Medical Advice?!?!

Post by jdm2857 » Thu Jul 09, 2009 1:40 pm

I don't think Johnny likes being called a DME.

Tarnishes his reputation.
jeff

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klockemy
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Re: Against Medical Advice?!?!

Post by klockemy » Thu Jul 09, 2009 1:43 pm

Sorry Johnny!

....cpap.com as my cpap supplier. :

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Muse-Inc
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Re: Against Medical Advice?!?!

Post by Muse-Inc » Thu Jul 09, 2009 1:50 pm

Hey Kevin, recommend you verify that cpap.com is 'in-network' for your insurance provider. Johnny's not for mine *sigh*.
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