Let's clear up some misinformation

idamtnboy wrote:

Ltts wrote:I'm not going to create a log in and as a result I cannot post links.

You would enhance your credibility a hell of a lot if you would.

I think any chance of that is long past. Jim

ltts wrote:

snuginarug wrote:I haven't read a single word of this thread, as the OP has an agenda that totally unrelated to the purpose of this forum. The purpose of this forum is for mutual support among patients. The purpose of this forum is not to cater to the insurance company, DME or billing companies that run back and forth between the two.

Now I'll ask the OP a question... why do you care?

I answered that question very completely in the other thread in which you asked it, so I will not repeat it here.

This is not a rhetorical question... I really do want to know, why do you come somewhere you are not welcome to try to change the minds of people who will not change their minds?

You never got around to answering this question. No, really, it is not a rhetorical question. I am a curious person, I like to find the answer to puzzling things. Inquiring minds want to know. Why are you doing this?

snuginarug wrote:Why are you doing this?

Imho, fear.

Lets give the poster a break, it's a terrible thing to live in fear.

Thanks, ltts.

Based on your valuable input in this thread, I will change the wording at that location to the following:

GET A FULL-DATA MACHINE: Your having a machine that can give you leak and apnea-hypopnea index (or, AHI) data will allow you and your medical team to make sure your therapy is as effective and comfortable as possible. Your local DME may feed you the misleading line that AHI data is a "feature not covered by insurance" in an attempt to get you to pay extra out of pocket. That is a sure sign of a DME that has chosen to put maximizing profits ahead of being helpful to patients. A similar trick is to claim that a particular machine (which just so happens to be the one that cost the DME the least) is the "standard" machine and that any other machine is "deluxe." Because of how common such unscrupulous practices are becoming in the DME industry, be sure to get a list of in-network DMEs from your insurance before you speak to any DME. That may allow you to push for a full-data machine, or perhaps allow you to shop around in the interests of fostering healthy competition among businesses. If necessary, get your doctor to put "AHI data" on the prescription. Some users have found it cheaper for them in the long run, and less frustrating, simply to buy their own equipment online instead of paying their insurance co-payments at local-DME prices. Some users have even found ways to get reimbursed from their insurance for online purchases.

New wording is in red.

Thanks again, ltts. It is rare for someone connected to the industry to be so forthcoming on the methods being used to "maximize profits" at the cost of decent patient care for poor, helpless, scared patients in this country who are at their most vulnerable and least knowledgeable and most griftable when they first arrive at the DME. You have done a big service to us all to explain so eloquently exactly how that is being done. VERY helpful stuff.

You have, INDEED, in harmony with the title of your thread, clarified the misinformation that DMEs use to milk patients that they are supposed to be helping.

LTTS wrote:.

There are many differences, the chief one being that online suppliers are not regulated. Many dispense PAP products against federal laws that regulate those products as prescription only. In addition, many operate in violation of state laws that require competent personnel and a state DME license to dispense RX only products.

Reply,

BUT, online suppliers are available on weekends and holidays while DMEs are closed from Friday noon till Monday morning, except may be a phone operator available. How would you feel if your mask's non rebreathing valve got caput and you need to wait for 3 days to get a replacement?

As to comparing DMEs to pharmacies, as you did, here again, many pharmacies are opened on weekends. By law, there should be several pharmacies in a neighborhood opened 24 x 7. So your reasons to prefer DMEs over online sellers disregard many patients treatment. You are concerned mainly with regulations issues.

Another issue is masks returns and replacements. DMEs have no incentive to provide proper time for returning a mask if the patient is not happy with it. This b/c DMEs are in a hurry to sending charges to the insurers.

Thanks again, ltts. It is rare for someone connected to the industry to be so forthcoming on the methods being used to "maximize profits" at the cost of decent patient care for poor, helpless, scared patients in this country. You have done a big service to us all to clarify so eloquently the methods being used to do just that. VERY helpful stuff.

Jnk, here again I am just a newbie, but it is good to read your comment. With all of the name calling and accusations, it is a bit hard to sift throw the odiferous bull droppings and see that there are some very valid points mentioned by many. I too am bitter that, after all of these years of sleep being the last thing I would have thought to be health threatening, I am struck with such a condtion, but I will give all of the DMEs that I may encounter in the future a fair chance to "honestly" let me know what they can/will or won't do.

Those who post on this forum are patients trying to help ourselves and each other get the best health care possible for ourselves and our friends on the forum. We all pay for insurance or government services or privately to earn the right to get treatment. We support each other with our experiences and successes. Anyone who has not shared our experiences with DMEs, insurance, doctors, etc. can NEVER know what we have been through and will NEVER get it! Registering and posting thoughtful refutation is one thing but long diatribes and angry sermons are the signs of a troubled mind.

avi123 wrote:
As to comparing DMEs to pharmacies, as you did, here again, many pharmacies are opened on weekends. By law, there should be several pharmacies in a neighborhood opened 24 x 7.

Comparisons to pharmacies is really eye opening. My pharmacists knows what she is selling. She taught me how to use my inhaler properly. Questioned sudden changes in prescriptions to verify my needs. She checks for any interactions. She doesn't expect me to call an 800 number to make an appointment to buy filters either. I can walk in at any time and request a refill or information on reactions and get a courteous smile. She informed me that I could get the same thing cheaper in over the counter vitamins when I didn't have insurance. When I run out and it is -30c and icy I can call and get it delivered. She doesn't try to sell me the inferior version to make more money. She and her technicians are friendly, competent and upto date.

And she is the owner/manager making a decent living of her capitalist business without ripping off her clients.

I sure wish I could find a DME as decent as your pharmacist--ANY pharmacist, now that I think of it!

chunkyfrog wrote:I sure wish I could find a DME as decent as your pharmacist--ANY pharmacist, now that I think of it!

Amen! My pharmacist is a jewel.

So, LTTS, does this mean that every time a doc prescribes an AutoPAP and the DME fills the prescription, the system is such that the DME loses money because insurance will only pay for a brick?

jnk wrote:Thanks, ltts.

Thanks again, ltts. It is rare for someone connected to the industry to be so forthcoming on the methods being used to "maximize profits" at the cost of decent patient care for poor, helpless, scared patients in this country who are at their most vulnerable and least knowledgeable and most griftable when they first arrive at the DME. You have done a big service to us all to explain so eloquently exactly how that is being done. VERY helpful stuff.

You have, INDEED, in harmony with the title of your thread, clarified the misinformation that DMEs use to milk patients that they are supposed to be helping.

Jnk, I get it! It is VERY helpful stuff to actually read how it's being done, but jaw-dropping nonetheless!

Robespierre wrote:So, LTTS, does this mean that every time a doc prescribes an AutoPAP and the DME fills the prescription, the system is such that the DME loses money because insurance will only pay for a brick?

Maybe I'm missing something here... but... the DME has to fill the script exactly as the doctor wrote it, including setting the pressure, whether the doctor ordered a brick or a fully data compatible machine. If the insurance company pays for it (mine paid for exactly what the doctor ordered), where is the problem? Of course, some ins companies pay more, some less, with some having deductibles and co-payments.

I suspect the OP has disappeared, leaving everyone wondering what this was all about.

Em
Not all prescriptions state exactly which machine to dispense. Mine just says cpap at 11 cm of water. I wish it had said auto or even a brand name, but I have since rectified the problem and have both at straight cpap and an auto cpap.

When I talked to the people at the sleep center last week, they said basically all the script will say is how much pressure will be required to keep my throat open. My referring doc is an internal medicine guy and I doubt that he would question the recommendation that the sleep center will be sending to the DME and them in turn to send the script request to the doc. Am I missing something?