DME question

mattman wrote:That is absolutely, unequivocably wrong. Horrible, dishonest and shouldn't happen. You should damn well be given what you paid for. And if someone DOES recover unused pieces from a product that was sold they damn well have no friggin business selling that part.
mattman

So if the intentions are laudible - then it's Ok to steal?

mattman wrote

Well that sucks and I don't blame you for sure! Out of curiousity, what was missing?

Just those items that the DME was taking to give to the "needy" plus the 1-page Write-up that described how to turn on AHI/Leak reporting.

I guess the DMEs and their good buddies, the CPAP manufacturers, don't want the user to be confused by seeing their AHI and Leak #s. They might think something is not working with their therapy if the #s are High (assuming, probably wrongly, that the DME or Dr. even talked about AHI and Leak #s before sending them home to use the CPAP for all their sleeping/napping hours for the rest of their lives). The DME (and Manufacturer), it seems, would rather have the user/patient feel so terrible from poor therapy due to leaks, for example, that they come see the DME for help, or make an appointment ($$$s) to see the Sleep Dr. Then, the DME and/or the Dr., without any information on AHI values and/or Leak values, can look in their "magic ball" and prescribe higher pressures or some other mostly random SWAG at making things better for the user/patient (us).

If my comments above seem "unreal", I apologize. In defense of my statements, let me just say that I have personally been impacted by these DME & Sleep Dr. attitudes and behaviors twice: first in 2005-2006 and again early in 2009 (my 2nd attempt at CPAP). My 2nd CPAP attempt was successful because of the knowledge I gained from reading this forum and from acquiring the software to monitor and track my sleep therapy. I received 0% help/information/useful guidance from my DME and Sleep Dr.

mattman wrote:
...........
You really don't have any idea what most patients are like. They are NOT the patients you see here. I'd say that fully 80% of the time if a patient was setup at my office they would get up to leave and leave every bit of paperwork, boxes, instructions, packaging etc there and ask me to throw it away. I'd have to FORCE a lot of people to at least take home their paperwork and the instructions. I'm not exagerating.


mattman

As a patient trying to help other patients, I do have a little bit of an idea. Just recently a new patient said after talking to me for a few minutes, "I just thought it was a machine you use and it helps you sleep."

I also know that nine out of ten patients I talk to cannot tell me the brand or model of the mask or machine they use. They also don't know the terminologies nasal mask, nasal pillows, or full face mask. Sigh.

mattman wrote:

rooster wrote: ........
So mattman, your position in the past was "just a little bit" of stealing was OK. What is your position now?

So you tell me how awful my mindset was when, ........
You make it sound like we were preying on innocent people, rubbing our hands together and trying to think of ways to screw people over. ...........

mattman

Nope, The Rooster did not accuse you of all that. I just restated your position that “a little bit of stealing is OK.”

My position is different. I think a little bit of stealing is not worth it.

To illustrate, just last week in line at the fast food counter, the old gent in front of me dropped two ones and did not realize it. I picked them up, caught up with him and gave them to him.

He said, “You are an honest man.”

I said, “No sir, I am not.”

He said, “But you gave me the two ones I dropped.”

I said, “But if it had been two fifties, I would have slipped them in my pocket.”

mattman wrote:That is absolutely, unequivocably wrong. Horrible, dishonest and shouldn't happen. You should damn well be given what you paid for. And if someone DOES recover unused pieces from a product that was sold they damn well have no friggin business selling that part.

I'm mystified by that statement.

You've already explained how there is no relationship between how you buy a product from a manufacturer and how you sell and bill for it.

You buy a mask, but sell (and bill for) a headgear, a mask frame, and a pillow. So what if there are three pillows in the package? You bill for one, and supply one. The other two are yours according to your explanation, to do with as you please. Why do you feel that they belong to the patient just because they came in the package?

And when you convince Medicare and/or the insurance companies to create a code for the packaging, you'll bill separately for that, too.

jdm2857 wrote

I'm mystified by that statement.

You've already explained how there is no relationship between how you buy a product from a manufacturer and how you sell and bill for it.

You buy a mask, but sell (and bill for) a headgear, a mask frame, and a pillow. So what if there are three pillows in the package? You bill for one, and supply one. The other two are yours according to your explanation, to do with as you please. Why do you feel that they belong to the patient just because they came in the package?

And when you convince Medicare and/or the insurance companies to create a code for the packaging, you'll bill separately for that, too.

Spock would be proud of you. You have stated a very logical and valid explanation of how the B&M DMEs operate their business model, AND have the full support of the Manufacturers (who primed the pump, so to speak, by requesting and receiving the numerous billing codes that "allow" the DMEs to bill for all the pieces that were packaged/connected together as one).

nocreek1 wrote:My doctor wrote a prescription for a new style mask (Full Life) FF. She sent said prescription to my DME and they called me to tell me that I could have the mask, but I was not due for a new headgear until November. I am a Medicare patient. Now my question is don't the masks come with the headgear, especially if you are getting an totally new type of mask? The mask I fear would not work with any headgear, but only the one designed for it.
Was I being given the usual run around or was she correct? She did mention that I could pay $49 for the headgear if I wanted the mask this month. I elected to wait until November.

ResMed S8 EScape System
Hunid Aire 3i
Quattra FF mask
11 pressure

This is in reply to the OP. I must say that when we've gotten a new mask after 3mos, a replacement of our original, the DME gives it to us complete with headgear in the closed pkg, although as per Medicare we're only allowed headgear every 6mos. When I checked the EOB statement I noted that they only billed Medicare for the mask. I think this is the first positive comment I've ever made about our DME, so I'm fair and balanced!

You have to be careful, Dori.

Since Fox News usurped the term, "fair and balanced" no longer has its original meaning.

CincoSieteSieteSiete --

Live long and breathe.

DoriC wrote: ....... When I checked the EOB statement I noted that they only billed Medicare for the mask. I think this is the first positive comment I've ever made about our DME, so I'm fair and balanced!

They had a new billing clerk who made a mistake.

Hey Guys, 1 positive out of 1million negatives ain't bad, it's a start! Maybe if I get Glen Beck and Bill O'Reilly on the case, the ratings will get better, you think? Now don't get all political on me, you'll scare me off!