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Need help selecting DME
#11
RE: Need help selecting DME
I too have Aetna and did have a problem with DME. 

My first company I was referred to by my doctor did not get back to me until after I contacted Aetna and found that they were not covered.  Another was referred to me by Aetna, so I contacted my Dr's office to have prescription sent.  They actually found one a local DME that worked with my Insurance and would be able to turn around the order in about 1 week.

Then I was contacted by them and said per my insurance I would need to make an CC payment to get my RT scheduled.  I was looking for a detailed bill and was told it would be at my appt.  I got there and found I was charged 100% not the 20% co-pay.  the office contacted billing and we worked to get it straightened out.  Then I proceeded with my appointment.

Now days you have to advocate for yourself.  My wife has used CPAP for years, always Resmed.  I was told I would get a dreamstation.  I wanted Resmed so had Dr revise prescription to say resmed and that is what I got.

It is a challenge, but where ever you go be proactive.  call them, and Gently push or you will just go through at their pace not yours.
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#12
RE: Need help selecting DME
(03-07-2017, 02:43 PM)KCFLY Wrote: Thanks to both of you!  I did confirm today that when they call to setup the appointment I can specify what machine I want and they said they should be able to accommodate that.  Let's hope that is true!

Fantastic!!!

When they put my machine (Dreamstation) in front of me, I picked it up as if to curiously check it over, and looked at the serial number to be certain of *which* DreamStation it was.  I knew I wanted to see 500 (for an Auto).
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#13
RE: Need help selecting DME
Well, some good news..

I finally got my Rx from the doc for my machine today. It only took 3 requests..

Got everything submitted to the DME.

AND, called Aetna and was told they do not want to see any compliance data. So, once I have my machine I can drive my own treatment without anyone needing to look over my shoulder!
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#14
RE: Need help selecting DME
Excellent! My insurance doesn't require compliance either. Even though I've been 100% compliant, I'm glad to not have to answer to anyone.
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#15
RE: Need help selecting DME
OMG, this process SUCKS.

Called my DME again today as I hadn't heard from them. They apparently didn't like how the order for the machine was written so they had faxed the doc for a new one. Didn't bother to call me to let me know. I then asked them how far out they were scheduling as they had originally told me from the day they get the orders I would have a machine in a week. It's been over a week now. They told me once the orders are approved, it would be at least another week before I could get an appointment. BAH!

This SUCKS
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#16
RE: Need help selecting DME
Ask your doctor's office to provide you with a copy of the order. Make sure YOU agree.
Sleeprider
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#17
RE: Need help selecting DME
(03-16-2017, 08:39 PM)Sleeprider Wrote: Ask your doctor's office to provide you with a copy of the order.  Make sure YOU agree.

Oh, I have copies of everything.  This is just them nit picking (in my opinion).  Everything they need is there.  They are insisting that since the order was written for an auto machine that a range of pressures be specified.  The order had a fixed pressure.

I'm working on it, it's just like beating your head on a brick wall with these DME providers some time.

As an extra bonus, I did ask them what machine they were planning on showing me once I got in for an appointment.  She told me very matter of factly "the Resmed Dreamstation CPAP"

Oh-jeez
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#18
RE: Need help selecting DME
(03-17-2017, 10:09 AM)KCFLY Wrote: As an extra bonus, I did ask them what machine they were planning on showing me once I got in for an appointment.  She told me very matter of factly "the Resmed Dreamstation CPAP"

Bwahahahaha.

At least you are armed with knowledge from here.
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#19
RE: Need help selecting DME
DME's are generally hard to work with. I had a call into Apria, but before they could get back to me a local DME my doctor uses most often had an appointment and equipment ready for me. Good Luck!
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#20
RE: Need help selecting DME
Oh-jeez
How did that hybrid ResMedonics work out for you?
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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