DME legal responsibility to follow Rx?

[DrMike]

On a whim, I asked the DME that supplied my CPAP for a copy of the doctor's prescription.

I am somewhat surprised they sent me a copy since they did NOT dispense what he ordered!

Clearly stated on the Rx was DreamStation Pro; what was dispensed was the ICON+.

In Florida Pharmacies are required to dispense what the doctor ordered if a specific brand name is on the Rx UNLESS the doctor has checked the box labeled "Generic may be substituted". 

Does the similar apply to DME's?

I'd be happy to attach a .pdf of the Rx to this post, but do not want to violate Forum rules as it contains specific Dr & DME info. 

Would a Private Message also violate Forum rules?

[PaulaO2]

Hmm, I would assume so. It is an prescription, the same as a medication prescription. If your doc did indeed check the "dispense as written" box, then they were in the wrong. Check your statement from the insurance company and make sure they were billed for the correct machine.

[PaulaO2]

Additionally, if you have the pdf of the script, just take a screenshot of it then use an image software to black out the personal data. I use Irfanview which is free and easy to use. You just drag a box around what you want removed and "cut" it.

For the record, as long as the file does not have a web site address on it, you can post it. But you certainly don't want your personal information visible.

[SarcasticDave94]

Yep agreed. If it's an "dispense as written" or similar, that's what they're legally supposed to do.

As Paula02 said, just black out personal info so as to maintain privacy, then post an image.

If you've got an all in one printer, scan the script, save a file of it to your PC, open the file and screenshot it, then post it as an attachment.

PS follow above AFTER you edit the image by blacking out personal stuff.

[Walla Walla]

It may depend on how long you've had the machine as to what if anything can be done. If it's been awhile than it may be implied that you accepted the machine.

[Sleeprider]

I think it's worth a try. You are really struggling with the ICON for lack of data, and of course your DME cannot meet any of your doctor's requests to assist you or report on your efficacy because they dispensed this no-data machine. Ask them to dispense what was prescribed by the doctor. As an aside, it might be good to say you will also accept a Resmed Airsense 10 Elite or Autoset. Either way, you'd have data that could be used to understand what is going on and potentially improve results.

If necessary, complain to your doctor's office the DME did not dispense the machine as written in the prescription. Let them know you want to be able to see data on your results and are having difficulties with the ICON. I'm sure this can happen as the DME does not have a leg to stand on here. They dispensed the ICON because it costs much less.

[greatunclebill]

definitely start at the doctors office and have the nurse call the dme and tell them how it is. the dme doesn't necessarily care about pleasing you personally, but they will bend over backwards to please the doctor and nurse because they send him business.

[DrMike]

THANKS ALL!

Medicare FRAUD is real.

Question: Does this sound like a simple case of it ... although United Health Care is the one being scammed in this case.

The alternative is to send a complaint to UHC to get them to drop the DME supplier.

Suggestions on which avenue is best to pursue: Medicare or UHC? Medicare is a legal option, while UHC is a supplier/payer situation.

This is a case of "Don't get me ticked ... I'm retired and have LOTS of time to pursue things."
(I even listen to the sales pitches I get and keep the pitcher on the line for 10-15 minutes before finally telling him/her to get lost ... finally telling him/her that my vehicle has 695,000 miles on it and don't think I qualify for your extended warranty.)

[SarcasticDave94]

IMO I'd call all 3 areas involved. The docs office, your insurance (both sides), and the DME. That's not a suggestion for you on an order of who to call, but in my mind that's the order I'd handle it, and for me it would be all calls one right after another. Hope you like muzak while being on hold.

Seriously, jump on this ASAP. And best to being successful with this.

[Melman]

Are you on original medicare with a UHC supplemental plan or on a UHC advantage plan. If your on an advantage plan I believe you need to take any grievances to UHC.