Should Sleep Dr Choose DME for me?

I can understand why a sleep center might send their prescriptions to a specific DME, but I don't like it.

I suppose there might be reasons for it that aren't evil such as being easier to deal with, having better stock, or the like.

There could also be inappropriate reasons, such as free pizza lunches for sleep center staff, an owner who gets frisky with the sleep center director, and so on.

As noted above, this is analogous to pharmacies. When I write prescriptions, I don't have much business where they're sent. I do sometimes point out that if the prescription is sent to a specific pharmacy it won't be covered and the patient will have to pay out of pocket. Once I've had to re-do enough prescriptions I will eventually refuse to send something unless the patient agrees that I won't re-do it. Despite warning people in writing and having them sign the acknowledgement that it won't be covered and I won't re-do it, at least once a week someone claims they never knew it wouldn't be covered at that pharmacy and requests I re-do a prescription! Apart from issues like this that cause me needless work, I really couldn't care less what pharmacy or DME a patient uses.

Thus, if it's known that a patient's prescription will only be covered at one DME (which is unlikely), there are plausible reasons just to go ahead and send it there. I still think the proper thing would be to tell the patient that it's believed the only place she can get her machine that will be fully covered by her insurance is that one specific DME and ask if the patient wants the prescription sent there or if they want it written so they can do whatever they want with it.

My doctor picked my DME and I couldn't be happier. I went in prepared with my "demands" for a specific machine, etc, and they already had the top-of-the-line equipment for me. They said my doctor requested that equipment specifically for me. My thought is, some doctors have good relationships with some DMEs and you don't get ripped off. I suggest checking it out, knowing what you need/want, and if they won't do it, shop around.

My experience has been much like Indyzoom's.

After my titration, my sleep tech told me they would call me and see where I wanted my script faxed to... I had no clue at that point. She said just let us know, we can't tell you who to use. I like that. So I came here and did more homework.
When they called, I told them I would come pick it up. It was both full reports and the script. I took it to the library, made 3 copies and went DME shopping. I am happy with the results.

Find out who the local in-network DMEs are. If you have a preference, go with it. If you want to go to the one your doctor chose, go with them.

Before you accept a machine, figure out what models are unacceptable and which ones are OK. Figure out if you have a preference. Before you go to pick up your CPAP machine, tell the DME what machine you want or ask the DME what machine they are going to supply you with. If you don't like the answer, call up another DME and tell them what you want.

It's better if you have a copy of your prescription. That helps you order supplies online in the future. However, if you don't have a copy, the DME should be able to get one directly from the doctor.

While I'm skeptical of the medical mafia, a "cozy" relationship between a doctor and a DME is not necessarily bad. A good, honest doctor may know the people at XYZ medical, know (or think) they do a good job, know how to work with them, know what they are capable of, etc. If the doctor works with that company a lot, he may be able to arm twist them a little to get things resolved.

Of course, a cozy relationship can happen for the wrong doctor, or the DME may be doing a bad job and screwing the patients, but giving the doctor the impression they're doing a good job.

chunkyfrog wrote:but they are all profit-centered operations.
Whenever you lose, they win.

My current DME is part of a non-profit heath care company. My previous DME (insurance change made DME change necessary) while a for-profit company has an approach I would better describe as win-win - help people get what they need while still making money. While too many companies don't care how they make a profit, there are plenty out there who truly want to help people while making money.

9 times out of 10, if a sleep lab is "automatically" sending Rx's to a DME, it's because there is a financial relationship. A reputable lab will give you a list of area providers and let YOU make the choice. Be very wary of a lab that faxes your Rx without your consent or input. Ask yourself this, does your doctor pick your pharmacy for your drug prescriptions?

There are no non-profits here that I know of and can access.
So far, of the others, two are not adverse to balance billing; one even falsifies codes to get a higher insurance payment.
I will be changing after the first of the year--giving someone else a chance to be decent.
I plan to fulfill my deductibles where I get the most bang for my buck.

chunkyfrog wrote:DME's are essentially pharmacies for devices, instead of drugs.

As such they also should have a "Patient Counseling Window," though I'm sure many of them don't offer any advice or counseling at all. I was lucky. When I left the sleep center I was given a form to fill in which included a list of all the local DMEs. I was asked to select up to three I would prefer to use. They sent the Rx to a different one from the ones I checked! The reason was, I was told, was this particular DME had a staff member who lived only about 10 miles from me so it would be more convenient to home deliver the machine to me. All them had offices 30 to 50 miles from me. Fortunately the doc prescribed the S9 Autoset with Climateline. I believe he only prescribed data capable machines. So far everything has worked out OK with this DME.

I'm back from my holiday vacation and ready to hit the ground running with the CPAP. While on vacation, I used my dad's CPAP and mask at my setting of 6. Unfortunately, I had other health concerns ( respiratory infection and bad side effects from the antibiotic) so I couldn't tell if it made a difference in my sleep. I did seem to dream more and woke up relaxed, but that could have been because I was on vacation and not the machine. Of the 8 days I was gone, I use the machine 6 nights and, for the most part, kept it on the entire night. I had no trouble sleeping with the mask (Mirage Quattro). One night I was just way too congested to use it, and the last night I had an allergic reaction to something (most likely the antibiotic), and was told not to use the CPAP.

I have an appointment on Friday to pick up mine. I decided to call the sleep center and ask for the specifics of the prescription. It was written for a PR System One REMstar Pro CPAP Machine with C-Flex Plus, humidifier, and Swift FX nasal pillow (Same one I used during the titration). From what I can gather, this is a decent machine that is fully data capable. Provided the DME doesn't try to change it, I should be good to go.

I was looking at the Sleepyhead software and it should work with this unit too, so I'll probably play around with it and the Encore Viewer software (I assume I'll get that with the machine?) to see which I like better (I'm a computer tinkerer). I can't wait to get it and start tracking my progress!

Is there anything I should be aware about this machine/mask?

indyzoom wrote:My doctor picked my DME and I couldn't be happier. I went in prepared with my "demands" for a specific machine, etc, and they already had the top-of-the-line equipment for me. They said my doctor requested that equipment specifically for me. My thought is, some doctors have good relationships with some DMEs and you don't get ripped off. I suggest checking it out, knowing what you need/want, and if they won't do it, shop around.

Well, you did not get the "top" of the line when it comes to Resmed because you would have gotten and Resmed S9 Autoset instead of an Elite.

So yes there is in issue with using a pre choosen DME. My sleep doctor actually will fax to the DME of your choice or they will give you a copy of the paperwork and let you do the leg work.

xm41907 wrote:Is there anything I should be aware about this machine/mask?

msradar65 wrote:PR System One REMstar Pro CPAP Machine with C-Flex Plus, humidifier, and Swift FX nasal pillow

xm41907 wrote:I was looking at the Sleepyhead software and it should work with this unit too, so I'll probably play around with it and the Encore Viewer software (I assume I'll get that with the machine?) to see which I like better (I'm a computer tinkerer).

Encore Viewer 2.0 costs $99 from cpap.com and it is doubtful that the DME will supply the software. It is not commonly something they stock. You can ask. If they have it..it won't be free and it is not something insurance will usually pay for.

Check my signature line for the PR S1 machine software options link. Viewer does NOT show the wave flow graph line. So it doesn't show the individual breaths that SleepyHead shows or the wave form data that is available with Encore Pro.

I have all the software choices available to use and I prefer SleepyHead. It shows all the same data and more and you can do so much more with it. If you want Encore Pro or Viewer send me a private message...no sense in paying for it unless you don't sleep well if you don't pay for Viewer.

The PR S1 Pro CPap with CFlex+ is a great machine. I have the APAP version of it. I can get you the provider manual for the PR S1 Pro when you need it.

Good luck and keep us posted.

Thanks Pugsy. I would like the provider manual. Could you email it to me? It sounds like Sleepyhead is a better program so I'll start with it. If I can't get it working right, I might ask you for the others though. I won't get it until Friday. Since the prescription was written for a specific model, I don't expect any troubles with the DME. They already said the insurance is set too.

Be sure it's really a PRS1 PRO machine and they don't "accidentally" give you a "Plus" machine instead. It should say REMstar PRO near the display.

I don't believe Encore Viewer will install on a 64 bit windows machine without some extra tinkering.

archangle wrote:I don't believe Encore Viewer will install on a 64 bit windows machine without some extra tinkering.

This is true. Something in the install Wizard setup.exe fails on the 64 bit computers.
If someone can simply open the disc and manually copy/paste the files and folders to a folder on the desktop and use the application exe file to open the program it works just fine. I did it on my new 64 bit computer. Didn't take but a few seconds to get it up and running. I don't use it but I could if I wanted to.
The problem is with the install process with the install Wizard. Bypass the Wizard and put it on the computer the old fashioned way and it will work just fine.