My DME Sent Me a Bunch of Stuff

plr66 wrote:

sleepypp wrote:It is a waste. Send it all to Washington DC as an example of what's wrong with insurance companies running healthcare. A new hose? Oh brother. Maybe it was sent by mistake?

Absolutely NOT sent by mistake! It's the classic DME racket and should be against the law, IMO. Insurance is being sucked for 3-10X the worth of these items, you pay the rest, for.....as you said, "unnecessary stuff!" Absurd that you would need a new hose or reservoir, and an entire mask with headgear can last for years, with the possible exception of the silicone interface with your face, which varies in terms of life-expectancy. Filters need to be replaced. A $6 item every 3 months.....so they load the box and collect BIG $$$$$$.

But hey. You can do like so many many others----sell the stuff on eBay or cpapauction and get some "free" income rolling in. Keep up the racket!!! Anybody who buys into & participates in this system of fraud and then complains about so-called socialized healthcare that we may inherit, needs to take a look at how they contributed to the state of things. We all thank you very much.

Don't get me started.
End of rant.

Ditto. Peptide Leucine Arginine, you saved me some keystrokes.

It's quite simple. Your insurance company says it will pay for replacements at certain intervals. Unless you intervene with your DME, that's when you will get them.

Sure it's more profit for the DME. (Why has running a successful business suddenly become "greedy"? )

Do you NEED them at those intervals? Only you can decide that. (Unless you want Washington bureaucrats to make those decisions FOR you, of course...)

Certainly it is a double edged sword. As mentioned, spares are always good. Your mask will only break in the middle of the nite on a long holiday weekend. Spares are also good if you travel. Get one setup for travel and another for home.

I am not condoning this setup only admitting I can do little about it. Solving 'World Hunger' may be easier.
The other side of the coin - should you wait until you need something it WILL take forever to get it. It took my DME 10 weeks to get me a different mask. So if your mask IS working and you have a spare, let them know you no longer need automatic delivery. Just be nice about it or you may never get anything ever again.

Good Luck Mr. Ganesh

Thank you all. Your responses confirm what I was thinking. It looks like the DME is 'maximizing their revenue potential' at the expense of my insurance carrier.

The suggestions to have some spare parts is a good one. But it hurts my heart to hear stories of people who have to pay 100% out of pocket for medical equipment they need to live. FUBAR is the appropriate term.

Although tempting, I will not sell the extra equipment online. I would rather give it to someone who doesn't have insurance. I need to talk to the DME and tell them to send me equipment 'on request' only. If they have a problem with that I am sure my insurance company would allow me to go to another DME that wouldn't cost them as much.

Healthcare is sick (and not in a good way)

Mark

Ganesha wrote:Thank you all. Your responses confirm what I was thinking. It looks like the DME is 'maximizing their revenue potential' at the expense of my insurance carrier.

Mark

Again, before you go off on a tear about how awful this company is - there is NO reason to think this is the case. They (and frankly, most DME companies I've ever worked with) are probably just trying to help as best they can. And they may be REQUIRED to send these to you by the people who set the rules for them - the insurance company!!

Seriously - just call them up and say you don't need automatic resupply. It will probably stop. It's just that easy.

I'm really sorry, I don't mean to come off as judgemental or anything it just breaks my heart to hear of a situation where things go all to hell for absolutely no reason.

There is nothing to suggest anyone is trying to screw anyone over or rip off anyone or even do anything shady. They most likely think they are doing the right thing for you and trying to make sure you get the best possible care.

I honestly truely and seriously don't see any conspiracy here. And even worse, I'd hate to see you stop looking to what could be an excellent partner in your case over a simple misunderstanding.

mattman

mattman wrote:....... it just breaks my heart to hear of a situation where things go all to hell for absolutely no reason.

..............

I honestly truely and seriously don't see any conspiracy here. And even worse, I'd hate to see you stop looking to what could be an excellent partner in your case over a simple misunderstanding.

mattman

A bleeding-hear liberal who defends capitalists?

What a refreshing change!

Mattman, I hope to see you around a lot.

rooster wrote:

mattman wrote:....... it just breaks my heart to hear of a situation where things go all to hell for absolutely no reason.

..............

I honestly truely and seriously don't see any conspiracy here. And even worse, I'd hate to see you stop looking to what could be an excellent partner in your case over a simple misunderstanding.

mattman

A bleeding-hear liberal who defends capitalists?

What a refreshing change!

Mattman, I hope to see you around a lot.

lol. Yeah, I guess I am. I will admit to being a bit of a liberal and I will admit to generally being a supporter of businesses and medical professionals. Heh. In my earlier days I'd been known to be the sort to wear a suit and birkenstock sandles or a tie-dyed tie, etc. I used to get some funny looks driving around in a shirt and tie in my vw camper with the deadhead stickers.

Mostly now I just give a crap about being fair all the way around and treating people the way I want to be treated. Oh, and underdogs. I'm a sucker for an underdog.

And I tend to come and go in spurts around here. I don't know what my join date here is but I'm guessing it has to be at least a couple years ago now.

I got a supply pkg from the DME once....seems that my doc, as he walked me to the scheduler to make a new appt and give her some paperwork, gave her a slip to fax to DME regarding me needing supplies..... this was all done right in front of my eyes/ears.....

Problem was, doc never mentioned need or frequency in our sufficiently long appointment! I emailed him to never make a request on my behalf which would cost me money......needed to discuss with me and let ME make the request. Besides, I order with a special staffer at the DME, and that is not where the fax went, so the filters were (again) wrong anyway!!

My point is that your doc may have triggered a shipment by some paperwork without discussing with you.......DME might actually be fulfilling what they have been explicitly been instructed by someone to do.......although I cannot see how ANYONE can place orders without involving the patient who is financially responsible!!!!

J

My DME calls me monthly with a VRU to see if I am still using the CPAP. It will also ask if I need supplies. If my insurance would pay for them, you can bet I would get them, at least sometimes. But I have a deductible so while they may approve it, THEY won't actually pay for it. I will. I got one "free" box of supplies when I met my deductible last year. I probably won't meet it this year so I will be buying supplies online.

Mattman,

It is difficult to pick up tone in a posting. I was not angry or trying to be accusatory. Mostly I was surprised. This is all new to me and I value the group's input (whether from bleeding heart liberals or card carrying capitalists). OSA seems to be a politically nuetral disease.

BTW, next to your post it says you joined in November 2006.

Mark

WOW.... here is some professional help for your dilema. I am a Registered respiratory therapist in texas and work for a dme company. It sounds like your dme company has a resupply program, which is not a bad thing. Most companies dont. While yes it may be revenue source for companies most companies do it to reduce problem calls to the branch and as some may promise the doctors and other referral personel that it is a part of their cpap progam. Every 6 months is common to resupply patients and that is dictated by the insurance company as that is when we are able to bill for such items. Now as for why you need all items replaced. We follow manufacture guidlines for normal daily use. Most masks worn nightly for 6-8 hrs a night with the oils from our face will start to break down and not seal as well. So if your cpap worked well and then after a few months just is not the same, headgear gets strectched out masks loose there seal. As for humidifier chambers and tubing after 6 months that is just due to hygiene. 6months of water in any chamber will be a source for microbes to grow and be inhaled, and can sit in the tubing and grow different bugs i would not want to be inhaling. Hence stuffy noses or increased eye crust in the morning. Hope this helps. All DME's are not Equal and all are not out to commit fraud or get you for all you have. Some of us are in the buisnness because we really care and enjoy what we do. Helping you

A DME is not allowed to auto ship in any situation. It is mandatory that you are notified when supplies are shipped.

(If you want, you can contact your insurance company that you recieved supplies without your consent. They will either stop payment or demand a refund and your DME will have to eat the cost) This will/may put you on your DME's list of patient's they don't want to deal with (something to think about). However it is your choice, your right...

Agape.

VIRGO RT wrote:As for humidifier chambers and tubing after 6 months that is just due to hygiene. 6months of water in any chamber will be a source for microbes to grow and be inhaled, and can sit in the tubing and grow different bugs i would not want to be inhaling.)

If you and your employer haven't noticed, humidifier chambers are easily washed. They should last way longer than 6 months. (The seals may wear out eventually.)

DMEs have a huge markup on humidifier chambers, and want to sell as many as they can. To make as much money as they can.

So spare us the pseudo-concern about our health.

There is no huge markup on humidifier chambers in some cases we give them at a loss. I suggest you look at Medicare allowables which most insurances follow and you will see chambers and most supplies is a service not a huge revenue stream. Our money is on the machine itself and oxygen and other non respiratory items. the advice i offered is from experience and my professional background, which is more than i can say for your sarcastic, unprofessional assumptions you should keep to your self than risk hurting someone.

virgo RT wrote:...your sarcastic, unprofessional assumptions you should keep to your self than risk hurting someone...

OUCH! Most here have had bad experiences with DMEs, thus are skeptical. We know what we pay at a DME and what we pay online for the same item...a big discrepancy leads us to believe there is gouging going on. Now that said, one ex-DME-employee explained that if Medicare assignment is accepted by the DME then the Medicare allowable becomes the least amt that can be charged, so my Hybrid was $301 from the DME (upfront they wouldn't bill insurance), I bought it online for $119...big difference, plus I got in in 3 days unlike the DME which stated they would have have to special order it (sometime) and then I should expect a 3-week wait...I said, "No thanks."