The World of DME's

[Zorki1c]

When my wife got her cpap seven years ago, no one told her she had any option. The doctor choose the DME which gave her a low end machine. They basically said "live with it." She never new she had and choice in masks either. When I was diagnosed this year and was able to switch to a different brand of machine, my wife was pretty upset. It was also interesting that my DME (different than the one my wife has) never tried to lowball me on any equipment. I automatically got an auto pap machine--even though I'm not using that feature--and heated hose.

[martinsr00]

Many people like to complain about insurance companies; but, in the realm of cheats, cons, graft and swindles, the insurance companies are rank amateurs compared to brick-and-mortar DMEs. In addition, the insurance company has a financial interest in the apneac getting SUCCESSFUL treatment (complications of unsuccessfully treated or untreated OSA are much more expensive than PAP), while the DME only has a finacial interest in the apneac being "compliant" (ie, ordering over-priced supplies regularly).

The best thing I ever did, in regards to my PAP treatment, was to call my insurance company and work out a way with them for me to get better treatment and save both of us money. They were more than happy to work with me.

I agree. Diagnosed recently, I connected with a friend who warned me about DME's. For me, better to get a prescription, buy it on line, set it up myself, adjust all the pressures as prescribed, and off we go. I got a very high quality data capable machine (PS System 1 Series 60 Bipap) for a great price, got the supplier to prepare the insurance paperwork, and am awaiting any payment the insurance will send.

Then the emphasis is on managing sleep apnea rather than managing insurance companies and DMEs while trying to get them into delivering bare minimums at some opaque price.

I hooked up with a local DME who gives me advice on masks and accessories and sells me supplies over-the-counter. As long as the DME provides me good advice and supplies, we're good. If not, buy the supplies on-line.

[Sleepster]

In addition, the insurance company has a financial interest in the apneac getting SUCCESSFUL treatment (complications of unsuccessfully treated or untreated OSA are much more expensive than PAP), while the DME only has a finacial interest in the apneac being "compliant" (ie, ordering over-priced supplies regularly).

In many cases the DME doesn't even care about that, because they can't make very much money selling supplies to a patient who has a good insurance plan. They make most of their money selling bricks to uninformed and unsuspecting patients.

[archangle]

ABSOLUTELY TOP PRIORITY is to get a good machine.

Many DMEs will try to sell you an inferior machine. Look at my signature line, and figure out which machines you should be willing to accept and why.

If one DME won't give you one of the better machines, find another one who is in network for your insurance and ask him if he will give you the machine you want.

[SleepEZ]

Well, I started this thread, but my experience so far has corresponded with DME nightmares described on this forum. Too much detail to go into, but I'm convinced my sleep center's DME didn't want to deal with me because it was evident I had done research and knew what I wanted for optimal treatment. So, she told me she didn't carry the ResMed S9 Autoset but could order it; however, she could refer me to another DME who stocks it so I'd get my equipment quicker.

Two-plus weeks later, after getting one automated voicemail from the newly referred DME that my order was in process ... and "stand by" for a call to set up delivery, I decided to call and verify the details of the order. This was the first of many calls, navigating an automated phone system, sitting on hold, getting very little information, but ultimately discovering that they had placed an order for a Respironics "brick" instead. Needless to say, I reacted vigorously and spent the next two weeks calling, waiting, asking my doctor to re-sign amended orders, waiting, calling, etc., etc. Hopefully you get the idea by now.

After much persistence I finally got a customer service rep who didn't put me into someone's voicemail or give me a "non answer." He eventually set up an appointment to go to the "local" brick and mortar location to pick up equipment (Tuesday of this week). I had to drive nearly 50 miles from work (about 30 miles from home) after taking off work in the middle of the day, to arrive and start my equipment demo. One of my first questions was related to the confirmation that he was supplying an Autoset machine, and he immediately went into "defense" mode. (I think they had a long set of notes on me that they passed along to warn that I wouldn't be easy to deal with because I'd done research and knew what I was talking about.)

The DME "therapist" started railing on me about the fact I shouldn't be doing research, but instead trusting him as my therapist to know what machine and settings I need. He was condescending, bordering on rude, and we could see his hands shaking right from the start, like he knew he might be in for a fight.

In essence, though I produced a "modified" prescription with all the equipment spelled out in detail ... and re-signed and dated by my physician, he told me the prescription was illegal, because it contradicted another copy of the same prescription that he had in his file. (By the way, my "revised" prescription had been completed in detail per the customer service rep in his organization a week earlier, and then later verified that "everything was fine and good to go!"

To make a long story short(er), he refused to give me the equipment until my doctor "re-signed" his copy of the prescription (an earlier version). So we had to leave and make another appointment for today, pending his receiving another copy of the prescription with a new signature and date.

I was so glad my wife was with me to corroborate the conversation and help me work through "what to do next" after we got home and started processing the whole experience. He (the "therapist") didn't even introduce himself by name, had bad grammar, was pushy, condescending, and felt "sleazy" and untrustworthy to us. In fact, though I didn't go armed with the information about how to identify an S9 Autoset, I was suspicious that it might be an Elite ... but can't prove that now.

After doing lots of research last night, we got up this morning and my wife decided to call a DME we had used for a mobility scooter and whom we trusted. We intuitively knew he didn't deal in CPAP equipment but thought he might refer us to a reputable DME we could trust. And, he did just that.

After hanging up we called the DME he had referred us to and had the most refreshing conversation we could ever hope to have with a DME sleep therapist. He said he knew the other DME and acknowledged their reputation for being difficult to work with and then said his company had decided that the way they would build their business would be based on patient education and satisfaction. In fact, he went on to say they will only dispense autoset machines, even if the doctor prescribed a CPAP at a set pressure ... simply because it gives the patient and doctor so much more versatility when needing to re-titrate due to changes in condition, avoiding the need for repetitive sleep studies in the lab. He went on to take my information and said he could have my equipment in a couple of days.

Now we wait again, but MUCH more hopeful and believing we may have found an honest DME sleep therapist that has the best interest of the patient at heart. Time will tell, but the difference was like night and day; and it was particularly refreshing to call, get a real person to answer the phone, and then be immediately transferred to the sleep therapist who was more than willing to spend time talking on the phone. The first DME felt like a version of the Wizard of Oz, with someone behind the curtain trying to make everything work, but it never did.

To be continued ........

But highly encouraged after a couple of rough, frustrating weeks.

If it's allowed, I'd be glad to name the DME I'd strongly recommend avoiding. They are nationwide, and I'd hate to see anyone get into a situation anything like what I just went through. I'd appreciate one of you "veteran" posters letting me know if it's OK to post the name.

Thanks for reading. :-)

[SleepEZ]

... and by the way, I forgot to say this, and it probably goes without saying, but my wife enjoyed calling the first DME to tell them we were no longer interested in dealing with them. :-)

[Paptillian]

In fact, though I didn't go armed with the information about how to identify an S9 Autoset, I was suspicious that it might be an Elite ... but can't prove that now.

Just for future reference and for others who might not know:

The ResMed S9 models can be identified by the label on the front panel, right above the START/STOP button. It'll say either Elite, AutoSet, Escape / Escape Auto, etc. This is true for their S9 VPAP series of machines as well.

[big_dave]

If it's allowed, I'd be glad to name the DME I'd strongly recommend avoiding. They are nationwide, and I'd hate to see anyone get into a situation anything like what I just went through. I'd appreciate one of you "veteran" posters letting me know if it's OK to post the name.

Thanks for reading. :-)

I'll take two guesses... Apria or Lincare. After I was diagnosed, I called both of them to ask for a price quote for a straight purchase of an S9 Autoset with no contract, a question that any normal business should be able to handle easily. They both acted like I was speaking Chinese, insisting that I would have to sign a contract without knowing what the cost would be. I lost my insurance after my sleep study but before I could get a machine, so I ended up buying my machine on Craigslist. I'm glad you were able to find a trustworthy DME.

[courtney123]

I got lucky I guess.
My DME gave me a dumb, non-data capable machine.
After hanging out here for a few days I quickly learned data-capable was the way to go.

I called the DME and said I wanted a better machine. No argument, she said she'd call my doc to revise the prescription and set it up. Three days later I had the good one.

Seveal weeks after that I decided I hated the mask and purchased a nasal pillow off an on-line store. It stated "Prescription Needed" but that was never asked for. They took my money and sent the mask. After several weeks of using it I decided that's the one I'll stay with.
Called the DME and said I'm switching masks. Again, no argument - they made the changes and that was it.

I had little training or fitting from them in the beginning but I learned more here in a week that they could have ever taught me.

In the end it all worked out.

Take your business to those who want it.

[SleepEZ]

This is helpful. Thanks.

Also got actual part numbers that appear on the backs of the machines (on a label next to the air filter):
Manufacturer Part No: 36003 = S9 Elite
Manufacturer Part No: 36005 = S9 Autoset ONLY
Manufacturer Part No: 36025 = S9 Autoset/H5i humidifier + Climateline combo
Manufacturer Part No: 36015 = S9 Autoset/H5i humidifier

In fact, though I didn't go armed with the information about how to identify an S9 Autoset, I was suspicious that it might be an Elite ... but can't prove that now.

Just for future reference and for others who might not know:

The ResMed S9 models can be identified by the label on the front panel, right above the START/STOP button. It'll say either Elite, AutoSet, Escape / Escape Auto, etc. This is true for their S9 VPAP series of machines as well.