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Another small rant.
12-24-2015, 01:50 PM
Haven't gone the change the mask route yet, but my DME sends my a card every 3 months and tells me it is time for replacements. All of this is covered by my insurance. I have two choices - all or none. Only problem is I have a good supply of tanks and hoses as I prefer the 10 foot hose and they don't have them any more so I by them online for around 15-20. So, I have a bunch of 6 footers. Think I may use one for a Dr Suess instrument (being a former low brass player). I do see my sleep doc every 6 months or so for a face to face and to also check my hearing loss (he is also an ENT). Loves it when I bring him a recap of Sleepyhead. Calls me his poster child for compliance.
03-13-2017, 07:44 AM
As a noob who is still trying to get in the door of my DME to get my machine you guys are not giving me a good feeling about all this!
I know it's all dependant on the DME, and I WILL by own best advocate, but still.
Anyway, it's all a good reminder to not take crap from anyone and insist on getting what you want, when you want it and that there are options out there. I just want to get started.
Thanks for sharing your experiences!
03-13-2017, 02:35 PM
(03-13-2017, 07:44 AM)KCFLY Wrote: As a noob who is still trying to get in the door of my DME to get my machine you guys are not giving me a good feeling about all this!
Once you know you are scheduled to pickup or have a machine delivered, be sure to call and ask exactly what machine is being set up. They will tell you, and it's a lot easier to decline if they are not at your door, or you are in their office. I did this for my wife in January, and got the change I wanted on the day of delivery.
03-13-2017, 07:01 PM
(03-13-2017, 02:35 PM)Sleeprider Wrote: Once you know you are scheduled to pickup or have a machine delivered, be sure to call and ask exactly what machine is being set up. They will tell you, and it's a lot easier to decline if they are not at your door, or you are in their office. I did this for my wife in January, and got the change I wanted on the day of delivery.
Yes!!!! Please heed this advice! It's a super easy conversation (if you can get them on the phone) to just ask "I'm just curious... Which machine are you planning on giving me?" and then be ready to respond "Great! See you then!" or "Oooh, I am actually wanting to get the xyz machine. Do you have that in stock?" (or however).
Once you're in the office, it's NOT an easy conversation to have... and they know they already have you there. Plus, once you're in the office, you're in the frame of mind that you're taking home a machine... and it's a bummer (bust still wise!) to leave without one.
03-14-2017, 03:35 AM (This post was last modified: 03-14-2017, 03:40 AM by Wrz77. Edited 1 time in total.)
I am on Humana Caresource - a Medicaid MCO in KY.
My DME vendor at least doesn't require me to visit each time I need a new mask. So far I have only asked for one full face mask kit replacement, and several FFM cushions. They mailed them to me via USPS Priority Mail relatively quickly.
Every 6 months I can get a new mask. When the next 6 month window arrives I plan to ask for whatever the newest ResMed FFM is. Then another 6 months probably will ask for a nasal pillow mask. I'm hoping they don't suddenly require me to show up in person for it.
The 'preferred provider' thing does suck but I'm guessing they have that policy because insurance companies often pay A LOT less than the published prices that those who pay out of pocket for. And if they were to pay for out of network providers that they haven't yet negotiated with the discounts probably wouldn't be as good.
The first time to accept my CPAP machine I was required to go there in person to waste an hour being instructed on its use - and learned absolutely nothing in that time (even though I was new to xPAP therapy I am well acquainted with technology and often do not need anyone to actually 'teach' me on how to use it in a classroom type deal). That was very annoying and they refused to just mail it to me.
03-14-2017, 12:38 PM
03-14-2017, 09:27 PM
The way insurance was initially intended, it was for UNintentional sickness and injury. You put in money, so that IF sickness or injury happened, you'd be covered.
It was bastardized into covering routine healthcare. We really shouldn't call it insurance any more.
Please organize your SleeyHead screenshots like this.
I'm an epidemiologist, not a medical provider.
03-14-2017, 10:49 PM
I have had my prescription from my latest sleep study for a month. I am glad that this forum was here to prepare me for this new round of heath care madness. Maybe it is me but I would think that a patient who was diagnosed with severe sleep apnea might get a little hustle from the medical community. Anyway, I got a call today, Hallelujah, from the DME. They want you to come in for an "appointment" to select your equipment. Told them I had already selected my machine and mask. All I needed to know is whether they have it in stock or do you need to order it. She said "we have everything in stock in our warehouse". So I asked her "You have everything?" Then she says "yes we have a large warehouse". So I told her that I lived almost 40 miles away, which would make it an 80 mile round trip, and that I would like her to check. Which she did and said they had both primary items and the accessories. I thanked her and we made an appointment for next week. So far I am not impressed with the "he said", "they didn't fax", and "someone dropped the ball" crap. I was prepared like I said, and that helped tremendously. I also thought it was nice that she quoted me what the costs for the accessories and first months"rent" would be as well as the month amount. She also confirmed that after the total of 13 months rental, the unit would be mine.
So mine is a case of "How the DME turns" so to speak. I shall see how this soap opera turns out in a week or so.
03-15-2017, 12:20 AM
Good for you. You've done your best. I hope they pull through, especially with that drive.
03-20-2017, 06:51 PM
Well tomorrow is the day I take the trip to the closest DME and get my new machine and mask. I am coming armed with specifics on both
items so I know that I am getting the ones my insurance will be paying for and the ones I told them about. I don't know whether they will
just hand me the items or try to "educate" me. I really do want to open the boxes and make sure things are all correct.
We shall see, and I will let you know.
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