DME angst

[zzzlessinMS]

My doctor wrote prescription for Resmed Aircurve 10 VAUTO.  I had to wait 4 days just to get an appointment with DME.  I called twice before appointment to be sure they indeed had a VAUTO in stock and was assured "we have all the machines." At my appointment DME had an Airsense 10 Auto all set up ready to deliver.  They didn't even read my doctor's Rx  (wonder how the tech interpreted the prescribed  IPAP EPAP and PS to set up an CPAP auto.) 

I immediately told them that was not the machine my doctor prescribed.   Then tech says they don't have a Resmed Aircurve 10 VAUTO in stock but they had a "Dreamstation Auto BiLevel."  No, my doctor specifically ordered Resmed Aircurve VAUTO.  "They are identical, just different brand name"  he says.  No, they aren't identical.  The algorithm for auto adjusting pressure is more responsive on Resmed preventing fewer clusters of OA events.  "Oh, I didn't know that, " he says.  Then I tell him the water chamber for humidifier for Resmed is 380 ml but DreamStation is only 315 ml.  That is important to me because my water chamber goes completely dry within 6 hours on my old S9 VPAP.   "But we have the DreamStation in stock.  We will have to special order the Resmed and you have to wait 1-2 weeks."  Fine with me. I only get a new machine every 5 years and you are required to follow my doctor's prescription. 

So 2 weeks have passed.  I call DME today.  Is my machine in? They  check "delivery tracking" and they tell me delivery is in 2 weeks.  It was shipped yesterday."  That doesn't make any sense.  No shipper takes 2 weeks to go from Resmed America to DME.  At most 7-10 days via cheapest shipping service. And I don't believe Resmed takes 2 weeks to process an order.  So I ask them for the actual date they ORDERED the machine. They "don't know when it was ordered. "  Surely you have paperwork or a notation in chart about orders. 

"The person who does the ordering is off this week (ridiculous?) and we can't go through his stuff. ?  It is the holidays and everything is backed up."  It wasn't holiday time 2 weeks ago when I had my appointment.  Can't say shipping is delayed due to holiday rush.   Thanksgiving is just this week and it would be here by now if they had ordered it. " Well, it will be 2 more weeks. Nothing we can do about that.  If you want it sooner, try a different DME."

This the only DME within an hour's drive so I am not going to start all over with this.  The idea that it was "shipped yesterday" tells me they haven't even ordered it yet.  They wouldn't be so willing to send me elsewhere if they had already ordered it and something they have never ordered before. They will be stuck with an item in stock they never deliver to another patient and would likely return it to Resmed.  This is my breathing every night.  I am not starting all over with a different DME.  I need to get this before new year and new Medicare Part B deductible.  So they say "1-2 weeks from today," exactly what they said 2 weeks ago. 

Is this par for Medicare competitive bid DMEs?

[SarcasticDave94]

Mostly, to varying degrees, absolutely, yes that's typical.

I had to deal with a similar situation to get my ASV machine. How did I resolve it? If you're willing and able, call them EVERY SINGLE DAY until you get the machine YOU want/need. You cannot let even one day go by without the DME hearing from you. The only exception is if they're closed weekends, etc. Won't make much sense to call then.

Keep questioning when did they order, what does tracking say, when did it ship, when will I get it, etc.

I was told 2-3 times that mine was shipped yet not pre-authorized on the next call. Or a variant, you'll get a call in 2 hours when to set up machine reception, but it hasn't even shipped. Lots of chain jerking from the DME. Just do not let up until it's in your hands.

[Mosquitobait]

Also, be sure to complain directly to Medicare about this treatment. Every complaint comes to the front when they reconsider awarding contracts. If this is Lincare or Apria, call their corporate office TODAY. There is no reason for you to be constantly lied to.

[Sleeprider]

It's refreshing to see a consumer that knows what they want hold the DME's feet to thfire to get what they want, and the doctor prescribed. Strong work!

[zzzlessinMS]

I called Medicare and talked with the Competitive Acquisition Ombudsman (CAO).   I explained the situation and just wanted the machine prescribed. I was getting the "run-around" from the DME and wanted to know what she could do to expedite getting machine ASAP.   She said she would call DME immediately and see if she could get information on whether machine is order, shipped, or whatever.  I gave her the names of the individuals I had talked with (the receptionist, the guy who is on vacation and does all the ordering and the technician I first saw).  She did a 3-way call but the DME did NOT know I was on the line and could hear the entire conversation.  This is small local DME (not APRIA, LINCARE, etc).  I chose them because of the reputations of those big corporate DMEs.  When receptionist answered my CAO immediately asked to talk with the "supervisor".  She identified herself by name and that she was calling from Medicare on behalf of a beneficiary about acquiring perscribed CPAP-related equipment.  And guess who she talked to? (the guy in charge of ordering who was "on vacation this week").  

OMG.  I heard a bucket of lies, accusing me of being belligerent, harrassing them, calling them liars, demanding a specific brand and they didn't want to deal with me.  DME stated that they never gave me a time frame about how long it would take to get it.   She let him "bla bla bla" for a few minutes.  But got to specifics of situation with them.  Had the machine been ordered or shipped ?   

The machine had not been shipped.  They do not like to order from Resmed because their machines cost $100 more than Philips-Respironics.  Resmed wants them to do "bulk orders" so it is a pain to order a single, rarely prescribed machine.  In his opinion PR machines are better and the code submitted to Medicare is the same so why do I feel "entitled" to a specific brand (despite a specific prescription with "do not substitute").  Yes, they had "ordered" it but were in the process of making lease arrangements (would be same for all CPAP, Bilevel, etc.).  That I had asked if I would get it before XMAS and they thought that was expecting too much even though they kept saying "1-2" weeks to me.  DME stated that they were writing a letter to my doctor (and sending me a copy) suggesting I deal with a different DME because they didn't want to be tied into a relationship with such an "unreasonable, demanding, menancing" person.  My sleep doctor is a board certified sleep specialist as well as a psychiatrist (he is also a world-renowned doctor who oversees a number of clinical trials with big drug companies).  So according to my DME, I must be some psychotic, dangerous person because my prescription was from Dr. K.  

The Medicare CAO person told DME emphatically that I did not want to start the whole process over with a different DME.  DME admitted to Medicare CAO that they cannot REFUSE to care for a Medicare beneficiary.   DME continued saying that they had never had a complaint to Medicare about them.  They were not "LINCARE".  Patients are all happy with them.  Couldn't understand why I would call Medicare.   DME told Medicare CAO that I would have my machine in TWO WEEKS.  If DME has not delivered or contacted me by Dec 5, she will personally contact them and work in my behalf to resolve this.  It is now between DME and Medicare CAO.  The DME will call me when the machine is received so I can come get machine and receive instructions.  Once I have the my device, I will have no need to followup with them unless I need warranty or service/repair service in next 5 years.  (I have had Resmed machines for 20 years and never had one break down).  So once I have my machine I will not have to do anything with this DME.

I have been getting my CPAP supplies from a Competitive Bid Contractor in another state via mail for the past 4-5 years and have never had a problem with them. So won't even need to mess with the local DME ever again.

So if you have original Medicare and are having problems with a Competitive Bid Contractor DME, call Medicare and get help from a CAO.  You will save yourself alot of hassle and likely see results much sooner.

[SarcasticDave94]

It's refreshing to see a consumer that knows what they want hold the DME's feet to thfire to get what they want, and the doctor prescribed.  Strong work!

[SarcasticDave94]

I called Medicare and talked with the Competitive Acquisition Ombudsman (CAO).   I explained the situation and just wanted the machine prescribed. I was getting the "run-around" from the DME and wanted to know what she could do to expedite getting machine ASAP.   She said she would call DME immediately and see if she could get information on whether machine is order, shipped, or whatever.  I gave her the names of the individuals I had talked with (the receptionist, the guy who is on vacation and does all the ordering and the technician I first saw).  She did a 3-way call but the DME did NOT know I was on the line and could hear the entire conversation.  This is small local DME (not APRIA, LINCARE, etc).  I chose them because of the reputations of those big corporate DMEs.  When receptionist answered my CAO immediately asked to talk with the "supervisor".  She identified herself by name and that she was calling from Medicare on behalf of a beneficiary about acquiring perscribed CPAP-related equipment.  And guess who she talked to? (the guy in charge of ordering who was on vacation this week).  

OMG.  I heard a bucket of lies, accusing me of being belligerent, harrassing them, calling them liars, demanding a specific brand and they didn't want to deal with me.  DME stated that they never gave me a time frame about how long it would take to get it.   She let him "bla bla bla" for a few minutes.  But got to specifics of situation with them.  Had the machine been ordered or shipped ?   

The machine had not been shipped.  They do not like to order from Resmed because their machines cost $100 more than Philips-Respironics.  Resmed wants them to do "bulk orders" so it is a pain to order a single, rarely prescribed machine.  In his opinion PR machines are better and the code submitted to Medicare is the same so why do I feel "entitled" to a specific brand (despite a specific prescription with "do not substitute").  Yes, they had "ordered" it but were in the process of making lease arrangements (would be same for all CPAP, Bilevel, etc.).  That I had asked if I would get it before XMAS and they thought that was expecting too much even though they kept saying "1-2" weeks to me.  DME stated that they were writing a letter to my doctor (and sending me a copy) suggesting I deal with a different DME because they didn't want to be tied into a relationship with such an "unreasonable, demanding, menancing" person.  My sleep doctor is a board certified sleep specialist as well as a psychiatrist (he is also a world-renowned doctor who oversees a number of clinical trials with big drug companies).  So according to my DME, I must be some psychotic, dangerous person because my prescription was from Dr. K.  

The Medicare CAO person told DME emphatically that I did not want to start the whole process over with a different DME.  DME admitted to Medicare CAO that they cannot REFUSE to care for a Medicare beneficiary.   DME continued saying that they had never had a complaint to Medicare about them.  They were not "LINCARE".  Patients are all happy with them.  Couldn't understand why I would call Medicare.   DME told Medicare CAO that I would have my machine in TWO WEEKS.  If DME has not delivered or contacted me by Dec 5, she will personally contact them and work in my behalf to resolve this.  It is now between DME and Medicare CAO.  The DME will call me when the machine is received so I can come get machine and receive instructions.  Once I have the my device, I will have no need to followup with them unless I need warranty or service/repair service in next 5 years.  (I have had Resmed machines for 20 years and never had one break down).  So once I have my machine I will not have to do anything with this DME.

I have been getting my CPAP supplies from a Competitive Bid Contractor in another state via mail for the past 4-5 years and have never had a problem with them. So won't even need to mess with the local DME ever again.

So if you have original Medicare and are having problems with a DME, call Medicare and get help from a CAO.  You will save yourself alot of hassle and likely see results much sooner.

BRAVO!

[Fats Drywaller]

Yep, they sure have taken over from used-car salesmen and politicians as the least trustworthy group of human beans.

Imagine the help-wanted ad: "Now hiring: Customer-service reps with extensive experience in lying, cheating, scamming, money-grubbing, stonewalling, being evasive, and giving runarounds, on the phone and in person. Top salary & benefits. Call today!"

[SuperSleeper]

I hear these types of stories time and time again.  It is unfortunately all too common.

With these types of DMEs, if a patient in any way shows that they are actually "educated" and they know their stuff with regard to sleep apnea treatment and CPAP, far too many DMEs will do exactly what your DME did-- vilify you and claim you're a psychotic, demanding and rude patient, and they will suggest you go to another DME.  WHY?  Because they want the EASY route and the more profitable route for THEM.

I had one DME tell my sleep center that I was verbally abusive, threatening and was "harassing" their front-line staff several times a day.  Of course, those were absolute and utter LIES, but it seems the standard operating procedure for dealing with a patient who is anything more than a dumb appliance-user.

Welcome to Apnea Board, where we DO feel your pain, because many of us have gone through the exact same thing.

[zzzlessinMS]

Wonder if DME thinks this whole circus they created was worth the $100 difference between Resmed and PR?

BTW. DME said Auto Bilevel costs them $800.