Post Reply 
DME
Author Message
Bladskinner Offline

Preferred Members

Posts: 65
Joined: Jan 2014

Machine: Resmed 9 Elite
Mask Type: Full face mask
Mask Make & Model: Resmed Q
Humidifier: Resumed H5 (disttilled) top up ,dish soap
CPAP Pressure: 11
CPAP Software: ResScan SleepyHead

Other Comments:

Sex: Male
Location: California USA

Post: #1
DME
Can I get a new DME or am I stuck with the one from the sleep center I went to. I mean they gave my info to a place an hour away.
01-12-2014 12:50 AM
Find all posts by this user Post Reply Quote this message in a reply

Donate to Apnea Board
zonk Offline

Advisory Members

Posts: 7,908
Joined: Feb 2012

Machine: A10 AutoSet
Mask Type: Nasal mask
Mask Make & Model: Activa LT
Humidifier: Integrated /ClimateLineAir
CPAP Pressure: 9/13
CPAP Software: ResScan

Other Comments: CPAP since Nov 2010

Sex: Male
Location: Australia

Post: #2
RE: DME
Hi Bladskinner
As far as I know, you can use any DME on your list of insurance approved DME if nothing changes since Obamacare
Hang on for someone in the know
01-12-2014 01:17 AM
Find all posts by this user Post Reply Quote this message in a reply
robysue Online
Wiki Editor
Advisory Members

Posts: 1,233
Joined: Oct 2013

Machine: PR Dreamstation BiPAP Auto
Mask Type: Nasal pillows
Mask Make & Model: Swift FX
Humidifier: PR Dreamstation humidfier
CPAP Pressure: min EPAP = 4; max IPAP = 9;
CPAP Software: SleepyHead EncoreBasic EncorePro

Other Comments: Papping since September 2010

Sex: Female
Location: Buffalo, NY

Post: #3
RE: DME
Bladskinner,

As long as your health care is not paid by an HMO, you can choose whatever DME you want, although your insurance may have certain prefered "in network" DMEs. You need to check with your insurance company about coverage.

If your health care is through an HMO, the HMO may have some very strict restrictions on what DMEs you are allowed to use. You need to check with the HMO to find out what restrictions apply.
01-12-2014 01:32 AM
Find all posts by this user Post Reply Quote this message in a reply

Donate to Apnea Board
Bladskinner Offline

Preferred Members

Posts: 65
Joined: Jan 2014

Machine: Resmed 9 Elite
Mask Type: Full face mask
Mask Make & Model: Resmed Q
Humidifier: Resumed H5 (disttilled) top up ,dish soap
CPAP Pressure: 11
CPAP Software: ResScan SleepyHead

Other Comments:

Sex: Male
Location: California USA

Post: #4
RE: DME
Ok, I do have ppo insurance so I'll will be changing as my current guy sucks and is to far away so I have to mail the card to be read by him. My only concern is that the new DME would not have made the money off the sale of the Equipment.
Do they charge the insurance to read the card?
01-12-2014 01:17 PM
Find all posts by this user Post Reply Quote this message in a reply
iheartsleep Offline

New Members

Posts: 3
Joined: Jan 2014

Machine: ResMed S8 Elite
Mask Type: Nasal mask
Mask Make & Model: unsure
Humidifier: unsure
CPAP Pressure: unsure
CPAP Software: Not using software

Other Comments:

Sex: Female
Location:

Post: #5
RE: DME
I had a horrible experience with my local DME, everything from overbilling my insurance to them harassing me on the phone. So I switched to an online provider and I pay directly for my equipment and parts. No insurance billing and no hassle. I've also found that it's strangely much more cost effective. I'm not certain what they (DME provider) were charging me so much money for, but since I switched to getting it all on my own I have much lower out of pocket.
01-12-2014 01:46 PM
Find all posts by this user Post Reply Quote this message in a reply

Donate to Apnea Board
me50 Offline

Advisory Members

Posts: 2,559
Joined: Aug 2013

Machine: resmed S9 VPAP Auto
Mask Type: Nasal mask
Mask Make & Model: Wisp and Silicone Head gear
Humidifier: resmed H5i
CPAP Pressure: 18/8
CPAP Software: SleepyHead

Other Comments:

Sex: Undisclosed
Location: USA

Post: #6
RE: DME
(01-12-2014 01:46 PM)iheartsleep Wrote:  I had a horrible experience with my local DME, everything from overbilling my insurance to them harassing me on the phone. So I switched to an online provider and I pay directly for my equipment and parts. No insurance billing and no hassle. I've also found that it's strangely much more cost effective. I'm not certain what they (DME provider) were charging me so much money for, but since I switched to getting it all on my own I have much lower out of pocket.

That is great you found out it is less expensive to buy online.

For me, it wouldn't be.

My cushion with insurance is about $9 monthly

Tubing about $8 every 3 months

Frame with cushion is $22 every 3 months

Filters are about $2 every month

Chamber is $4 every 6 months

Chin strap is $4 every 6 months

Head gear is $8 every 6 months

I have rounded the price up
(This post was last modified: 01-12-2014 02:16 PM by me50.)
01-12-2014 02:16 PM
Find all posts by this user Post Reply Quote this message in a reply
Bladskinner Offline

Preferred Members

Posts: 65
Joined: Jan 2014

Machine: Resmed 9 Elite
Mask Type: Full face mask
Mask Make & Model: Resmed Q
Humidifier: Resumed H5 (disttilled) top up ,dish soap
CPAP Pressure: 11
CPAP Software: ResScan SleepyHead

Other Comments:

Sex: Male
Location: California USA

Post: #7
RE: DME
Yes the insurance was billed 3600 dollars for what anyone can get for 1000 bucks on the web. They only paid 1600 and I'm waiting for the bill. I'm sure I won't be happy when it comes.
01-12-2014 09:03 PM
Find all posts by this user Post Reply Quote this message in a reply

Donate to Apnea Board
me50 Offline

Advisory Members

Posts: 2,559
Joined: Aug 2013

Machine: resmed S9 VPAP Auto
Mask Type: Nasal mask
Mask Make & Model: Wisp and Silicone Head gear
Humidifier: resmed H5i
CPAP Pressure: 18/8
CPAP Software: SleepyHead

Other Comments:

Sex: Undisclosed
Location: USA

Post: #8
RE: DME
(01-12-2014 01:46 PM)iheartsleep Wrote:  I had a horrible experience with my local DME, everything from overbilling my insurance to them harassing me on the phone. So I switched to an online provider and I pay directly for my equipment and parts. No insurance billing and no hassle. I've also found that it's strangely much more cost effective. I'm not certain what they (DME provider) were charging me so much money for, but since I switched to getting it all on my own I have much lower out of pocket.
sounds like Apria. It would be scary if there were 2 different DME companies that were like this.

Some DME's charge for the download and some don't. I had one that wanted to charge $25 and we all know it takes but a minute to do it. Another one didn't charge but they half the time didn't do the download right. You can look at your data yourself though if you have sleepyhead or Rescan on your computer. If for compliance data, ask your new DME to provide a modem for you to put on your machine and then they can retrieve the data that way.

As far as a new DME goes, they will be providing your supplies won't they?
(This post was last modified: 01-12-2014 09:19 PM by me50.)
01-12-2014 09:17 PM
Find all posts by this user Post Reply Quote this message in a reply
me50 Offline

Advisory Members

Posts: 2,559
Joined: Aug 2013

Machine: resmed S9 VPAP Auto
Mask Type: Nasal mask
Mask Make & Model: Wisp and Silicone Head gear
Humidifier: resmed H5i
CPAP Pressure: 18/8
CPAP Software: SleepyHead

Other Comments:

Sex: Undisclosed
Location: USA

Post: #9
RE: DME
(01-12-2014 09:03 PM)Bladskinner Wrote:  Yes the insurance was billed 3600 dollars for what anyone can get for 1000 bucks on the web. They only paid 1600 and I'm waiting for the bill. I'm sure I won't be happy when it comes.

are you responsible for say, 20%? you should only have to pay whatever % you are responsible for but of the allowed amount only. It doesn't matter what the DME bills your insurance company because the in network DME's have a contracted price with the insurance company and that is all they will get whether it is paid in full by the insurance company or partially by the insurance company and you.

Did the $1600 include the humidifier?
01-13-2014 01:04 AM
Find all posts by this user Post Reply Quote this message in a reply

Donate to Apnea Board
PsychoMike Offline

Advisory Members

Posts: 551
Joined: Aug 2013

Machine: ResMed S9 AutoSet
Mask Type: Other
Mask Make & Model: Varies with mood, ResMed F10 is my primary
Humidifier: ResMed H5i
CPAP Pressure: 12-17
CPAP Software: SleepyHead

Other Comments: asthma, cyclist upgraditis, just a little crazy (honest :D )

Sex: Male
Location: Alberta, Canada

Post: #10
RE: DME
Yeah, most DMEs local to me are welcoming to new patients. Sure, they might not get the "big ticket" item of your CPAP machine, but masks, hoses, filters, liners, office visits for "check ups" and such add up in between when you might need a CPAP machine purchase.
01-13-2014 01:58 PM
Find all posts by this user Post Reply Quote this message in a reply
Post Reply 


Forum Jump:

Who's Online (Complete List)