Options for Changing DME's

For those that have followed my threads, it's pretty obvious that I've got some serious issues with my DME. Here's what I'd like to ask some input on --

Let's say I make up my mind I'm done with these people and want to change. Obviously, I need to select a new DME and get my doctor to fax them the order for everything I need. But here's my question:

My current DME has been working with me since November. I had a cpap machine for a month, then switched to a bipap that I had until last week. I've got an oxygen concentrator, not to mention them letting me try every full faced mask they had, plus they ordered a few others for me to try. While I find them sometimes incompetent, they HAVE done a tremendous amount of work for me.

I have paid them NOTHING thus far for any of their services or equipment. There HAVE been bills to my insurance and I've seen what my co-pays would have been, but thus far, they haven't billed me squat.

What happens if I fire them and move on to another company? Do I simply return the equipment and they bill me for what they've done thus far? Anyone ever had to deal with this?

This far into your xPAP use, if you change providers, you can expect to pay the extra months (from November to when you switch) to the new provider either when first starting w/them or after you have completed the rent to own number of months. After alll, your insurance is only going to pay x amount of dollars for an xPAP, they've already paid your current provider x amount of months, they will fnish paying the new provider what's left of the balance they are willing to pay and then they are done and you are responsible to the new provider for the shortage. All this according to my understanding when I was checking into ditching my first provider. (I just stuck out the 13 month Medicare capped rental for the device - but switched to a new provider for my accessories).

Thank you for this information. It's what I was afraid of, but it makes sense.

I feel so screwed. I think my situation is above this DME's RT's level of experience and really think I need to change. But I don't know if I can afford to.

Things sure do get complicated, don't they?

Kathy,
This is far from being a reply to your question -- I don't have one -- but some thoughts:

You clearly need a knowledgeable Respiratory Therapist who is cpapable of observing and learning. If the one you're speaking of now is the same one who did not know what "Auto on"/"Auto off" was the she is not the right person for a case as complex as yours.

I don't know the American health system, so forgive me if this is ridculous, but, is there any way for you to obtain good RT sevices, regardless of who supplied your equipment? Perhaps an RT your doc knows? A professional whose services you can pay for? Are you sure the woman mistreating you has the proper education to do what she is attempting to do?

O.

You might also contact your current provider's manager or owner and explain whilst you appreciate all the help they have been w/equipment, masks, etc. that it is obvious that you need a much more experienced, knowledgeable RRT than they have been able to provide.

Then contact your insurance company and tell them the same thing, service and equipment has been good, but they just do NOT have an RRT w/enough knowledge and experience to provide the advice and assistance you need. There MAY be a way to wiggle out of this and get a more knowledgeable and experienced RRT.

Perhaps your pulmonoligst or family doctor can find or recommend a knowledgeable RRT.

Madalot~ where in VA do you live. I'm also in Va and may be able to help.

TALK TO YOUR INSURANCE COMPANY!!!

Your current DME doesn't sound that bad to me, but if YOU want to switch, that shouldn't be a problem. Your insurance co has several options when dealing with your current DME and a new one. FIND OUT WHAT THEY ARE! Then....talk to your current DME and see if it's financially adviseable to switch to another DME or stay where you are.

I recently switched insurance companies, and my DME wasn't one of their prefered providers. I spoke with my insurance, found out my options (which would have cost me three monts rental!!) then spoke to my DME, who were willing to WAVE the balance owed and let me keep all my equipment.

Everyone's insurance, and DME's are different, you may not ge the same results as I did, but you won't know unless you ASK! Talk to your insurance, talk to your DME, and talk to your NEW DME, and see if something can be worked out.

GOOD LUCK!!!!!!!!!!!

Can your ask your doctor for a good RT to work with - maybe he knows one at a hospital or has one in his office? Yes the RT at the DME is lacking but is the rest of the DME okay? You work with the RT the doctor chooses not the DME one but keep the equipment and all from the DME? Is this feasible?

Thanks to everyone for their input here. I really do appreciate it.

As it stands right now, my RT DID get the order request to my doctor on Friday and they agreed on a course of action (AVAPS). My doctor has confirmed that she ordered this and is okay with the settings they discussed. For now, I am going to go with this and see what happens.

I have a major character flaw that I expect people to handle things the way *I* would. Having spent 27 years in customer service, I learned early on that keeping your customers informed (even if you can't do what you promise) is key to keeping them happy. I was told by both bosses and customers that one of the reasons they liked me so well is that if they asked me to do something, they knew it would either get done or I would tell them I couldn't do it and why. But until they learned that about me, I made sure they knew when their request was completed. I guess I'm a snob about it and have a low tolerance for people that don't share that philosophy and thus don't meet my expectations.

My RT did everything she said she'd do and got it done, other than communicating it to me completely. I need to realize that this is the best she can do. Everybody else (other than my hubby) seems to think this is okay, so I guess I'm wrong for thinking differently.

That's not to say that I won't change down the road, but I think at this stage of my treatment, it would be safer to stick it out with these people. I've come this far.

My DME is very nice but very casual with how she responds - first time she fitted my mask without connecting to the cpap unit! Their back office people are more helpful with equipment, etc.

I found that the head nurse at the sleep center was my savior - visited her many times to tweak my machine, to tweak my masks, download my data (before I learned how to do it myself), plus words of encouragement, etc. It helped my first time calling her that I brought box of italian pastries

That's not to say that I won't change down the road, but I think at this stage of my treatment, it would be safer to stick it out with these people. I've come this far.

At the moment, I think this is your best option. You want to be able to get a good handle on your treatment, get the rest you need and deserve, then maybe down the road you can change. At least that's what I would do. Best of luck and let us know how things go.

Slinky wrote:This far into your xPAP use, if you change providers, you can expect to pay the extra months (from November to when you switch) to the new provider either when first starting w/them or after you have completed the rent to own number of months. After alll, your insurance is only going to pay x amount of dollars for an xPAP, they've already paid your current provider x amount of months, they will fnish paying the new provider what's left of the balance they are willing to pay and then they are done and you are responsible to the new provider for the shortage. All this according to my understanding when I was checking into ditching my first provider. (I just stuck out the 13 month Medicare capped rental for the device - but switched to a new provider for my accessories).

I know this is a very very old post, but I'm in a similar situation. I started with a DME and have had a CPAP machine for about three months.
Now I would like to switch to a more local DME, so that I can go into the shop and be able to try on several masks and get fitted. Also this new DME had a good recommendation here.

The paper-work is pretty much all set - the new DME has everything they need except the insurance authorization. My insurance company informed me to ship the CPAP back to my current DME and then they will be able to switch the authorization over.

HOWEVER, I hadn't thought about the capped rental issue, which my insurance company does I believe. I never thought to ask if I will be on the hook for three months rental charges to the new company. I guess I will call my insurance company tomorrow! Of course the problem is that with health insurance companies, you can talk to someone on the phone and get an answer, but you never know if the answer is correct.

The new DME may be willing to waive 3 months worth of rental, but not 10 or 11. You'll have to ask.

Since I am the OP here and this thread prompted a PM from someone offering mask help, I felt the need to post a reply.

I ended up staying with the DME in question. The mask issue has been solved, as I finally decided that the FFM given to me day 3 into my therapy was the easiest and most comfortable for me to use. My DME has me on a 3-month replacement schedule and I've told them unless I say otherwise, just give me the same one. I have two new masks in reserve as I have found that my old one quits on me without any notice, so it's good to have one or two available.

My situation took a drastic change from bipap to ventilator, which changed the game a lot when it comes to working with DMEs. Am I in an perfect situation? Nope, but we're working with it as best as possible. My DME does not have a full time RT any longer (the one they had left -- I'm not sure if she quit or was fired as I've heard both). They have contracted with an RT from a local hospital to help as needed, but I'm not sure how familiar she is with the equipment and such.

At this stage, I am fairly stable in my treatment and I use all the resources available to me when I have a problem -- my doctor, my DME (they can contact the RT) AND this forum. Between all these resources, I am doing okay most of the time.

Glad you are doing okay (most of the time)

we are always rooting for you kiddo!