Competitive DME Medicare Contractors Not Filling Orders

I changed CPAP suppliers to one that had a subcontract with a competitive DME contract with Medicare. I have been waiting 3 weeks for the new supplier to "approve" filters for my VPAP. I also need a new mask.

I called today and they said they didn't have all the documentation they needed. I asked why they had not contacted me and apparently they are so backlogged trying to get documentation for every supply order. Are you kidding me? They need all of this to get FILTERS????

Sleep Study
Sleep Study Interpretation
All doctor's notes from all visits
Prescription that is less than a year old (I got a new one last month)
All compliance reports from my doctor visits (from the very beginning)

and Require an annual sleep doctor check-up (I had one just last month)

They already had prescription and sleep study. I'm way past compliance check period but apparently they want to deny if you aren't compliant ALWAYS. I'm 100% compliant as I've been on CPAP for 13+ years.

This is WAY BEYOND what Medicare requires but they keep stating that they have to have all of this under competitive bidding process. So to save a little money, suppliers have made getting supplies very difficult and will find any possible reason to deny.

I told the subcontractor to forget it and called a local DME contractor (not a subcontractor) to see if I get what I need.

Call Medicare, too.
Somebody needs to whup some butt.

Filters are cheap, buy your own online and screw them, but I think Medicare does have new documentation requirements to get coverage from a competitive bidder.

Does anyone know exactly what is really required by Medicare now (not what the DME thinks is required)?

One should not have to go thru all that for filters! I have some filters stockpiled so PM me and I can send you some,
Carrie

I sense there's some restlessness among the natives .

About two months ago I just got on board with Apria when I placed an order for four items. Two were for the S9: One new H5i tank one new ClimateLine Max hose (harder to find find than the regular one). The third item was a Wisp fit pack. The last item were filters of the hypoallergenic persuasion. In two days I got the tank, filters and Wisp fit pack. <happy, happy>. I waited a week and called Apria's local phoneline and was assured they'd special order this wonderful hose for high pressure patients. They also said they call me the next day and update it's status. No call for five days so I called them back and they said they'd check with the warehouse and call me. No call for five days. I called again and had the same runaround. At this point I was so pissed off I thought I'd start a "Why I'm pissed off with Apria" thread on this forum (I wouldn't be the first ). Anyway, this morning the special order hose arrived at my doorstep with no call and no warning. However I'm not complaining... I don't want to get on Apria's blacklist Life can be like this, maybe a sign of the times?

Hi All,
I haven't logged on in so long I forgot password.

I had to reply to this Regarding APRIA and Healthcare in general.......In my part of NC They are saying they have to have a NEW PRESCRIPTION for EVERY mask I order. They also stopped CPAP Clinics (you could walk in from 1:00 to 2:00) In addition they are discouraging you from calling them with a "We will call you back when we get your order" This is new to me, I have usually had no problem getting supplies including masks. I am NOT a mask hog! Only order when needed.
I want to get the Quattro Air for Her. I emailed my "Dr" Monday for script to be faxed to Apria........NO reply all week. Ok, I know they are busy! This is my "Primary Dr"! So I called the office this morning ONLY to be told She is NO LONGER at this location!?! No letter was sent out, no e-mail, NADA, ZIP!...... Now I have another "Primary Dr"!
They ARE getting my script ready, but I just totally lost ALOT of faith in Medical care of any kind today!
This makes me nervous because of my past Cancer diagnosis. I guess we are all just OUT OF LUCK with Healthcare now.
Susan
I WON'T be waiting for them to call, I will be calling back on Monday!

Fatiguedme2 wrote:Hi All,
I haven't logged on in so long I forgot password.

I had to reply to this Regarding APRIA and Healthcare in general.......In my part of NC They are saying they have to have a NEW PRESCRIPTION for EVERY mask I order. They also stopped CPAP Clinics (you could walk in from 1:00 to 2:00) In addition they are discouraging you from calling them with a "We will call you back when we get your order" This is new to me, I have usually had no problem getting supplies including masks. I am NOT a mask hog! Only order when needed.
I want to get the Quattro Air for Her. I emailed my "Dr" Monday for script to be faxed to Apria........NO reply all week. Ok, I know they are busy! This is my "Primary Dr"! So I called the office this morning ONLY to be told She is NO LONGER at this location!?! No letter was sent out, no e-mail, NADA, ZIP!...... Now I have another "Primary Dr"!
They ARE getting my script ready, but I just totally lost ALOT of faith in Medical care of any kind today!
This makes me nervous because of my past Cancer diagnosis. I guess we are all just OUT OF LUCK with Healthcare now.
Susan
I WON'T be waiting for them to call, I will be calling back on Monday!

So in addition to now requiring a photo ID to vote, an ultrasound to get a abortion, and requiring vinegar to make barbecue sauce, the Tarheel state now wants you to get a new prescription each month for a mask cushion?

Hmmmm sounds screwy, even for North Carolina.

There is probably a disconnect in the wiring with some of the staff telling you that. Ask to talk to a supervisor who actually knows what he or she is talking about.

A prescription usually lasts for at least a year. This should be no different.

And it sounds like you go to a group practice clinic? Well doctors quit, move, and die all the time. They are human beings. The clinic will give you a new doctor, or, hey, big idea, you can find one on your own. That new doctor will give you a new prescription if you even need one.

Hyperlexis,
I know Apria is messing with me. I intend on voicing my grievance on Monday. I have been with them since 2009.
My "Primary" Dr Comment wasn't meant to come across as casual as you make it seem. I have MY health to look after, I am upset that she went to another office and I wasn't notified. I am very serious about who is on MY Medical Team because I had a very aggresive form of cancer! I will survive her leaving, just highly upset that there seems to be no concern like there used to be.
Susan

Fatiguedme2 wrote:Hyperlexis,
I know Apria is messing with me. I intend on voicing my grievance on Monday. I have been with them since 2009.
My "Primary" Dr Comment wasn't meant to come across as casual as you make it seem. I have MY health to look after, I am upset that she went to another office and I wasn't notified. I am very serious about who is on MY Medical Team because I had a very aggresive form of cancer! I will survive her leaving, just highly upset that there seems to be no concern like there used to be.
Susan

Yes, alas such concierge service has gone the way of housecalls, well-uniformed nurses, and dressing up for an airline flight during which you would actually be fed.

Although some things are getting somewhat better. Medical care is more advanced, and last week I actually got my lab results sent by an internet link from the lab company. Pretty nifty.

Hopefully the new doctor you get will be even better than the prior. Stay positive.

Honestly, Medicare has made some major changes and frankly the new system is unsustainable. Competitive bidding has accomplished exactly what it set out to do -- it put the caring, mom and pop providers out of business leaving only the largest and cheapest in a futile attempt to undercut one another.

In my neck of the woods "bid winners" are actually turning away customers due to the sheer volume of people forced to switch providers..

How this is going to improve our quality of care is beyond me......

If I have to dip into my PEHP account for anything I should get through Medicare, but can't,
I will be filing complaints, speaking to media, and raising holy heck!

jdr999 wrote:Honestly, Medicare has made some major changes and frankly the new system is unsustainable. Competitive bidding has accomplished exactly what it set out to do -- it put the caring, mom and pop providers out of business leaving only the largest and cheapest in a futile attempt to undercut one another.

In my neck of the woods "bid winners" are actually turning away customers due to the sheer volume of people forced to switch providers..

How this is going to improve our quality of care is beyond me......

Um, you're on Medicare?

Ummm, at 44 years of age?
Good catch, hyperlexis.

Just a FYI for Medicare users....If you use a Medicare Advantage plan, the competative bidding does not apply. You can get your supplies from any DME in your plan. This is the time period you can select your plan for the next year. If you have Medicare Advantage Plans in your area, at least look at them. There are some good ones and some not so good. I have used the AARP Medicare Complete Plan for 3 years and love it.

Unless you are with Humana Gold plus. Than your one and only option is Apria,