Whoppers I have been told from DME, techs, etc

Slinky wrote:Aw, come on, maybe he ordered one for himself AFTER you told him about them??? Yeah, right!

And, DME provider's aren't "liars". They just, sometimes, tend to be "less than truthful".

I got the distinct impression that he had been using one for a long time.

If you aren't in the Diplomatic service, you should be!

thanks for the good tip-I'll tell them I'm recording and lay the phone on the table between us.

The morning after my titration at the sleep lab, that was in a hospital, I was taken to a room where a DME person already had a CPAP machine waiting on a table for me. This CPAP was a non data capable, PR System One REMstar Plus CPAP Machine. They told me that the System One Plus was the same CPAP that the sleep lab used. Though, I had noticed in my room at the sleep lab that they had an OmniLab Advanced, which is a multi-mode titration system. So maybe the DME just meant that the Plus model and the Omnilab were both made by the same brand, which was Respironics? Anyway, they had already started feeling out the paperwork for the Plus model, and I asked them if I could have a choice in which machine I wanted. They said that I could, and asked which ones in particular I was looking for. I mentioned the S9 Auto Set and also the PR System One REMstar Auto CPAP Machine with A-Flex. The DME said they didn't have either of those. Couldn't they have ordered them though if if they really didn't have them? So I decided to look at other DME's and I found one that I liked. The one that I picked had told me that they only carry the high end CPAP machines. Though, they did try to use the line about an upcharge fee because my prescription was for CPAP at a certain pressure, and I had wanted an Auto CPAP. My sleep doctor wouldn't re-write the prescription, so then I told the DME that I thought an upcharge fee wasn't allowed since I have Medicare insurance. He quickly changed his mind and said he could waive the fee. lol

Anyway, I have a few questions about DME's? I have been trying on a couple of different masks during the first 30 days, since I have a month to find a mask I like. Though, the 30 days ended last week, and I haven't heard anything from my DME. I thought he would have called? Or am I supposed to call him? Cause I just don't want to get charged for the second mask since my insurance is going to pay for one mask. Also, when I do let the DME know which one of the two masks I want to keep, will he give me a brand new mask? Since I assume the masks I've been trying on have been used by other patients during their own mask trial period, and were sanitized?

beyondtired wrote:Anyway, I have a few questions about DME's? I have been trying on a couple of different masks during the first 30 days, since I have a month to find a mask I like. Though, the 30 days ended last week, and I haven't heard anything from my DME. I thought he would have called? Or am I supposed to call him? Cause I just don't want to get charged for the second mask since my insurance is going to pay for one mask. Also, when I do let the DME know which one of the two masks I want to keep, will he give me a brand new mask? Since I assume the masks I've been trying on have been used by other patients during their own mask trial period, and were sanitized?

It really depends on the DME - and what they can get away with. For instance, the Apria in my town will only let you buy the mask. They don't have mask 'trials' -- that would be unsanitary. At least that's what they told me, even though the sleep lab I went to re-uses and santizes all their masks. With Apria, when they give you a mask like the hybrid, they'll keep all the extra bits you don't use, even though it came in the kit and you paid for the full mask. They did everything they could to rip me off. Needless to say, I dropped them.

This may not be the case with your DME, in which case, you found a keeper. If you aren't satisfied with the mask you're currently using, you may need to contact your DME.

Were the masks they were providing brand new and in sealed packaging? Was the packaging marked anywhere as "Sample" or "For Short Term Use Only"? Here's the scoop:

1. All of the major mask manufacturers have return programs. If you have a mask that you're not getting along with, you can return it to the DME within 30 days, and they can get "credit" for the mask by the manufacturer by filling out some paperwork. They don't have to physically return the mask, and most DME's will throw the mask away when you return it, because it's too much trouble to clean for someone else to use.

2. All of the major mask manufacturers provide FREE samples to DME's and sleep labs. SOME DME's actually use them for their CUSTOMERS--allowing you to try on the sample masks and even allowing you to take them home and try them before actual purchase (Typically you will buy the first mask, but if it doesn't work out you can try other samples until you find the right one, after that, when it's time to purchase a mask again, you'll get the mask that worked for you). Other DME's sell the sample masks on the grey market (if you look at cpapauction.com, for example, almost all the masks being sold on that site are unopened samples) for their profit and YOUR loss since they make it expensive, difficult, and time consuming for you to find a good mask.

It's my belief that the "30 day" trial period applies to EACH and EVERY mask. So if Mask #1 didn't work out and you returned it within 30 days, you have 30 days for Mask #2, and 30 more days for Mask #3, etc. I'm not sure your DME would agree --if they are giving you "real" masks rather than samples, that's a lot of paperwork the DME has to do each time you return a mask.

So that's why I'm asking whether the subsequent masks you were given were samples or actual purchases (which usually come with an "extra" like strap covers or a fancy carry bag).

In order for masks to be "commercially" reused they have to be "sterilized" via specific standards. Probably the majority of local DME providers do NOT have the necessary sterilization equipment.

My DME (Crapria) told me I could only return one mask within the first 30 days of starting therapy and never again after that. I know that with our host, cpap.com, you have to purchase mask insurance if you want to exchange so I tend to believe that what Crapria said is true in this case.

Crapria told me that they would "Allow" me ONE exchange in my lifetgime as a customer PERIOD !

One time and that is it.

I learned this when they supposedly gave me an appt for a mask fitting. The guy had a mask sitting there on the table and he told me to "Hold it up to your face".... He looked at it and said "Ya... that's the size you need". Never had me snap it on or hook it up to see if it leaked.

Of course, it was really WAY too large and I had to go back for the smaller size. That's when they said I was using my one Lifetime exchange.

To top it off.... Crapria sent me a bill for $40.00 for the mask "Fitting". I forwarded the bill to my insurance company and have not heard anything further.

My sleep doctor did specify the exact machine for me to receive, same one I use now. As nearly as I can tell it was a top of the line machine in 2008, when I got it. So yes, docs can do that.

DME opened lots of sterile mask packages for me to test. He said that it costs his company nothing, they just bagged up the tested ones and sent them back to the manufacturer, I guess for recycle. He wanted to go back out the truck to get more samples for me to try. I suspect they would have let me try any number of masks for nights in the first thirty days, but they would have gone into the return bag, which is not quite kosher in their deal with mask manufacturers. He told me he had an 89 year old woman on his route who had really bad arthritis in her hands. Every month he went to her house to change filters, hose, whatever the machine needed. He always tried to have at least two hours of time to sit and talk with her, because she was lonely. That DME is out of business now.

I would be bet some Docs twist the DME's arm to tell patients things like, "you can not change machine settings." so that one might not be their fault.

I am looking at a new machine now. I have been told that if Medicare pays its portion, I must go back to sleep doc soon after (in I think it is 30 to sixty days) to have it and my data and me evaluated.

What is becoming annoying is that the low reimbursement rates for Medicare effecting the quality of how I am treated. DME's, like every US company are trying to focus on the next quarter profit and do not want to pay to do things. Like keep things in the warehouse, have competent people or equip them with the tools they need, like good computers and software.

beyondtired, I would never wait for a DME to call me to check on anything. My RT has and eemail address and is very good about returning phone calls. Be proactive and call/ask for what you need. Also, it helps to cultivate a relationship with one RT or tech and deal only with them. The same with the receptionist who answers the phone- if you tell her who you are often enough she will remember you and (as long as you are polite) make sure messages get passed on and otherwise smooth the way for you. I expect quality service from my DME so I treat them with respect. That said, I am lucky to have a really good DME with an RT who has taken me under his wing.
Don't have any real whoppers to tell, except about the one DME I quit who for a solid year had a computer call me every three months to check on me. Now there's not much you can say to a computer. It took me four phone calls to finally get the calls stopped.

This is one of the reasons we tell newbies that when they are choosing a DME, one of the things they should ask about up front is the "mask return" policy and to select a DME with a "liberal" mask return policy--in my mind that is one that will work with you and keep switching out masks until you find one that works for you. The manufacturers make this possible (because they understand when you find "the" mask it will potentially give them a lifetime of repeat sales) by giving DME's sample masks and by taking sold masks back. Crapria and other DME's that limit your ability to try masks in your real sleeping situation for several nights are too lazy to do the paperwork to get credited for the masks that don't work--plain and simple.

What is becoming annoying is that the low reimbursement rates for Medicare effecting the quality of how I am treated

. DME's whine, but they get around $1300 for a blower unit that online suppliers RETAIL for around $400. That's not low reimbursement, at all. They get away with lousy customer service because we LET them, and because we, the CPAP users, are not considered to be the "customer" by the DME's. They regard the doctors and insurers as their customers, not us.

If we don't vote with our feet whenever possible (I understand that it's not always possible because of insurance), by walking out of DME's that treat us badly and finding ones that treat us better (or buying out of pocket online), then that's the kind of treatment we get.

Janknitz wrote:Were the masks they were providing brand new and in sealed packaging? Was the packaging marked anywhere as "Sample" or "For Short Term Use Only"? Here's the scoop:

1. All of the major mask manufacturers have return programs. If you have a mask that you're not getting along with, you can return it to the DME within 30 days, and they can get "credit" for the mask by the manufacturer by filling out some paperwork. They don't have to physically return the mask, and most DME's will throw the mask away when you return it, because it's too much trouble to clean for someone else to use.

2. All of the major mask manufacturers provide FREE samples to DME's and sleep labs. SOME DME's actually use them for their CUSTOMERS--allowing you to try on the sample masks and even allowing you to take them home and try them before actual purchase (Typically you will buy the first mask, but if it doesn't work out you can try other samples until you find the right one, after that, when it's time to purchase a mask again, you'll get the mask that worked for you). Other DME's sell the sample masks on the grey market (if you look at cpapauction.com, for example, almost all the masks being sold on that site are unopened samples) for their profit and YOUR loss since they make it expensive, difficult, and time consuming for you to find a good mask.

It's my belief that the "30 day" trial period applies to EACH and EVERY mask. So if Mask #1 didn't work out and you returned it within 30 days, you have 30 days for Mask #2, and 30 more days for Mask #3, etc. I'm not sure your DME would agree --if they are giving you "real" masks rather than samples, that's a lot of paperwork the DME has to do each time you return a mask.

So that's why I'm asking whether the subsequent masks you were given were samples or actual purchases (which usually come with an "extra" like strap covers or a fancy carry bag).

Well on March 22, I got my first mask from the DME, which was a Mirage softgel nasal mask. He got the mask off of a mannequin head that was on display, so it was already opened. The DME showed me that he has a big box full of opened masks. So I assumed that they were all 30 day trial masks in the box that had been sanitized?

I had wanted to try another type of mask, but also hold onto the Mirage softgel for the time being. So I went back a week later on March 29 to get a Swift FX nasal pillows mask. He did the same thing as before, by taking the Swift FX from a display head. The actual pillows were sealed though, cause he had to fit me for the right size. He decided on a medium after seeing the small size was too small. Though, he didn't give me the rest of the sizes of nasal pillows to take with me, just the size medium. Since then I've been deciding on which one of those two masks that I wanted to keep.

Mary Z wrote:beyondtired, I would never wait for a DME to call me to check on anything. My RT has and eemail address and is very good about returning phone calls. Be proactive and call/ask for what you need. Also, it helps to cultivate a relationship with one RT or tech and deal only with them. The same with the receptionist who answers the phone- if you tell her who you are often enough she will remember you and (as long as you are polite) make sure messages get passed on and otherwise smooth the way for you. I expect quality service from my DME so I treat them with respect. That said, I am lucky to have a really good DME with an RT who has taken me under his wing.
Don't have any real whoppers to tell, except about the one DME I quit who for a solid year had a computer call me every three months to check on me. Now there's not much you can say to a computer. It took me four phone calls to finally get the calls stopped.

Well I've been having a tough time deciding between the Mirage softgel and the Swift FX. When I first tried the Swift FX, I definitely liked that mask better. Though, I then tightened the dark blue back strap cause it moved around some during the night, and I ended up having real sore and red nostrils. After that, I loosened the backstrap, and I've been having trouble keeping a good seal at times. When I move around, sometimes the small tubing pulls on the mask also. Last night I used the Swift FX and it was the first time that I was ever over the 24 L/min leak rate limit for my S9 Autoset, since I had first started using it. Maybe I could use a size large, I'm not sure.

Another reason that I haven't called the DME yet is cause I'm upset that I haven't started feeling better at all yet, since starting CPAP on March 22, even though my AHI's are usually real good, and my leak rates are always under the limit(except for last night). So I guess I'm being a little lackadaisical about it, but it's very frustrating to have to keep feeling sleepy and exhausted all the time, and also have a bad short term memory.

The last mask I tried from the former DME was clearly labeled 'NOT FOR HOME USE" I made the appropriate excuses-money problems, etc. returned it.
---And bought a 'real' one from cpap.com.
The last mask from current DME was opened and missing the hose coupler for the quick clip--the little piece. --Not usable without it. Duh!

Beyondtired,

Have you or your insurer been charged for those sample masks he's giving you to try out? I hope not because these are clearly samples, not brand new in the packaging masks. Therefore I would not worry about the 30 days at all. Figure out which one you like (or find out if you don't like EITHER) and then tell him you're ready for a purchase.

As far as the Swift FX--its greatest attribute is also its greatest flaw. The fact that it is so loose and soft also means that it is not very stable. But there are things you can do to stabilize it without making it too tight. See my blog link below for Swift FX Fitting Tips. Namely, you can sew some velcro hook tape (the stiff side) in the inside back strap to keep it from slipping on your head. And, if you hang the hose with a commerical or homemade hose hanger, the weight of the slinky hose won't pull it out of your nose. If you like the Swift FX but just can't get it stable enough, consider the Swift LT (there's a "for her" version if you have a smaller head). It is very comfortable and much more stable.