Madalot wrote: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?
First of all, I think you are in the US. If not I aplogize because the following might not apply:
Ok, this the maybe the first time that I can actually help someone on this forum, rather than asking questions.
The problem is of course, that every insurance company is different, so I can only tell you what my own experience was.
I'm not on Medicare, but rather on an HMO through my employer, which pays 100%.
With my HMO I can go online and see exactly what the insurance was billing the old DME. Basically, I sent back only the CPAP pump, because that was a rental.
The rest (tubing, mask, headgear), I didn't bother to send back because the in because my insurance paid for those outright.
I WAS able to switch three months into the capped rental for the CPAP machine. It took a lot of time on the phone, mostly to my HMO, but in the end I
was able to do it, and luckily the company switched to, took the time and effort to work with me. Mostly the reason it was not so straight-forward is
that my insurance was still renting from the old company.
In my case, the things I needed: A _new_ prescription from the referring doc, the dx and titration reports, and a switch of insurance authorization from the old company to the new one. In my case, my insurance took an overnight tracking number as proof and _immediately_ switched the authorization to the new DME.
You can PM me for details, and I don't know how your insurance works. But the way it worked with me is this: They basically started the "capped rental" over again from square one, including the mask. In other words, everything starts a-new as if I had never had CPAP before.
it DID take a lot of time on the phone to figure out how things would work out - It's a bit more complicated when your insurance is renting the CPAP from your current company. It's easier I hear if you already own the CPAP (in other words if the capped rental is paid for).
I suppose for liability reasons, both my current and new suplliers told me to keep the current CPAP until I get the new one. However I got lucky - my insurance accepted an overnight tracking number - they needed that to switch the insurance authorization from the old DME to the new one, and actually I was able to mail the CPAP back, and then pick up a new cpap and mask from the new company the same day!!
So pretty much, yes, that's the way it worked in my case - I sent the original DME's cap overnight, coordinated everything with the insurance company and with the new DME, and luckilly got an appointment with the new DME the same day.
And I tell you, it was VERY MUCH worth the trouble.
PM me if you need more details, or have any questions.
