+- Apnea Board Forum - CPAP | Sleep Apnea (https://www.apneaboard.com/forums)
+-- Forum: Public Area (https://www.apneaboard.com/forums/Forum-Public-Area)
+--- Forum: Main Apnea Board Forum (https://www.apneaboard.com/forums/Forum-Main-Apnea-Board-Forum)
+--- Thread: DMEs in the PNW (Story & Question) (/Thread-DMEs-in-the-PNW-Story-Question)
DMEs in the PNW (Story & Question) - SquishySquishCat - 01-26-2023
I got my diagnosis a little earlier this month and my doctor sent my prescription to Performance Home Medical (it looks like they have an office in one of the buildings that the doctor's hospital owns). The prescription is for an auto CPAP with a range of 5-15. I start doing the google thing and see what I can find out about the different machines out there and what people are saying about them. That's also how I found this forum. From all this, I decide I want the ResMed Airsense 11 Autoset.
A week and a half goes by and yesterday I finally get a text saying they're ready to schedule me for getting set up. Give them a call, and after being on hold for 11 minutes, the call drops. I call back and this time opt for the "press 1 to hold your spot in line for a call back". They call back and they say that my insurance will cover 90% (yay) and the first month out of pocket for me would be $80 and then $10 every month after that for 10 months. Sounds reasonable and I ask if they take HSA cards; she says yes. Cool.
Then they say they're going to order a Luna G3 and it should be ready in a week. I asked if I had any choice in which machine I get, and after a somewhat awkward pause, the woman says that nothing was specified on the prescription, so I could in theory make a request. I ask for the ResMed and she tells me it would be 3 weeks at least to get approval from my insurance. I let her know I'm fine with waiting, and she sounded almost reluctant to agree to make a note and say that I should hear back from them in 3 weeks. She also said they won't need my payment info at this time since I won't be accepting the Luna.
Today, I start thinking back on the conversation, and it seems a bit skeevy that the overall combined cost of what they would be charging me and my insurance would be over $1500 for a machine that I've seen for under $800. Then I get a call from Performance Home Medical, but they hang up before I get a chance to pick up my phone. I call back and go through the rigamarole to get a call back. When someone finally calls me back, they say they don't have my machine ready and that it'll be 3 weeks. I let them know I received a call and just wanted to know why. The person on the phone sounded extremely confused and said there were no notes on my info about a call. She said it might have been one of the managers, but without any notes or anything, no one can tell for sure.
I brought this up with my brother, who has been using a CPAP for 6 years (ResMed Airsense 10), and he suggested I reach out to his DME, Sound Oxygen Services, to see if they're in network for me and all that. I give them a call, and someone picked up right away. They said as long as my doctor specifies a machine on my prescription, they'll get that one for me. I was given a fax number to give my doctor and overall, it was a positive support experience.
I've gone ahead and messaged my doctor with the request to have the prescription sent to Sound Oxygen with a mention of my preferred machine. Currently waiting to see how that goes over.
Has anyone had any experience with Performance Home Medical or Sound Oxygen? What are your thoughts? How would you rate them?
I do plan to start uploading my data to OSCAR, which was another reason I want the ResMed. I want to give myself the best chance of success here. Diagnosis is for "mild" OSA. AHI is 6.9 with REM AHI at 30.9. I want to know what it's like to not be tired and brain foggy all the time.
RE: DMEs in the PNW (Story & Question) - Melman - 01-26-2023
Get s copy of your prescription. Then you will be free to choose a supplier without going through your Dr. Sound like he has a setup to bring in more profits for himself.
RE: DMEs in the PNW (Story & Question) - Sleeprider - 01-26-2023
DME quality varies a lot and any DME offering the Chinese made Luna is putting profit before your needs. Get the Resmed you want, in fact, insist on it. My DME that dispensed my Resmed Vauto in 2016 went out of business and I was referred to a Hometown Oxygen (aka Dynamic Healthcare). In March its year someone named "Tracy" suspended my account just as a request for a new machine was submitted. She said I needed a new sleep study. I knew this to be wrong and I recently had the pleasure to engage Rotech about my needs. Within 2-weeks I have a new set of supplies heading my way and the machine is in progress. It makes a difference who your work with. Don't work with people you don't feel confident are representing your best interests.
RE: DMEs in the PNW (Story & Question) - SquishySquishCat - 01-26-2023
Thanks for the responses. The doctor who sent in the prescription wasn't the same one who initially ordered my in-lab study but someone I consulted with a while back for my at-home study (delay between at-home and in-lab was due to the at-home being right before they started shutting everything down from Covid, and then I was unemployed and then had an ill pet to care for). I have a virtual appointment with the doctor who ordered the in-lab in 2 weeks, so I guess we'll see how that goes, and I'll see if I can get a copy of my prescription "for my own records" to have on hand just in case.
My brother has been using his DME for 6 years now and hasn't had any complaints, which is probably the most glowing review I've heard from anyone I know in regards to their DME. Performance Home Medical just really seemed to send those red flags waving. I'm mostly just glad I knew before that call that I didn't just have to roll over and take whatever they gave me.
RE: DMEs in the PNW (Story & Question) - Sleeprider - 01-27-2023
Keeping a complete record of your sleep studies, prescriptions and documentation of use and physician consultations is very important to your insurance coverage, now and in the future. Having those records is the best way to avoid additional studies being required when you eventually go on Medicare with the rest of us old guys. Be sure to put some effort into obtaining and maintaining a record.
RE: DMEs in the PNW (Story & Question) - SquishySquishCat - 01-27-2023
I see my sleep study results are supposed to be arriving today in the mail (USPS Informed Delivery is great). My mom was always very insistent on keeping documents filed away for at least 7 years because she was a small business owner and said you never know when you'll need something for tax records, so I've just defaulted to squirreling things away too. Hopefully I'll hear back from my doctor today or on Monday about changing DMEs, and we'll see where things go from there.
RE: DMEs in the PNW (Story & Question) - SquishySquishCat - 01-27-2023
Latest update: Doctor's office called to see if my only complaint about Performance Home Medical was the delay with getting the machine I wanted, so I clarified how I felt talking to the DME's support and the online reviews that showed they might not be very transparent in their practices. Mentioned I would feel better working with a DME that's already trusted by someone I know, and they're going to send my prescription over to Sound Oxygen with a dispense as written for the Airsense 11.
Still waiting for my sleep study results in the mail (I'll check again tomorrow), but hopefully now I'm moving in the right direction.
RE: DMEs in the PNW (Story & Question) - Hydrangea - 01-28-2023
Way to go, Squishy! Great job advocating for yourself, and not falling for the slimy DME trick.
RE: DMEs in the PNW (Story & Question) - SquishySquishCat - 01-28-2023
Thanks, Hydrangea! I should be hearing back from Sound Oxygen somewhere in the next "7-10 business days" according to my doctor. PHM tried calling me this evening (about an hour after they're supposed to be closed), but I didn't bother answering. The voicemail message they left just said to please call them back, and given the last time they called me no one knew why they called....I don't think it's worth giving them any more of my time.
I can't wait to get my machine and finally experience what it's like to be well rested. I'll definitely be reaching out to you guys to help get things optimized. Everyone here has been really great so far!
RE: DMEs in the PNW (Story & Question) - Phaleronic - 01-28-2023
Years ago when I was just beginning my journey I went through the insurance/dme BS for my first machine (DS1 APAP). It was Norco here in the PNW, and it was absurd, and they ended up charging me and my insurance around $1600 for that $700 machine. I haven't used insurance or DMEs or sleep docs now for 4 years and I never will do so again. Please get a copy of your prescription and learn to use Oscar so you can self titrate..