Dr.'s rant on DME... advice for my next step???

birdiebaby · Post by **birdiebaby** » Wed May 24, 2006 10:17 am

I accompanied my husband to the sleep doctor yesterday. After talking to my husband, he asked me how I was doing. I told him that I was still waiting for the machine.

I gave him the summary... DME had the order on May 2nd, Ordered the machine on May 11th, and told me that it would be about a week. I told him that I have called and left messages for them and have not received ONE phone call from them even to let me know that they had received an order or that it would be late or that they got my messages.

My dr proceded to RANT about the DME and how poor their service is. He said that I should email them and copy him on it, and that I should also write my insurance company about the poor service I am receiving.

I am going to call today and ask the receiptionist for an email address. I'd also like to know if anyone has any other suggestions. The message that I left yesterday made me feel like a bill collector! I really like to treat people as I want to be treated, but I think I'm over it!

sleepylady · Post by **sleepylady** » Wed May 24, 2006 10:32 am

BB,

This is ridiculous!!!! You are their customer. If they can't help you with this one item, then I see a big problem if you try and continue to work with these people. My suggestion is that you call your insurance company and let them know the problems your having with this DME. Then ask what other DME's they participate with. From that list call those DME's and "interview" them. In other words, tell them what equipment you want and if they keep it on hand. Try to find one that deals with the product you want. You may also want to contact billmyinsurance.com and see if your insurance will work with them. If so, then I suggest you order online.

Good luck and keep us posted.

Melinda

Guest · Post by **Guest** » Wed May 24, 2006 10:39 am

Just tell them you are going to another DME. If you still don't hear from them it shows they have no concept of customer service. Did you get referred to them by your doctor? Some how it think it was your insurance......

birdiebaby · Post by **birdiebaby** » Wed May 24, 2006 11:45 am

I was referred by the insurance company. They have an exclusive contract with Apria, so I can go elsewhere, but it will be 100% out of pocket for me. My first thought was to purchase my machine from cpap.com, but now I'm a little strapped.

The service is appalling. How many people would loose their job if they waited 10 days to respond to an order then another week to place the order with the supplier! She said it would take a while because they were having problems getting the machines in. I called Resmed and asked if there were were a backorder for the S8 Vantage. They said no... call the supplier again.

ARRRRRGGGGHHH!

OK.. I have the lady's email address...

johnnygoodman · Post by **johnnygoodman** » Wed May 24, 2006 12:47 pm

BirdyBaby,

Sounds like you have CIGNA, which does have an exclusive with Apria. If this isn't the case, you should give BillMyInsurance.com a call and see if they can help you. They accept BCBS, Humana, Medicare and United Healthcare.

Johnny

Mile High Sleeper · Post by **Mile High Sleeper** » Wed May 24, 2006 1:07 pm

birdiebaby, the same thing happened to me with Apria. They LOST my prescription. When I followed up, it took an extra 3 weeks of suffering before I got my machine. Machine is excellent. But Apria set the prescription incorrectly! It took me 2 1/2 months to find out that machine was set for split sleep study, so I was only getting the therapy for half the night. Next, they sent a wrong size mask. Next, they reset the pressure, again making the same mistake in sleep mode (half the night). It was like pulling teeth to get them to give me a copy of the software printouts. Mask fitting was little more than taking it out of the box.

Apria seems to have an inability and disdain for communication between customer service (regional) and the local branch, whether by phone or computer system. They gave me inconsistent, opposite answers on how to deal with them, depending on who I talked to. They never return my phone calls. My stress in dealing with them was huge with subsequent health effects. Now they don't know how to authorize a mask my insurance will pay for, and aren't getting back to me, as usual. Unfortuately, they are the only DME available on my PacifiCare HMO plan.

dllfo · Post by **dllfo** » Wed May 24, 2006 1:23 pm

I PM'd you. Lots of people have trouble with Apria, but I haven't. Oh, I gripe because of some minor things, but I got my machine in ONE DAY. If my long PM does not put you to sleep, it should work with them. If nothing else, call Courtney at the number I gave you. She said it would be ok to give her name/number out for people having trouble with Apria.

I have Tricare (US Govt) and they use Apria. Tricare can be a pain in the
Gluteus Maximus. But I have pursued my healthcare treatment aggressively
and have had EXCELLENT results. I have also filed two congressional
investigations on them when the goof up was bad enough. It is not nice to say, but if they perceive you will go away and wait. I am afraid some companies will be fine with that. It feels like they are telling us..if you were REALLY sick or if you REALLY needed the CPAP machine, you would be beating on their door to get one. Sad, and I may be wrong, but it doesn't feel that way most of the time.

Good luck.....

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birdiebaby · Post by **birdiebaby** » Wed May 24, 2006 2:31 pm

Yaaaaahhhhhooooooooooooooooooooooooooooooooooo
Sort of anyway...

I left two more messages today and FINALLY got a call back. My machine is in, and I am going to pick it up tomorrow. The bad part is that they don't have the mask. I'm trying to grasp the image of me sitting up tomorrow night sucking on hoses without a mask...

For anyone else who has to order a 'special' machine (ie., anything other than Respironics' equipment) They supposedly have to go through 'corporate' for approval to order something different. I don't really believe that especially since that was the SECOND story I've gotten on the delay.

So, after I get fitted for the mask tomorrow, I may just buy my own darned mask from cpap.com after I know what size to get.

Thank you all for your responses! I'm almost there.....

snoregirl · Post by **snoregirl** » Wed May 24, 2006 2:51 pm

Mile high,

I also have Apria and I also found the guy set my machine for split night.
I luckily have been sitting around here for a month reading posts and when I got the machine yesterday, one of the first things I did was to check ALL the settings and fix the split night.

Thank goodness for this forum!!

sleepyinsunnyvale · Post by **sleepyinsunnyvale** » Wed May 24, 2006 5:44 pm

CIGNA no longer deals with Apria, at least here in No. CA.
Several months ago I was informed that I would need to switch from Apria to Centrix (or some name like that). After my first conversation with the new DME it was clear that the Centrix relationship was going to be quite stressful. I called CIGNA and asked if I could order it from cpap.com and submit a bill. . No problem and best of all no DME.

Bookbear · Post by **Bookbear** » Wed May 24, 2006 6:13 pm

Birdiebaby, earlier you said:

"The message that I left yesterday made me feel like a bill collector! Twisted Evil I really like to treat people as I want to be treated, but I think I'm over it! "

Yes, dealing with Apria (or most DME's) WILL develop an edge in you. heeheehee, don't worry about it, it will serve you well in future dealings. But isn't it sad that so MANY people have had such terible experiences.

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Guest · Post by **Guest** » Thu May 25, 2006 6:26 am

Cool topic, very intresting!

pratzert · Post by **pratzert** » Thu May 25, 2006 7:53 am

[quote="sleepyinsunnyvale"]CIGNA no longer deals with Apria, at least here in No. CA.
Several months ago I was informed that I would need to switch from Apria to Centrix (or some name like that). After my first conversation with the new DME it was clear that the Centrix relationship was going to be quite stressful. I called CIGNA and asked if I could order it from cpap.com and submit a bill. . No problem and best of all no DME.

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Sleepyinsunnyvale...

I also have CIGNA ( I'm on the East Coast ) and just very recently went through the "DME Dance" with Apria. CIGNA told me they had a National Contract with Apria and had to use them. I wonder if Cigna is going to make a change... I can only hope. Cigna only signed the contract with Apria this past February. BUT... there was an alternative.

I too, ordered my machine from cpap.com and am submitting my bill to CIGNA for reimbursement as an "Out of Network" expense. This will cost me a $300 deductable and then CIGNA will pay 60% of the remaining amount.

If I had used Apria, I would have been covered 100% with no deductable, but I fought with them for a month to get the machine my Doctor prescribed to no avail.

So, it is costing me out of pocket money, but I got the machine my Doc said I needed and have finally started my therapy.

Apria was impossible to deal with. Arrogant, idiotic, rude, uncaring, and just plain old stupid are my thoughts on Apria. I know a "few" have had better luck with them, but an overwhelming majority have reported bad experiences with them.

Wulfman · Post by **Wulfman** » Thu May 25, 2006 9:31 am

pratzert wrote:If I had used Apria, I would have been covered 100% with no deductable, but I fought with them for a month to get the machine my Doctor prescribed to no avail.

I just can't comprehend this! A DME should fill the prescription as per the way the doctor has filled it out. Would they be able to change your prescription if it related to oxygen? (IE: "Well, we don't think you really need 5 L of oxygen and we're only going to give you 2 L.")
Or, "You can get by with only ONE crutch for that broken leg, can't you?"

Den

snoregirl · Post by **snoregirl** » Thu May 25, 2006 10:10 am

You may not comprehend it but it is so true and sad.

I was able to get my AUTO machine from Apria only because I waited them out and kept working on it. I had a used machine (straight cpap) so I knew I had time to play the game and still start CPAP. Having the used machine made me less crazy and gives me a backup machine. Total time from last Sleep study (titration) to machine (the one that I wanted) about 3 months.

Not all of us are even as lucky as $300 deductable and 100% coverage out of network.

Mine is about $1000+ deductable out of network and 60% coverage, so if I chose to go CPAP.com the total bill was mine. That is why I chose to get the used machine and fight the good fight, knowing if I really lost I would go for the Auto from CPAP.com.

The $300 deductable for the and 100% coverage pratzert has is about as good as my in-network coverage (20% copay of an inflated Apria price after deductable of $618 -- which was met for my sleep studies for this year at least).

I envy you folks with 100% in network coverage and a reasonable out of network deductable.

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Machine	Mask

Additional Comments: Avg. AHI .4