How to spot a shady DME?

[James87]

Hi All,

I went to the DME supplier on Monday and started treatment for the first time Monday night. I am confused as to the conflicting information that the supplier told me vs what was indicated on my prescription. On my prescription, there is a check mark next to Nasal Mask (A7034) and the doctor specified that I be given the F&P Evora Nasal mask or another mask of the same style. 

When I went to the DME, I had a list of several masks that I was interested in trying that were both full face and nasal masks by F&P, and Resmed, however the DME insisted that I try a mask by a brand that I had never heard of and stated that the doctor wanted me to have a full face mask. The supplier then went on to tell me that this was their most popular mask and that no one who had tried one had ever returned it because it was just such an amazing mask. It's a 3B Siesta full face mask. 

I was not interested in trying a mask by a company / brand that I had never heard of, but since all this is new to me, I wasn't sure what my (for lack of a better word) "rights" are. Just because they push or suggest something, I would assume that I am under no obligation to purchase it, right? 

At the time, I thought maybe he had just been mistaken, but the mask is very irritating, the Velcro straps have virtually no holding power and the mask does not want to stay attached to the headgear which has been extremely irritating over the past week. I feel a bit like I was sold a pig in a poke rather than something with a decent track record.  Do DME's get kickbacks for selling certain types of products over others, even if those products are clearly not specified on your prescription? 

The DME said they have a 7 day return policy. If I return it, should I be firm and say you're going to show me what I want to see? or would it be better if I just went somewhere else? I'm not above showing my ass, but since this is all new to me, I don't know what's what yet.

Any thoughts or suggestions are appreciated. Thank you - James

[Crimson Nape]

Be firm! This DME is shining you on. If they do not provide the prescribed mask, move on to another DME.

- Red

[gainerfull]

This is not a DME you want to be working with. They likely don't have the masks you want in stock so if it were me I'd move on. Otherwise, call beforehand to share with them your needs / expectations then accept nothing less when you arrive. Most DMEs offer 30 day return policies on masks.

[Gideon]

Be firm.it's your money.
Simply tell them to provide what you ask for or you will go to another DME.  
Typically DME's are very profit oriented.  
On the subject of kickbacks yes. same for some doctors.
Payment is made on the basis of the code (A7034).  There are many masks that fall into this umbrella.  Put yourself in the DME's profit focused role. Since you get paid the same for ANY A7034 device, which one do I make the most money on?  Answer the cheapest to me.

That said there are some very good people working for DME's that do care about the people/patients and will put the patient first but IMHO you are far better acting on your own behalf.
The same applies for any and all medical equipment and meds.  Be your own advocate and coming to apnea board you are off to a good start

A7034 is a valid 2023 HCPCS code for Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap or just “ Nasal application device ” for short, used in Used durable medical equipmen

This means any nasal or Pillow mask, Request ResMeds P10 Pillow Mask Fit Kit.  The Fit Kit contains 3 different pillow sizes so when in doubt go bigger. Pillow Masks fit and rest on the outside of the nares/openings of your nose with a very small conical portion that will not touch but will be slightly inside your nose.  You will only feel it on the rim of your nose.  This is the smallest lightest and quietest mask out there.  How quiet? My wife kept waking me when I started using it, just to make sure I was still breathing (she couldn't hear me breathe like she did with every other mask I've used.

All that said, get OSCAR and post your daily charts. Unless your doctor to exceptional he/she will rarely if ever look at them managing off of summary data instead.  We here at AB will help you understand and read the detailed data to help you tune your cpap machine.

[Gideon]

I'll add, This is how you spot a shady DME
Congrats!!!

[Sleeprider]

Your DME is trying to inflate profits by pushing Chinese sourced equipment. You can't trust them to work in any way on your behalf.

[Rich66]

The biggest thing a DME hates is an "informed" client. It sounds like you should also make sure the doctor is aware of the issues you're having, so he might "refer" people differently.
And don't feel alone. Most people on here have their own DME stories to tell.

[SarcasticDave94]

How to spot a shady DME?

See your post.

When the DME doesn't have choices, will not allow you to choose what you want, run away. Shop elsewhere. They are not using that mask, so who decided they dictate to you what you must choose? That would be their shady policy. Nope see ya bye.

Call your insurance and get a list of local in-network DMEs that aren't Shady Spot. You decide where you'll go, even if it's limited to in-network.

Your therapy, your money, your choice on what to use to get that therapy. No isn't acceptable.

[James87]

Thanks for all your responses. I exchanged it, they were crappy to me about it which solidified the impression that I already had about them and I won't be going back. I will be leaving an honest review for them on their Facebook, Yelp, and Google pages. I'll reach out to my insurance company for the list of suppliers near me and pick another one. I'm sure there's one around that is better.

[nkasoff]

My main machine is an AirSense 11 with the P10 mask. I bought a Luna II when my 11 was in the shop, as a backup machine - it was $250 brand new, and they included a Siesta mask at no extra charge. Which is to say, that mask must cost them next to nothing. And I hated it. Pure trash. I thought it might be a good alternative if I'm really congested and need a full face alternative to the nasal pillows, but it was so horrible I would rather just skip a night of CPAP than use it. If that's what the DME is pushing, you definitely need to go elsewhere.