DME Tricks

monarch22 wrote:Early2rise, that must have felt so good to be in control of the situation and not let them take advantange of you or even waste your time arguing with them. You should be very proud of yourself!!

Yes, it does feel wonderful as I am working with a much better company now and my machine is on order

OldLincoln wrote: Early2rise has it right about talking to then BEFORE they fill it. If they fill it they will tell you it's filled and you have to take what they give you. Not true but that's what my first one told me (before I found this site).

Thanks OldLincoln, I have learned so much from everyone and its blessing that I stumbled across it.

Otter wrote:

CruzTerri wrote:What I find very interesting is that I started CPAP therapy on 1/10/2011; however, neither my DME nor my MD have ever requested to see my data (full or otherwise).

You must be doing very well, then.

Well, I sure think I am. Check my data every morning, (really need to change that to once a week or so), I'm staying at 2 and below for AHI. No more bathroom breaks; no more dry mouth, no more snoring, no more falling asleep at work (and else where). I have this site to thank for my success.

CruzTerri wrote:I have this site to thank for my success.

You and hundreds of others here, Terri (including me). Congrats!

CruzTerri wrote:
What I find very interesting is that I started CPAP therapy on 1/10/2011; however, neither my DME nor my MD have ever requested to see my data (full or otherwise).

If you are on Medicare, the DME is required to prove your compliance within the first 90 days of use, so if they have never bothered to check it means that somebody faked your info to Medicare. Most--but not all--insurance companies also want to see some proof of compliance.

If you're wondering about paying an upgrade fee, check out my "Don't Pay that Upcharge" blog post here: http://maskarrayed.wordpress.com/dont-p ... -upcharge/

In most cases, it's illegal in your state and/or a violation of your insurance company's contract with the DME for the DME to charge you more than the insurance company's allowed amount. It is always illegal for a Medicare patient, UNLESS the DME does not take assignment (most do, if they want to stay in business). HMO's are different, and in the case of an HMO you may have to pay an upchage, but it's always worthwhile to research this before paying the upcharge because in most cases it is not permitted.

Janknitz wrote:

CruzTerri wrote:
What I find very interesting is that I started CPAP therapy on 1/10/2011; however, neither my DME nor my MD have ever requested to see my data (full or otherwise).

If you are on Medicare, the DME is required to prove your compliance within the first 90 days of use, so if they have never bothered to check it means that somebody faked your info to Medicare. Most--but not all--insurance companies also want to see some proof of compliance.

hehehehe, not old enough for medicare Have Anthem Blue Cross PPO through work - who are paying since I'm getting those EOB's (Explanation of Benefits) stating that they have. But still thought that they would want some kind of proof of compliance if nothing else.

Janknitz wrote:

CruzTerri wrote:
What I find very interesting is that I started CPAP therapy on 1/10/2011; however, neither my DME nor my MD have ever requested to see my data (full or otherwise).

If you are on Medicare, the DME is required to prove your compliance within the first 90 days of use, so if they have never bothered to check it means that somebody faked your info to Medicare. Most--but not all--insurance companies also want to see some proof of compliance.

If you're wondering about paying an upgrade fee, check out my "Don't Pay that Upcharge" blog post here: http://maskarrayed.wordpress.com/dont-p ... -upcharge/

In most cases, it's illegal in your state and/or a violation of your insurance company's contract with the DME for the DME to charge you more than the insurance company's allowed amount. It is always illegal for a Medicare patient, UNLESS the DME does not take assignment (most do, if they want to stay in business). HMO's are different, and in the case of an HMO you may have to pay an upchage, but it's always worthwhile to research this before paying the upcharge because in most cases it is not permitted.

Jan just signed up for your blog on DME's and thanked you
i posted on my 'changing EME's thread somehwere near the top. Your blog is so good. Thanks