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Need Help Finding a Good DME (in USA)
#1
Money 
I have good insurance. Now I just need a good DME.  I had a good one where I used to live, but they can't figure out my insurance since I moved. I'm sick of calling them and my insurance, to get them straightened out, so I'm going to move on.

I've asked around, and I can't find anyone near me who uses a DME.  :-/

My insurance won't allow me to use online DMEs. :-/

Yelp hasn't been helpful.

How do I find a good DME?  I'm due for a new mask, my cushions are all stretched out... I need a DME!
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#2
Where are you ?

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#3
Your insurance should have a list of DME's that they contract with. Call them and ask.
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#4
You might check Supplier #30 who will invoice and work with many different insurance companies. If that is not a solution, no one can help you without the list of in-network providers from your specific insurance policy.
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#5
Hydrangea,

May good fortune come your way in your quest for a new DME. I too will be looking for a change in DMEs as soon as we return home from a trip to visit family. I have been disgruntled with my corrent arrangement for a long time but when I was told yesterday that they could not provide me with a 15 mm hose, they could only provide the 22 mm hose, that was the final straw on the camel's back. There are several to choose from in our area so my chore is to find a good one.

As to your situation, hopefully by Google or other means you can find out what's available and then find out which ones areacceptable to your insurance company. If you would go ahead and share your location maybe other members in the same area can provide input. Hope you find a good one.

Stan
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#6
I'm going through something very similar. Dealing with the DME in my network, I have had nothing but problems with them. I have good insurance, but they will only deal with in network DME's. There only about 4 in my area, and the only one that carries my gear is the dirt bags I'm using now. I've been searching pricing and gear, I was able to find a Dreamwear Gel Pillow at a good price from a company out of NH. If you call them they give you a better deal. Close to what I'd pay with my insurance.
"I say, you work eight hours, and you sleep eight hours - be sure they're not the same eight hours."








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#7
I am not sure that good can be used as an adjective with DME. However, while you may be stuck the putz(s) that the insurance company approves, a possible solution to getting the mask or hose you want or need is to make sure that the doctor has prescribed it exactly and puts dispense as written - no substitutions. The DME cannot change a scrip - so they need to get it for you. If they don't you call the insurance company and say this is what was scripted and what I use and they are now saying they can't provide it - what would you like me to do - might have the suggestion of "hey, I checked and I can get it for $22 instead of the $23 you have been paying at DME - would you permit me to purchase and submit for re-imbursement at in-network rates". Gotta play it by ear. Be prepared to have a lot of frustration and a lot of fights. Depends how much time and emotional energy you have.
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#8
Well, I've got bummer news.

I think I found a halfway decent DME, thanks to better searching on Yelp. I was unsuccessful searching for words like "DME", "medical equipment", "medical supplies", & "sleep apnea"... they mainly resulted in sleep drs. But once I searched for "cpap", it gave me better results and fewer sleep drs.

I called a DME that actually gets good reviews. They took my insurance info and my Rx, and called my insurance.

Apparently [my insurance says] the DME can't accept my Rx because it's from a different region (the other side of the country). I have to see a dr here who is willing to write me an Rx.

So I have to pay another cost-share of seeing a new dr.

Or maybe I should just buy my CPAP supplies out-of-pocket. This is what I'm inclined to do. I've already been supplementing by ordering stuff from Amazon. I suppose I can just continue.

I've tried talking to my DME across the country, and they're having trouble getting $ from my insurance company due to me having moved. This is why I decided to just find a DME local to me.

Additionally, this local-to-me DME thinks the other DME (where I moved from) is going to have trouble getting the insurance $ for the rental payments on my machine that I got from them very shortly before I moved.

Oy.

Any thoughts or advice?
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#9
Are you going to be changing insurance plans with your new location? I had a similar issue when we were using the California retirement system insurance here in PA. In our case, there were provider lists specifically for out of area DMEs. The answer to your question may be that you need to contact the insurer about your situation.
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