Fired by my DME!!!!!!! :(

OMG -- I just got a phone call from the DME supplier my testing company sent me to, Red Oak Medical in Chicago.

The woman told me they got my Rx from my GP but that no, now they will not be able to help me. My MD specified the PR1 60 on the script and because of that "We won't be able to make any money" if they ordered it. She literally said that to me over the phone.

This is unreal -- they are a contracted BCBS participating DME supplier! They wanted me on a cheaper Intellipap but I can't believe they can do something like this. WOW.

I called BC and reported it and then called the local Respironics rep -- now I just have to go find another DME supplier that stocks the better machines.

At least they faxed me my Rx back. Sheesh!

poopyheads!

put it in writing to your doctor and bcbs with an info copy to the BBB. people on the phone can talk a good game, but do nothing. when a letter comes in, people lose their jobs if it isn't routed to the correct person and something comes up later. always put these kinds of things on paper.

I would also copy your State department of insurance / agency that licenses DME / Home medical equipment as well.

Insurance is a contract - hold their feet to the fire.

be thankful you found out before you entered into a contract with people like this. the licensing authority for your state are the people you want to notify

I suspect that this is insurance of the future. Doctor, or agency can not make enough money, "We do not want you as a patient."

If you can afford to do so and your insurance provider will agree to reimburse you for it, purchase your desired equipment from CPAP(dot)COM and then create an invoice and send it to your insurance provider.

This is what I did seven and a half years ago. My insurance provider considered me to be "in-network" and agreed to reimburse me for 80% of my equipment. I ordered online from CPAP(dot)COM and charged it to my credit card. Then I created an invoice (basically duplicated the one I got from CPAP(dot)COM, complete with insurance codes) and sent it to them.

I've read over the years that BCBS will do that. You might want to check with them.

I have never gotten any of my supplies from a brick & mortar DME. Following that initial purchase, I have also never used my insurance for CPAP supplies or related purchases. All of my subsequent purchases have been out-of-pocket due to the relatively high deductible that I never met.


Den

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purple wrote:I suspect that this is insurance of the future. Doctor, or agency can not make enough money, "We do not want you as a patient."

Aw there is always someone, always, that will want your business. No different in medicine. You don't want to treat me? Fine. There are plenty of enterprising, highly skilled doctors coming here from across the globe who will be very glad to have your job.... The market will provide for the demand.

These people who dumped me probably just set up their business around the profit margins available from handing out specific, cheaper machines. Anything else sets their profit model out of kilter and they would rather avoid the hassle. So f*** em. They want to alienate customers, then fine. Pay the price when people report them on Yelp or whatnot.

I have already called two places that stock Respironics (only) and take my BC plan, so I'll just go with them. Obviously there must be some way these places are able to stay in business stocking the more costly machines. Maybe a deal with Respironics. Maybe a better reimbursement from the insurer.

Spektor wrote:I have already called two places that stock Respironics (only) and take my BC plan, so I'll just go with them. Obviously there must be some way these places are able to stay in business stocking the more costly machines. Maybe a deal with Respironics.

I suspect that they get a better bulk price from Respironics and thus that is why they stock them.

When I first started cpap therapy my DME sold ResMed machines only. They did tell me that they would get me a Respironics machine if that is what I just had to have because they wanted my other business.
He was very up front on the fact that they really had to pay for a special order machine more than they had to pay for their bulk ResMed purchase and they really wouldn't make any money on it but they were nice about it and said they would do it. As it was I found a private purchase machine that was less than my copay if I had used my insurance so I bought privately. That was 3 years ago.
Since they had been willing to work with me and had offered to get what I wanted... I elected to still use them for mask supplies.
Last fall I went in to get a new mask and low and behold...they are now stocking Respironics machines. So I just asked him "got a better bulk deal on Respironics machines" and he was honest and said "yep sure did".

Your first choice for DME that offered only the Devilbiss machines probably was in a similar situation and for them to special order another brand would have cost them more money and they elected to choose machine profit margin over any further business from you for any other supplies that you might be going to buy. So now you found someone who will happily supply the machine you and your doctor wanted and they also make money and also get the benefits of further supply sales.

Spektor wrote:OMG -- I just got a phone call from the DME supplier my testing company sent me to, Red Oak Medical in Chicago.

The woman told me they got my Rx from my GP but that no, now they will not be able to help me. My MD specified the PR1 60 on the script and because of that "We won't be able to make any money" if they ordered it. She literally said that to me over the phone.

This is unreal -- they are a contracted BCBS participating DME supplier! They wanted me on a cheaper Intellipap but I can't believe they can do something like this. WOW.

my guess is they will make money but can make more money some other way, maybe they should sell drugs on a street corner.

the love of money is the root of all evil

I think you should appreciate their honesty, rather than giving you the lies and runarounds that many other DME's do. You were saved from wasting a lot of time and energy with them as they would try to steer you toward a lesser machine.

I don't think the DME has an obligation to do business if it doesn't make a decent profit for them. But it's also somewhat short-sighted of them. Presumably, a little less profit in the beginning could earn them a lifelong customer for supplies and replacements--in the long run they could make a very decent profit. Surely some DME's will want your business because they recognize this.

Be sure you tell the sleep center about this in writing. Perhaps they don't want to continue to refer people to a DME who chooses not to supply equipment the doctor orders.

Janknitz wrote:I think you should appreciate their honesty, rather than giving you the lies and runarounds that many other DME's do. You were saved from wasting a lot of time and energy with them as they would try to steer you toward a lesser machine.

I don't think the DME has an obligation to do business if it doesn't make a decent profit for them. But it's also somewhat short-sighted of them. Presumably, a little less profit in the beginning could earn them a lifelong customer for supplies and replacements--in the long run they could make a very decent profit. Surely some DME's will want your business because they recognize this.

Be sure you tell the sleep center about this in writing. Perhaps they don't want to continue to refer people to a DME who chooses not to supply equipment the doctor orders.

Hehehe .....well the sleep study people are apparently owned by the same people who own the DME company. So I bet they must know something. Going to be kind of awkward when I have to schedule that titration study in a few weeks....

I wonder if its even legal to own both businesses and refer your patients from one to another....

Do yourself a favor, and avoid the drama. At least the DME supplier was honest enough to not play games and waste your time. Therefore, instead of wasting any more of your time and going after them for turning down your business, just find a new DME supplier that will fill your CPAP Rx and take care of your future DME needs.

Spektor wrote:Hehehe .....well the sleep study people are apparently owned by the same people who own the DME company. So I bet they must know something. Going to be kind of awkward when I have to schedule that titration study in a few weeks....

I wonder if its even legal to own both businesses and refer your patients from one to another....

this is exactly the kind of business arrangement everyone should avoid at all cost. they cannot have your interest in mind

unless there is one person who works at both places it is not likely they talk to each other on this level

Sorry to hear about your bad encounter! But good for you for standing up and not taking any of there crap. You get the best machine you can, as you will be using it everynight, for your treatment. Let us know how you make out.

Mike