Heated Hose: Need a script?

[OpalRose]

My DME told me the same, that I need an updated script on file to continue to order supplies from them.

Every time I call, it's the same set of questions:

When did you see your Doctor last?
Why do you need new nasal pillows? Are they soft?
Why do you need new filters?
Why do you want to replace your humidifier chamber?
Why do you want a new hose?
Why, Why Why???

This morning, I lost my cool! I asked them: Why do you ask me the same questions every month? Do you want my business or not?

Their response: it's their policy, and I will also have to get a new script every year.

Note: Been on APAP for over 14 months, and I own my machine.

I think it's their job to make my crazier than I am.

[Mr. Van Winkle]

My DME told me the same, that I need an updated script on file to continue to order supplies from them.

Every time I call, it's the same set of questions:

When did you see your Doctor last?
Why do you need new nasal pillows? Are they soft?
Why do you need new filters?
Why do you want to replace your humidifier chamber?
Why do you want a new hose?
Why, Why Why???

This morning, I lost my cool! I asked them: Why do you ask me the same questions every month? Do you want my business or not?

Their response: it's their policy, and I will also have to get a new script every year.

Note: Been on APAP for over 14 months, and I own my machine.

I think it's their job to make my crazier than I am.

Wow what a pain!
I'm fortunate my DME is automatic every 6 months they call and remind me it's time to reorder supplies , filters, masks/cushions, hose, humidifer tank and what ever else is needed for our CPAP treatment.
That's what gets me is I've been told once you have sleep apnea chances are you will need to continue with CPAP all your days, so once you've been scripted for it why do they continue to want the script updated? just to get more co-pay's out of you?
I also have been on the hose for 13 months now and never any problems...Knock on Wood. (hope i didn't jinx myself)
Good Luck OpalRose.
Mr. Van Winkle

[OpalRose]

Mr. Van Winkle,
Your lucky you have a good DME, and I know they all operate differently.

How can you jinx yourself with a name like Mr. Van Winkle?

[justMongo]

Because my supplies are paid for by medicare, they want a recent Rx on file from my doc.
But, I have never been asked why I want an item.
(I do buy some disposable supplies outside the system -- and out-of-pocket.)

[Stargazer]

Some DMEs tell you that you need a prescription in order to get a heated hose. That is just a DME requirement and not a legal requirement. It seems to be designed to discourage you from ordering a heated hose.

Thanks, Payton. I thought as much but wanted to be sure. Been lucky with mine; almost 2 years old and still going strong.

My wife will be upgrading shortly to a heated one (terrible rain-out); her DME is actually ok...not great but also, not from Hell as mine was!

P.S. Great to see familiar "faces" still on here since my hiatus!

[Mosquitobait]

Because my supplies are paid for by medicare, they want a recent Rx on file from my doc.
But, I have never been asked why I want an item.
(I do buy some disposable supplies outside the system -- and out-of-pocket.)

Yes, I buy filters from online sources. Cheaper than the 20% I have to pay through Medicare DME AND I get Resmed brand rather than some substitution. I also think it's a DME thing. The code for a hose vs. a heated hose appears to be the same. I do appreciate this conversation as I will get more backup supplies before my year is up. I don't see any point in going back yearly since they didn't do anything to resolve my other issues.

[robertbuckley]

Much as I would like to blame the DMEs, in their defense, the questions are insurance and Medicare driven. I have been hosing for over a decade under, first traditional insurance, then Medicare, last year a Medicare advantage plan (don't even ask), and now back to original Medicare. With original Medicare, the DME is going to want a scrip on file each year usually to make sure if they are audited by CMS their ass is covered. They should do the 3 month supply routine, and are required to ask you if you need the supplies, in part so it doesn't appear that they are trying to sell them to you and make money if you don't need them. The insurance companies just follow suit.
The worst experience I ever had was under the Medicare Advantage plan from Healthfirst in New York last year where the insurance company "medical necessity" people did not know from PAP and supplies and even though I had a scrip on file with "refills" would not permit the DME to provide supplies without a new scrip EVERY month. I tried to explain that not only was it not required by Medicare (they told me they had their own criteria), but that they were not prescription items. Like talking to a brick wall. At one point I was screaming at them about going to a doctor that they were going to pay $150 for to get $4 in filters made about as much as selling ice to polar bears. So, I sold ice.

[Mosquitobait]

Stargazer, my prescription does not say 'heated hose' but nether Lincare (medicare/insuranc) nor online suppliers have cared about it. You don't actually need a prescription to get any kind of hose if you are self-pay. It is not considered a prescription item UNLESS you want someone else to pay for it.

[PaytonA]

Stargazer, my prescription does not say 'heated hose' but nether Lincare (medicare/insuranc) nor online suppliers have cared about it. You don't actually need a prescription to get any kind of hose if you are self-pay. It is not considered a prescription item UNLESS you want someone else to pay for it.

In other words, there is no legal requirement for a prescription in order to get a heated hose.

Best Regards,

PaytonA

[Stargazer]

Stargazer, my prescription does not say 'heated hose' but nether Lincare (medicare/insuranc) nor online suppliers have cared about it. You don't actually need a prescription to get any kind of hose if you are self-pay. It is not considered a prescription item UNLESS you want someone else to pay for it.

In other words, there is no legal requirement for a prescription in order to get a heated hose.

Best Regards,

PaytonA

Well, surprisingly, my wife got the heated hose without any difficulty and we think, with no extra cost. Not sure why the DME wanted the script again from the Doc when we just saw her for the brand new set-up for my wife; weird! I didn't think a script was needed, just wanted to double-check with everyone. I think a heated hose has the same ins # as a regular hose...we will see if there are any additional costs. Honestly, the DME should've just given her it in the first place. Oh well.

Thanks for all the responses. They are all surely appreciated!!