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DME Question
#11
RE: DME Question
(12-01-2017, 09:46 PM)Sleeprider Wrote: What is your insurance like?  Do you have co-pay and/or deductible?

Starting at the beginning.  Your insurance has a list of in-network providers where they have agreements to reimburse for DME supplies.  It's not likely just one company.  Get the list and shop around.  Be sure you get the machine and equipment you want, and many will deliver to your home.

You should not buy your CPAP from your doctor. That is a conflict of interest.  Get the list of in-network suppliers.

If your deductible is fairly high, you may be much better off buying a new Auto CPAP on Amazon.  Current price of the Resmed Airsense 10 Autoset is $519, and the Philips Respironics Dreamstation Auto is at $364.

Get copies of your sleep studies and prescription.  You can keep those for your personal records and use any supplier as the years go by.  It is the most empowering thing you can do.

Uh I've met my maximum out of pocket for the year so everything has been free since the beginning of last month medicine and doctors visits. I think the moist I saw was a 5% after deductible on pretty much everything that needed payment in the insurance guide. I've also gotten a pre-authorization it looks like for the DME in town. (Hard to read insurance company things. )  I'm able to do a search on their website and it shows me some further out but in-network as well
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#12
RE: DME Question
Since you have met your deductible, be sure to get the machine as a sale, not a rental, or you will be in a whole new year. As far as a mask, try the Resmed Airfit P10 pillows. They sell as a set with headgear, 3-sizes of cushion
Sleeprider
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#13
RE: DME Question
Here's my thumbnail sketch of how I got my latest CPAP/ASV blower:

1. I called my health insurance Customer Service, we discussed which DME's were in-net nearby, I noted names/addresses/phone #

2. I called above noted DME's to decide which I wanted to deal with, determined mostly by geographic location and products carried, AND by reputation

3. After the ASV version of PSG, I called the pulmonary docs office to tell them which DME to use for the ASV script

4. Called DME, doc, and insurance MULTIPLE times until my script was filled with newly prescribed ASV

5. Waited 24 hours and repeat step 4 then step 5 over for a few weeks

BTW step 5 has NO sarcastic intent; this is really what happened. I didn't sit very long while waiting on these 3 amigos to do anything. At least one of the 3 heard from me every day until I knew the machine was to placed in my hands on a certain date and time.

Just my 2 cents, and best to ya on progress.

Dave B
lots-o-coffee lots-o-coffee lots-o-coffee
Dave

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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#14
RE: DME Question
(12-02-2017, 11:50 AM)SarcasticDave94 Wrote: Here's my thumbnail sketch of how I got my latest CPAP/ASV blower:

1. I called my health insurance Customer Service, we discussed which DME's were in-net nearby, I noted names/addresses/phone #

2. I called above noted DME's to decide which I wanted to deal with, determined mostly by geographic location and products carried, AND by reputation

3. After the ASV version of PSG, I called the pulmonary docs office to tell them which DME to use for the ASV script

4. Called DME, doc, and insurance MULTIPLE times until my script was filled with newly prescribed ASV

5. Waited 24 hours and repeat step 4 then step 5 over for a few weeks

BTW step 5 has NO sarcastic intent; this is really what happened. I didn't sit very long while waiting on these 3 amigos to do anything. At least one of the 3 heard from me every day until I knew the machine was to placed in my hands on a certain date and time.

Just my 2 cents, and best to ya on progress.

Dave B
lots-o-coffee lots-o-coffee lots-o-coffee
And that's how you "own" your treatment.  Too many people let the system take control.
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#15
RE: DME Question
Agreed, KSMatthew. If I wanted to get things done, it was up to me to do it.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#16
RE: DME Question
Well to necrothread just a bit can anyone say anything good about a DME provider they use with Aetna insurance? I have just switched insurance as my employer no longer offers the insurance company I have been with for the last 10 years I have used CPAP. As to the DME I have used, I will not mention their name (they are national) but they are still available to me but are the last possible choice, I will not miss them at all. I do have a current DME list from my insurer, it includes AMERICAN HOME PATIENT, COMMUNITY SURGICAL, LINCARE, MEDLINE INDUSTRIES, ROTECH, and US MEDICAL SUPPLY. I am located in central Florida, but since I have always used mail-order anyway its probably not all that relevant. TIA for any pointers.
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#17
RE: DME Question
FWIW I've used Rotech with a "franchise" office of same Rotech called CPO2 in PA. I switched to another DME called Apria to get my ASV machine. With either, I called to get whatever needs done. I had paper script and sleep studies to provide Rotech/CPO2, Apria received info via their regional rep that visits the pulmonary doctors office weekly. I called the DME to get updates if deadlines expired. They just got tired of hearing from me, so they had to get it finished.

And I've heard fairly good reviews about Lincare.

I suggest research each DME you're interested in and make notes of phone number and address of each. Note the devices and masks available, with notes again. From that list, make some calls or just go visit the offices. But to save a bit of time, you could do a quick call first anyway. Note what device and mask you want, find out if DME can provide it. Once you've visited a few DME offices, or talked on the phone, you should have an impression, either good or bad. Then finally, go with the one you believe will service your needs the best.

BTW when it's time to take delivery, read the paperwork carefully before you sign. IMO you shouldn't give the DME your credit card number, unless you're paying and not the insurance. Check the product they're giving you against the invoice/receipt before you sign. Does the info match the product, your script, and what you asked for? Best to check the machine hours as well. If it's new, it has zero machine hours, which is different than user hours.

Sorry for the info dump. I can help further if needed.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#18
RE: DME Question
The one I'm using seems to be bad....I switched  out my mask at 4 days in because of massive leakage..they ended up giving me the wrong replaceable mask bits...then when I noticed the two weeks later I brought them by the office locally and was promised they'd order me new ones because they didn't have them. I've been using the same piece for 6 weeks because they haven't gotten me the 5 they owe me still. I have to find another..but will that mess things up with insurance?
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#19
RE: DME Question
My opinion, it shouldn't be a problem, but do follow-up with a call to your DME and insurance customer service to let them know your situation and get guidance on steps to take.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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