buy what you want and not what your DME wants

higgy · Post by **higgy** » Wed Jun 06, 2007 3:28 pm

I meant to put this as a post under biting nails, I started a new thread by mistake.

I just went through this, there are severals ways to do this and get what you want.

I checked with my insurance and they pay 1800.00 for any xpap since they all have the same code for prescription.

In fact if the doc gives a prescription for x to y pressure they will give you an auto machine, if the prescription is for x pressure they can sell you anything but a bi pap.

In my case the insurance company allowed me to buy the machine that I wanted and reimburse me 85% of the cost of the machine. The local DME was going to give me a basic m series, a good machine, but not what I wanted. they were going to charge my insurance 1800.00 for a machine that I could buy for 375.00 with the humidifier on cpap.com. My de-ductable on that was 270.00 most of the cost to just buy outright. I got the a-flex with mask and humidifier for approx 900.00 from cpap.com and my de-ductable was approx 130.00 and I got a much better machine.

pm me if you would like details on how this can be accomplished.

I do not work for cpap.com and I am in no way affiliated with them. I just had a great experience with them and getting what I wanted for a good price and as they promised.
_________________

CPAPopedia Keywords Contained In This Post (Click For Definition): humidifier, cpap.com, DME, Prescription, auto

_________________

CPAPopedia Keywords Contained In This Post (Click For Definition): humidifier, cpap.com, DME, Prescription, auto

Wulfman · Post by **Wulfman** » Wed Jun 06, 2007 3:51 pm

I've already detailed the "how-to" on this MANY times in the last two years.

If you do a "Search" (above) on "reimburse" with author "Wulfman", there will be over a page of threads listed.

Den

higgy · Post by **higgy** » Wed Jun 06, 2007 3:54 pm

OK, I did not know that, found my own way through, nice to know.

Wulfman · Post by **Wulfman** » Wed Jun 06, 2007 4:24 pm

higgy wrote:OK, I did not know that, found my own way through, nice to know.

Congratulations!
I also found this out on my own BEFORE I got suckered into some "black hole" contract with a DME. As soon as I was told (by the sleep lab tech) that I had sleep apnea, I did as much research on the WEB as I could. So, by the time I met with the sleep doctor to get the results of my test and my prescription, I had some things narrowed down. With the help of Becky at CPAP.COM, we ironed out the rest of the questions and I was all set to go.

Far too many sleep-deprived patients get railroaded into these situations and then realize that they've been screwed. They could have had a better machine (or several machines and masks) for the same money.
Hell, if you can READ, you can set these machines up.

One of the biggest obstacles is the mask.....which needs to be given a considerable amount of thought before chosing one. People (like me) who mouth-breathe need a full face mask. I wish I had a dollar for every one of the times I've read on this forum (and others) that somebody's therapy isn't working for them.....or was and has since gone downhill. You look at their profile (or they provide the information) that they are using a nasal mask.....DUH! You're leaking therapy air!!!
Did they have a choice from their DME?......probably NOT.....they were just handed the cheapest piece of crap and told "That's what you need."

Then there's the software........
I don't know how anybody can have "effective" therapy without monitoring it with software (of course, you have to have a machine that records the data).
Insurance typically won't buy it, but it's worth every damn penny......even at the currently highly-inflated prices. How much does it cost to go back to the doctor?.....too much!

QUESTION FOR JOHNNY.......

WHERE DOES THE SITUATION STAND WITH RESPIRONICS AND THEIR ENCORE PRO SOFTWARE AVAILABILITY??? (or whatever they're doing)

I'll get off my soapbox now. Sorry for the rant, but I felt like I needed to get some things said.

Den (two more to go)

higgy · Post by **higgy** » Wed Jun 06, 2007 4:52 pm

Your course of action and mine were almost identical, and I was pissed when I found out what they were going to do (but did not have the chance).

I want the software, as I would like to be involved as I can be with my treatment, but it is not available from Resperonics.

I am with you transparent information from about our treatment and what you are ACTUALLY going to charge these people that are at their mercy.