Can a doctor force me to use a specific machine?

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
Guest

Re: Can a doctor force me to use a specific machine?

Post by Guest » Mon Dec 30, 2013 10:21 pm

I have good news to report!!

I had to be back at work today (and can't use the phone while I'm there), so I explained all the details to my husband, and left him a detailed list of who to call, what to say, etc.

The first step was to call and get a copy of the prescription. They tried to talk him out of it, but he had reasonable answers to all of their objections. They were still hesitating, so he finally said, "Would you prefer to send that by fax or e-mail, or would it be more convenient for you if I pick it up in person at lunchtime?" They sent the fax!

It turns out that the prescription was in fact written for one specific machine--and even a specific mask--the one that left my nose feeling bruised for 2 full days after the last study. By this point it was lunchtime, so I was able to call the DME supplier I want to use. She had me fax the prescription to her, and she called the doctor's office to ask if a substitution was possible. Once she started questioning, "I'm curious about why this patient is being limited to one machine...", she said they immediately started backtracking and said I could choose any machine I want. They reissued a new prescription immediately, and the order for my ResMed I wanted will be placed in the morning!!! I'm so excited!

I feel like a huge weight has been lifted off my shoulders, and I'm relieved to know that I'll be sleeping better by the weekend! Thank you all for your advice and support!

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NateS
Posts: 1716
Joined: Wed Dec 14, 2011 8:53 pm
Location: Kaatskill Mts-Washington Irving

Re: Can a doctor force me to use a specific machine?

Post by NateS » Mon Dec 30, 2013 10:44 pm

Guest wrote:I have good news to report!!

I had to be back at work today (and can't use the phone while I'm there), so I explained all the details to my husband, and left him a detailed list of who to call, what to say, etc.

The first step was to call and get a copy of the prescription. They tried to talk him out of it, but he had reasonable answers to all of their objections. They were still hesitating, so he finally said, "Would you prefer to send that by fax or e-mail, or would it be more convenient for you if I pick it up in person at lunchtime?" They sent the fax!

It turns out that the prescription was in fact written for one specific machine--and even a specific mask--the one that left my nose feeling bruised for 2 full days after the last study. By this point it was lunchtime, so I was able to call the DME supplier I want to use. She had me fax the prescription to her, and she called the doctor's office to ask if a substitution was possible. Once she started questioning, "I'm curious about why this patient is being limited to one machine...", she said they immediately started backtracking and said I could choose any machine I want. They reissued a new prescription immediately, and the order for my ResMed I wanted will be placed in the morning!!! I'm so excited!

I feel like a huge weight has been lifted off my shoulders, and I'm relieved to know that I'll be sleeping better by the weekend! Thank you all for your advice and support!
That is wonderful news!

Congratulations!

Happy New Year, Nate

Just out of curiosity, what were their "objections" to complying with Federal Law?

_________________
Mask: DreamWear Nasal CPAP Mask with Headgear
Additional Comments: ResMed AirCurve 10 ASV; Dreamwear Nasal Mask Original; CPAPMax Pillow; ResScan & SleepyHead
Central sleep apnea AHI 62.6 pre-VPAP. Now 0 to 1.3
Present Rx: EPAP: 8; IPAPlo:11; IPAPHi: 23; PSMin: 3; PSMax: 15
"I've had a perfectly wonderful evening, but this wasn't it." —Groucho Marx

Guest

Re: Can a doctor force me to use a specific machine?

Post by Guest » Mon Dec 30, 2013 11:15 pm

The first thing they said was that they couldn't send the prescription to my husband due to the HIPPA laws. He told her that I had included him on the list of people who were allowed access to my medical information. She wanted to know when I had signed that release form, and where it was. After he told them it was part of the packet I filled out on my first visit, and should be in my chart, I think they felt pretty stupid.

Next, she made some snide comment asking if we were going to buy something from some 'no-service' place off the Internet. He said, "No, we have a friend who owns a DME, and we've decided to work with her."

There was a long pause while she tried to think of another objection.

Then she said that this other DME probably wouldn't be in-network for our insurance, so we should really just stay with the one they recommended. He assured her that we had already verified it with our insurance company.

Another really long pause, at which point he prompted about which way they preferred to give him the prescription.

Oh, and at first they said they were going to e-mail the prescription to him, but it never came. They said that the e-mail kept bouncing back because it was encrypted (Does that even make sense?). So then she agreed to fax it, and it came through immediately.

My husband found the whole thing comical because he said he could almost hear the wheels turning in her head for what she could say to talk him out of it. I wouldn't have been so amused, but I'm just glad it had a happy ending.

User avatar
NateS
Posts: 1716
Joined: Wed Dec 14, 2011 8:53 pm
Location: Kaatskill Mts-Washington Irving

Re: Can a doctor force me to use a specific machine?

Post by NateS » Mon Dec 30, 2013 11:39 pm

Guest wrote:The first thing they said was that they couldn't send the prescription to my husband due to the HIPPA laws. He told her that I had included him on the list of people who were allowed access to my medical information. She wanted to know when I had signed that release form, and where it was. After he told them it was part of the packet I filled out on my first visit, and should be in my chart, I think they felt pretty stupid.

Next, she made some snide comment asking if we were going to buy something from some 'no-service' place off the Internet. He said, "No, we have a friend who owns a DME, and we've decided to work with her."

There was a long pause while she tried to think of another objection.

Then she said that this other DME probably wouldn't be in-network for our insurance, so we should really just stay with the one they recommended. He assured her that we had already verified it with our insurance company.

Another really long pause, at which point he prompted about which way they preferred to give him the prescription.

Oh, and at first they said they were going to e-mail the prescription to him, but it never came. They said that the e-mail kept bouncing back because it was encrypted (Does that even make sense?). So then she agreed to fax it, and it came through immediately.

My husband found the whole thing comical because he said he could almost hear the wheels turning in her head for what she could say to talk him out of it. I wouldn't have been so amused, but I'm just glad it had a happy ending.
That is truly delightful! Thanks for taking the time to fill in the detail, so that we could share in enjoying your well-earned triumph!

Best wishes, Nate

_________________
Mask: DreamWear Nasal CPAP Mask with Headgear
Additional Comments: ResMed AirCurve 10 ASV; Dreamwear Nasal Mask Original; CPAPMax Pillow; ResScan & SleepyHead
Central sleep apnea AHI 62.6 pre-VPAP. Now 0 to 1.3
Present Rx: EPAP: 8; IPAPlo:11; IPAPHi: 23; PSMin: 3; PSMax: 15
"I've had a perfectly wonderful evening, but this wasn't it." —Groucho Marx