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DME run around
#1
DME run around
Ok, I'm trying to figure out how much of this run around I'm getting is for real, due to required rules, and now much of it is a DME who needs to be fired (again), and how much of this is normal and I'm just going to have to live with it.

I picked up my cpap machine from DME 1 (affiliated with a local hospital, same hospital that runs the sleep lab I was tested in, and who owns the doctors office of my primary care physician) back on February 7th.  I have paperwork from them stating that it was a purchase and not a rental. I was given a list of various parts, etc, with how frequently my insurance covered replacing them.  I was verbally told to call them to order the filter and cushion at the 30 day mark, but that after that they'd call me for the ordering.

30 days was March 8th, but due to my schedule and DME 1's hours I didn't get a call into them till March 11th.  I ordered a filter and a cushion as per the paperwork they had given me.  They said they'd call me to let me know when it was available to pick up from them as they don't mail those (??).

Two weeks later, on March 25th, I hadn't heard from them, so I called them asking how much longer it was going to take.  Got a run around, something about waiting on my insurance, and how it usually takes two weeks, and.....I said whatever and hung up.  Called my insurance company to see if there was steps I could take to speed things up.  My insurance company informed me that neither require nor expect a check in with them for the ordering of filters etc and that there was nothing to speed up.  When I asked if I could change DMEs they said they didn't care as long as it was a DME who accepted my plan they'd cover it.  When I asked about ordering supplies online and getting reimbursement they said that it would have to be from a provider who accepted my insurance (ie: not Amazon), in order to be covered.  I looked up local DMEs and sent off a bunch of emails to each asking if they accepted my insurance and if they carried supplies for my machine.

On March 26th I had my followup with my Pulmonary doctor, asked about changing DMEs, explained why.  I have a feeling he won't be recommending DME 1 any further, he was as unimpressed as I was.  He said he was willing to send the needed prescription and info to which ever DME I wanted to go to, he specifically mentioned a locally owned company that had been mentioned positively by other patients.  I got home to find that the only DME who'd responded to my email was the same one my Doctor had recommended, AND it was a personalized reply and not a form letter.  Works for me.  Called them to find out what they needed, and then fired off an email to my doctors office making the request.

Getting the required info sent from the doctors office to DME 2 took most of a week.  So today, April 2nd, after speaking with DME 2 and making sure they have everything they needed to get me set up, I called DME 1 to cancel my STILL pending order for a by gawd filter, and to tell them I was closing the account.  "Oh, you can't just close the account, the machine is a rental.  You'll need to either return it or pay $250 to get it as a refurbished machine."

Hammer

Hang up on her, call DME 2 back, explain what I was just told.  Now its ever so much more complicated.  Now my doctor has to send a new prescription for a machine to DME 2, DME 2 has to get appropriate permissions to have a modified rental period.  Now I actually need a new patient visit to the DME to pick up a new machine, which means MAYBE next week.  Which means........ugh. (to be sure I also called my insurance company and confirmed, it is a rental, why I have paperwork from the DME that states otherwise I have no clue)

$250 is a not bad price for this machine which is essentially brand new.  I don't really want to spend the money (I don't really HAVE the money to spend), but hell, then the machine is mine and screw them all.  One thing for sure I'm NOT staying with DME 1 for the remaining 8 months, even if it would be easier, if they can't even handle the process to get me a $1 filter I don't want to trust them to get me anything else on schedule either.  DME 2 is a completely locally owned company, and so far has been very helpfull within the limits of what they appear to be allowed to do.  On the other hand, my initial impression of DME 1 was good too.  I ordered a pack of filters from Amazon yesterday, they're cheap and this way I have backups.  Course, now that I've placed the order who knows if I'll even have the same machine next week.
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#2
RE: DME run around
Confirm with insurance machine was on a rental basis. If insurance states teh machine was on a purchase you're clear and you can call the State Attorney General and file a theft complaint. If your machine was a rental, but DME 1 told you it was a purchase, you can call the State Attorney Genera and file a complaint of theft by deception, especially if you have a receipt. If you didn't get a receipt, what kind of business is this? File a complaint with BBB and write a Google review. Make DME 1 miserable and let as many people know about them as possible with online reviews and BBB complaints and possibly legal complaints. If they are a Medicare provider, there are easy to file complaint forms for that.

Good luck with your next supplier. On Apnea Board, you will never hear anyone recommend you buy your equipment through the physician, clinic or hospital that performed your diagnosis. There is simply too much conflict of interest and generally a poor outcome.
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#3
RE: DME run around
I did just call my insurance company and confirm its a rental. I have a delivery confirmation from DME1, which lists what was paid, but doesn't appear to specify rental vs purchase. And I have a sheet from them with the options of

____Purchase
____Rental for _____ months

Where the purchase is the one checked and a 0 in the months slot.

I don't think I conciously realized that DME 1 was all part and parcel untill I picked up my machine and it was on the paperwork. The sleep lab asked if I had a DME preference, and I said I did not, so I shouldn't be surprised they sent me to their own shop.
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#4
RE: DME run around
And yes, I know I should have had a preference. But even if I'd done my research, my FIL gets his cpap supplies via DME 1, and hasn't had any serious issues, so I likely wouldn't have balked at being sent there.
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#5
RE: DME run around
I'm sure you signed into their contract or agreements. Don't feel bad. We go to these suppliers expecting they are there to help us, but later find they are simply maximizing profits by arranging a rental or providing a sub-par machine or both. At this point, just do the math and decide whether it is better to complete your contract term or pay any penalty to get out. If the buy-out is $250, your insurance may cover that cost subject to deductibles and copay. That doesn't sound like a bad deal.
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#6
RE: DME run around
Yah, thats my set of phone calls for the morning, in between recieving trucks at work, to find out if my insurance would cover any of the buyout, confirm what exactly is involved in the buyout, decide if I can spring that much out of the budget. And so on.
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#7
RE: DME run around
Sounds like deja vu for me. I had such a similar experience.

I agree with the above - crunch the numbers, and go with whatever you want.

Way to go, holding firm boundaries!
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#8
RE: DME run around
Ok, thats the amount after my insurance pays their part. Apparently if I want it covered 100% I'd have to stick with the rental. So I'll be submitting the receipt to the FSA account to see if they'll reimburse for it. If not, whatever, its mine now, and that simplifies supplier choices. Now to get a minute to write up a FB review for DME 1.
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#9
RE: DME run around
(04-04-2019, 12:40 AM)Hydrangea Wrote: Sounds like deja vu for me.  I had such a similar experience.

I agree with the above - crunch the numbers, and go with whatever you want.

Way to go, holding firm boundaries!

This has been really frustrating.  I've worked customer service jobs my whole life and I know how it always seems that there's that ONE account where everything that can go wrong will.  If at any point during this mess they'd called me to tell me my order was in and so sorry it took so long we had X problem, I'd have sympathy.  But they, repeatedly, don't seem to understand why I was upset at a 3+ week time frame for my supplies.  The fact that they screwed up my paperwork was just the icing on the cake!
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#10
RE: DME run around
If you're happy with the machine, then it's not necessarily bad to just keep it, pay on it, and let that be.

With my experience with my jerk DME1, they would only give me a CPAP (not an APAP). After less than a month on a fixed pressure, I realized why an Auto is a better choice. But they refused. So I gave them back the machine, and found another DME that would dispense a machine I wanted.
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