Let's clear up some misinformation

rocklin · Post by **rocklin** » Tue Jan 24, 2012 1:52 pm

ems wrote:I vote for ending this thread on the above note.

WTF? Uh, darlin', do you have any idea of the prep work that was put into this thing?

Let's scotch any censorship impulses pronto.

Check your PM, K?

The Choker · Post by **The Choker** » Tue Jan 24, 2012 1:57 pm

idamtnboy wrote:
The Choker wrote:There is not a dime's worth (2012 dollars) of difference between your beloved Democratic Party and the Republican Party.
Actually, neither one is my beloved! Believe it or not, I voted pretty much straight Repub until W changed my thinking after his first 4 years.
It is just a simple matter of whom they target to get reelected.
That's for sure. Carl Rove honed that concept to a fine edge with regard to right wing Christians. That method gets reinvented and refocused about every 12 years.
Do you think either one of those parties will do anything bold to deal with the three big spending items that are driving the borrowing and threatening to destroy this country: Military spending (and military adventurism), Medicare, and Social Security?
Actually RR did a great job with revamping SS back in the early 80's. Of course, the only way he managed to get it passed was to delay some of the more major impacts (like full retirement age) for 20 years, but at least he was astute enough to know how to do it. W, on the other hand, saw nothing wrong with letting a private contractor be paid $2 million to do a job the Feds could do for $1 million, especially with military functions. In fact, he saw it as a win-win. Reduce the size of the Federal workforce and give work to private contractors. Ignore the fact the taxpayers were getting screwed.

Now surely you don't think either one of these parties is more interested in opening up the healthcare and insurance markets than they are interested in their own reelection, their own power, and their own financial enrichment!
They never have been, and never will be, except for an occasional politician, who usually ends up being thrown onto the trash heap of expired politicos.

Sorry, I will end my part of this particular discussion with you. I have interests in the future of medical and health care and not in rehashing who voted for whom and who made a mess out of what. All are valuable points and important for knowing what does not work. But at this point I want to move forward.

idamtnboy wrote:They never have been, and never will be, except for an occasional politician, who usually ends up being thrown onto the trash heap of expired politicos.

I am only interested in discussions where the parties involved believe major restructuring and improvement can and will be achieved.

Besides this seems to be very much a nuts-and-bolts discussion between ltts and others about the present situation.

Good day,

ems · Post by **ems** » Tue Jan 24, 2012 2:06 pm

rocklin wrote:
ems wrote:I vote for ending this thread on the above note.
WTF? Uh, darlin', do you have any idea of the prep work that was put into this thing?

**Yes I do... over, and over, and over and over again!

Let's scotch any censorship impulses pronto.

**I'm not for censorship of any kind - but when the same thing is said a hundred times and one side isn't hearing the other, after 20 some pages it's time to stop, doncha think?

Check your PM, K?

**PM? Nope.

SleepingUgly · Post by **SleepingUgly** » Tue Jan 24, 2012 2:08 pm

I stopped receiving notifications on this thread, and now I'm pages behind, and I'm sick and can't read posts longer than a few lines without zoning out, so I can't catch up. Is it fair to say that we stand in the same place we stood 5 pages back: Everyone is pissed at the OP, who they think isn't listening, and the OP thinks everyone is not listening to her (and why do I keep thinking it's a "her")? Am I all caught up?

Would it have made all the difference in the world if the OP had come in and said a bunch of validating things about our bad experiences with DMEs, how tough it is to be sick and tired and have to be hassled every step of the way toward therapy, yada yada, and then launched into her schpill? Is it as simple as that? (And why am I the only one who seems enthralled with the process here (and long ago lost track of the content)...)

I think the OP offered at least a couple useful pieces of information: Things may suck for us more as competitive bidding takes hold (yay, got that to look forward to ) and if your DME is doing something wrong, cut them off at the knees by complaining about them to their accrediting body. I do think it's useful to know what's permissible (even if it's WRONG in my book, like giving someone a used machine of a smoker!), as it would be embarrassing to complain to the accrediting body about something that is actually allowable.

Can we not find some common ground like we all hate insurance companies, or something? (((group hug)))

NightMonkey · Post by **NightMonkey** » Tue Jan 24, 2012 2:11 pm

jnk wrote: You claim we are ignorant because we don't fully know or understand what goes on between DMEs and insurance, but that is a testimony to your failure to appreciate that such details are not our concern.

...

Learn or don't learn. It is up to you.

You might want to consider taking the advice to learn and avoiding the attitude of "such details are not our concern".

It is up to you.

GTOJim · Post by **GTOJim** » Tue Jan 24, 2012 2:37 pm

I will do a short recap of my local DME the only one my insurance let me use.

Always shipped incorrect items, usually returned telling them to forget replacement. What I didn't know is the DME was not
crediting my insurance for any returned items.

Insurance billed many times for the same item, billed amount sometimes changed, resulting in insurance sometimes paying more than once for the same
item.

Insurance billed for a complete face mask when I ordered and received a cushion. DME claimed insurance only paid them for a cushion, statement from insurance showed they paid 3X over what the DME stated was paid by insurance.

Countless billing errors, yet not one time once in my favor.

Replacement CPAP. Non respiratory therapist regularly issuing CPAP's. After a sleep study, took doctors prescription to DME. I was given a
factory sealed box with a brief explanation of how to install the filter. This person said " If I was incapable of installing the filter he would
do it for me". CPAP not set to doctors prescribed pressure.

What the OP said would be great in a prefect world, unfortunately we don't live in a perfect world.

SleepingUgly · Post by **SleepingUgly** » Tue Jan 24, 2012 2:47 pm

Doctors could be more useful in this regard. As the OP said, if a DME cares about a referring doctor's business, if a doctor would call the DME pissed at the service the patient is getting, the DME might snap into line faster. So damn the insurance companies, the DMEs, AND the doctors!

ems · Post by **ems** » Tue Jan 24, 2012 3:11 pm

SleepingUgly wrote:So damn the insurance companies, the DMEs, AND the doctors!

But, I really like my doctor!

SleepingUgly · Post by **SleepingUgly** » Tue Jan 24, 2012 3:19 pm

ems wrote:
SleepingUgly wrote:So damn the insurance companies, the DMEs, AND the doctors!
But, I really like my doctor!

Traitor!!

ems · Post by **ems** » Tue Jan 24, 2012 3:24 pm

LOL!

Edit: A little humor is good for the soul. My neck is already more relaxed.

BlackSpinner · Post by **BlackSpinner** » Tue Jan 24, 2012 3:25 pm

SLeeping Ugly - she basically came down to:
a) Insurance companies rip people off and are bad. (like we didn't know that)
b)The poor struggling DME should be cut some slack by us sick people so they can make lots of money ripping off both us and the insurance industry (and probably in order to keep the mentally deficient employed).
c) We should all just suck it up and be good little dumb patients.

jnk · Post by **jnk** » Tue Jan 24, 2012 3:36 pm

NightMonkey wrote: It is up to you.

You may have misunderstood my intent. I will clarify my meaning, Mr. Monkey, if you don't mind. (No one else has to read this, of course. I know I won't. )

I have no way of knowing how much my DME paid for my machine and how much profit they make after overhead. I will not volunteer my time to tighten up their business practices or to renegotiate their contracts for them. The pertinent information, the detail of that, is in private contracts of which I am not a party and for which I cannot be held responsible. It would, in my opinion, be inappropriate for me to ask for that information. However, if they want to draw me in, to enter into the fray of judging what they can or cannot afford to give me, and especially if they claim my insurance doesn't pay enough, and they expect me to believe that, then the only way I could verify their claim would be for them to allow me to come audit their books to verify their claim that they would go out of business if they give me a decent machine with average features. If they are unwilling to prove the statement in that way, then their statement is all about "details" I can't be concerned with, as a practical matter, since I have no way of finding out. In that sense, it is not up to me, since I have no way of learning that information.

Furthermore, I don't care if the word "deluxe" is one used by insurance in certain settings; it doesn't make it so. I also, as I said, do not care what color paper the forms from insurance are that the DME has to fill out. I don't care how many hours it takes a DME to fill out that paperwork. I don't care about their electric bill or their lease on the office space. I don't care about their retirement plan. I don't care how much they pay the RRT to pretend to set up the machines. I don't care about how they pay their taxes. That is their business. Not mine. I don't care why they choose to be compulsive liars to me, as long as I recognize the lies. What I DO care about is whether or not they force substandard machines on me and the other patients they attempt to vicitmize by doing so. All the whys of their doing so falls under the category of "excuses," as far as I am concerned. Negotiate a better contract, or get out of business so that you stop victimizing patients. Because if the only way you can stay in business is to victimize patients, you need to go out of business in order to be able to wake up with yourself in the mornings.

However, the thought process, overall, that the OP is explaining is one that I agree with you that we all need to learn and learn well. As I said:

jnk wrote: I say, listen closely to what the OP has said. It represents what many believe and what we may be hearing more of in the months and years to come, as money gets even tighter.

NightMonkey · Post by **NightMonkey** » Tue Jan 24, 2012 3:51 pm

Sorry, you did not need to write a long explanation for me.

However, if they want to draw me in, to enter into the fray of judging what they can or cannot afford to give me, and especially if they claim my insurance doesn't pay enough, and they expect me to believe that, then the only way I could verify their claim would be for them to allow me to come audit their books to verify their claim that they would go out of business if they give me a decent machine with average features.

I hope you meant that as a ridiculous strawman.

The only point from me is whatever you are dealing with from mushrooms to mops to myloectomies, make sure you understand what you are contracting for and what it will cost you and what your alternatives are.

There is something about medical care that seems to blind us: We don't look at the prescription, we don't understand what the supplier plans to deliver, and we did not find out what it will cost us. You would not buy a car like that eh?

(Reply: Under the stress of untreated apnea judgement will not blah, blah, blah, )

NightMonkey · Post by **NightMonkey** » Tue Jan 24, 2012 3:56 pm

SleepingUgly wrote: Everyone is pissed at the OP, who they think isn't listening,

To the contrary, I am not pissed at the OP and I do think she is listening.

I think she is up against a lot of poorly informed, long and convoluted diatribes.

But I don't know what she is doing here and why she would spend such time and effort.

What am I doing in this thread???

jnk · Post by **jnk** » Tue Jan 24, 2012 4:05 pm

NightMonkey wrote: . . . make sure you understand what you are contracting for and what it will cost you and what your alternatives are. . . .

Maybe YOU are smart enough to understand DME policies (if you've ever seen them in writing, that is) and all the ever-changing fine print of insurance policies that never quite work out the way things read in plain English, but I AIN'T, and I certainly can't afford to hire YOU!

Thanks for you thoughts, though, NightRooster!

Let's clear up some misinformation

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