Good evening. I think my DME is an idiot. Aside from the fact that he requires me to notify him monthly to send me my 2 filters and 2 nasal pillows, I think he's on his own schedule. I have BCBS.
If I recall correctly, it seems that I should get the pillow interface / mask every 3 months, 2 pillows and 2 filters a month (technically every 2 weeks), a tube every 3 months, and the humidifier every 6.
Does this sound right?
According to my DME, he says:
1 pillow a month, 1 filter a month, tubing tub and "headgear" every 6 and mask every 6. I appreciate the advice of the masses here. How do I address him on this? Or do I call BCBS and complain. (At least I have no copays or coinsurance on this. Thank you in advance.
Insurance schedule
- Roman Hokie
- Posts: 438
- Joined: Wed Jun 02, 2010 8:08 am
- Location: Central NY
Insurance schedule
The best education comes from hard-fought experience. Someone else's.
If you see me acting unruly, call me on it. PMs are welcome.
If you see me acting unruly, call me on it. PMs are welcome.
- ChicagoGranny
- Posts: 14547
- Joined: Sun Jan 29, 2012 1:43 pm
- Location: USA
Re: Insurance schedule
No, call BCBS and ask them for a copy of the replacement schedule. It's their replacement schedule, not the DME's. Even within BCBS, policies vary, so no one here can tell you what your policy says.Roman Hokie wrote:Or do I call BCBS and complain.
- chunkyfrog
- Posts: 34450
- Joined: Mon Jul 12, 2010 5:10 pm
- Location: Nebraska--I am sworn to keep the secret of this paradise.
Re: Insurance schedule
What she said.
Get it in WRITING, confront them with any discrepancy, and , if necessary,
TAKE YOUR BUSINESS ELSEWHERE.
Get it in WRITING, confront them with any discrepancy, and , if necessary,
TAKE YOUR BUSINESS ELSEWHERE.
_________________
Mask: AirFit™ P10 For Her Nasal Pillow CPAP Mask with Headgear |
Additional Comments: Airsense 10 Autoset for Her |
Re: Insurance schedule
Some insurance (including Medicare) do not allow regular shipments of supplies ...the patient must request them. IMO..no one needs the supplies on a regular basis. Who needs a new hose every 3 months they never wear out. Same with most masks and humidifiers.Roman Hokie wrote:Good evening. I think my DME is an idiot. Aside from the fact that he requires me to notify him monthly to send me my 2 filters and 2 nasal pillows, I think he's on his own schedule. I have BCBS.
If I recall correctly, it seems that I should get the pillow interface / mask every 3 months, 2 pillows and 2 filters a month (technically every 2 weeks), a tube every 3 months, and the humidifier every 6.
Does this sound right?
According to my DME, he says:
1 pillow a month, 1 filter a month, tubing tub and "headgear" every 6 and mask every 6. I appreciate the advice of the masses here. How do I address him on this? Or do I call BCBS and complain. (At least I have no copays or coinsurance on this. Thank you in advance.
Because they are free doesn't mean you have to take them....that's why out healthcare system is in the shape it is in.
_________________
Machine: ResMed AirSense™ 10 AutoSet™ CPAP Machine with HumidAir™ Heated Humidifier |
Mask: Fisher & Paykel Vitera Full Face Mask with Headgear (S, M, or L Cushion) |
Additional Comments: Back up is S9 Autoset...... |
Last edited by LSAT on Sun Jan 08, 2017 6:58 am, edited 1 time in total.
Re: Insurance schedule
Call your Ins. (as already said) but also make sure the DME is only billing for what they are sending not what you think they should send.
Re: Insurance schedule
I went to the new DME place cause I got new insurance and the lady at the desk never heard of the new F20 mask when I went to order. Not happy with them.