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My DME story...
#11
(10-17-2014, 10:37 PM)Whitewabit Wrote: I don't think a DME needs your prescription with your settings on it .. all they need is the prescription for the machine itself. It is between you and your doctor what your settings are and due to privacy laws here in the US I'm not sure if they have the right to that information . They don't need that information for insurance compliance requirements. It would be interesting to hear a legal opinion on this !!

Good job sticking up for yourself more of us need to do this and DME's would have a different attitude.

I just went thru this last December. The "Sleep Doctor" (whom I never met) recommended a CPAP at pressure 14, so my Rx was originally written that way. When the Rep from the DME called, I asked what was required to get an S9 Autoset. He said they needed a pressure range, not a single pressure. I contacted my Primary Care guy and requested the Rx with a range, and he obliged. Then the DME tried to provide a non-ResMed unit, but was willing to order what I wanted, and the rest is history.

The key was that the Rx be written with a pressure range.

Later on, a RT at the DME started to give me a lecture about changing my settings, starting with "You aren't even supposed to know how to do that . . .". I hauled her up short, and she backed off. Clearly this was about protecting their turf.

It's pretty sad when these people think that they prosper by the ignorance of their patients.
A.Becker
PAPing in NE Ohio, with a pack of Cairn terriers
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#12
Most DME's are in this game for the money. BIG money to be made if one is ruthless in selling and servicing.

Personally, I don't bother with the DME, read my data on a regular basis and print out the graphs, etc., into a binder, which I take to the doc every once in a while. Seems to me that he follows my instructions these days.

BUT, you MUST get yourself educated and up to speed with how all of this works. The clinician's manuals are all online somewhere. Find them and read them five times each. Ask questions from folks that have been there and have the T shirt. I was shot down on another board when I suggested that one should be aiming for ZERO leak rate asides from intentional leak rate (i.e. the chart in the back of the Mirage Quattro manual) and that effective interpretation of data was impossible until achieved. Sheeesh.

As I say... this is not medical advice but merely suggestions and experience shared. One MUST educate and digest their own data and come to their own decisions.

I surely would never deal with this DME again. Ever.
----------------------------------------------------------------------------
Educate, Advocate, Contemplate.
Herein lies personal opinion, no professional advice, which ALL are well advised to seek.



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#13
Completely agree - nobody has to live in YOUR body except YOU. Therefore, YOU need to be knowledgeable and in control of what happens, if at all possible.

SO glad you held your ground with this DME.
Evpraxia in the Pacific Northwest USA
Diagnosed: 44 AHI when supine, O2 down to 82%
Treated since 20 Sept 2014:: 0.7 AHI, Settings 7-15, EPR on Full Time at Level 3
Better living through CPAP/APAP machines!
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#14
(10-18-2014, 11:46 AM)Evpraxia Wrote: Completely agree - nobody has to live in YOUR body except YOU.

Well, sort of.... There are those other guys that live in my body with me. I asked one of them to move out the other day, but he didn't want to. So I quit talking to him again.
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#15
(10-18-2014, 11:49 AM)retired_guy Wrote:
(10-18-2014, 11:46 AM)Evpraxia Wrote: Completely agree - nobody has to live in YOUR body except YOU.

Well, sort of.... There are those other guys that live in my body with me. I asked one of them to move out the other day, but he didn't want to. So I quit talking to him again.

Ah, that must be what happens when I talk to myself and I get snarky comments.
Evpraxia in the Pacific Northwest USA
Diagnosed: 44 AHI when supine, O2 down to 82%
Treated since 20 Sept 2014:: 0.7 AHI, Settings 7-15, EPR on Full Time at Level 3
Better living through CPAP/APAP machines!
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#16
(10-18-2014, 08:16 AM)me50 Wrote:
(10-17-2014, 10:37 PM)Whitewabit Wrote: I don't think a DME needs your prescription with your settings on it .. all they need is the prescription for the machine itself. It is between you and your doctor what your settings are and due to privacy laws here in the US I'm not sure if they have the right to that information . They don't need that information for insurance compliance requirements. It would be interesting to hear a legal opinion on this !!

Good job sticking up for yourself more of us need to do this and DME's would have a different attitude.

they would need a prescription or at the minimum the information on the pressure setting/s in order to complete the set up on the machine. After that, it is none of their business what happens to the pressure settings unless the client expects the DME personnel to change the settings. The DME only has to report compliance to the insurance company if the insurance company requires it. I wonder how many insurance companies actually get proof that the insured is compliant. Does the DME have to send them a print out of compliance or do they just verbally report to the insurance company that there is compliance. At any rate, that is all the DME needs to be concerned with as far as the insurance is concerned UNLESS the client expects the DME to change the pressure settings for them.

When the DME submits the claim to the insurance, they state on a line that the patient was compliant and the percentage. The DME is required to keep the actual paperwork on file in their office to support what they claim on the form. If they are ever audited, they then have to show that paperwork. It is not submitted with the claim though.
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#17
From what I have seen, a lot of RTs working for DMEs aren't even qualified to be
flipping burgers or dipping fries at Mickey D's.
I sure don't want anyone like that adjusting my equipment remotely.
That is between me, my machine and my Pulmonary Doc.
Everyone else can BUTT OUT!!
If fact I will avoid using a machine that can be adjusted via internet!
That is overuse of technology that is not needed.

'nuff said
"With ordinary talent and extraordinary perseverance, all things are attainable." - Thomas Foxwell Buxton

Cool
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#18
(10-18-2014, 08:52 PM)Shastzi Wrote: From what I have seen, a lot of RTs working for DMEs aren't even qualified to be
flipping burgers or dipping fries at Mickey D's.
I sure don't want anyone like that adjusting my equipment remotely.
That is between me, my machine and my Pulmonary Doc.
Everyone else can BUTT OUT!!
If fact I will avoid using a machine that can be adjusted via internet!
That is overuse of technology that is not needed.

'nuff said

I'm afraid in the future we won't have a choice when getting a new machine. It appears all the new models will have a modem of some sorts for remote data recovery!

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#19
I'm afraid in the future we won't have a choice when getting a new machine. It appears all the new models will have a modem of some sorts for remote data recovery!

What do you think aluminum foil hats are for? Tehy are no just for people.
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#20
My modem is removable, and I am thinking about removing it once my Compliance time is complete.
Evpraxia in the Pacific Northwest USA
Diagnosed: 44 AHI when supine, O2 down to 82%
Treated since 20 Sept 2014:: 0.7 AHI, Settings 7-15, EPR on Full Time at Level 3
Better living through CPAP/APAP machines!
Post Reply Post Reply


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