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New "Rant" about DME/Wisp
Well, it had been three months since I received my original Wisp. And while it is still working well I wanted a "spare" on hand...just in case! So I called my DME to ask if they had the one with the fabric frame in stock. They did. The next day I drove there and picked up the new mask and one extra cushion. All to be billed to my Insurance. When I got home I realized they had the clear frame and not the fabric. I called and told them I would take it back today and exchange for the fabric one. They had already thrown the charge slip away from the day before. Wrote me up a new one for today. Then the RT says, "let me open it up and remove the two cushions you do no fuse." I told her "no", I wanted them. I know they had given me a new cushion from a mask set a couple of months ago and then charged it to the insurance. So they received $$ for it twice. That is why she wanted to get the two extra in the package today!!!! This is fraudulent. That being said....if anyone on here uses either the smallest cushion or the largest cushion for the Wisp I will gladly mail them to you (if you just pay for shipping) I am debating whether to say something to my insurance company. I feel this goes on a lot!!!! Also noticed on todays receipt they charged for 2 nasal cushions ( I was given ONE.....1 nasal mask, (given ONE) and 1 headgear. I was not given this as it is included in the whole mask set up. So now I am going to wait and see how they actually bill for this. If they do it incorrectly I will for sure call my insurance. Are there less honest people in the world now???
Views: 418
Replies to This Discussion
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Permalink Reply by Mary Z on
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I think this kind of behavior may be the norm with DMEs. I happen to have one of the good ones so I'm lucky. It would be great if you called your insurance company. You can steal millions if you steal $40 from a bunch of people. The DME probably thinks these amounts are small enough to not trigger any alarms. Well it triggered your fraud alarm.
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Permalink Reply by Ginny Edmundson on
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My insurance is Medicare plus supplement. SO I pay nothing out of my pocket. BUT it is coming out of ALL out pockets...........My DME is a nationally known company. I am really thinking of calling the medicare hotline.
Mary Z said:I think this kind of behavior may be the norm with DMEs. I happen to have one of the good ones so I'm lucky. It would be great if you called your insurance company. You can steal millions if you steal $40 from a bunch of people. The DME probably thinks these amounts are small enough to not trigger any alarms. Well it triggered your fraud alarm.
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I agree Ginny, it does come out of all our pockets. I too have Medicare with a Humana supplement and insurance with my partners work. This is the only year I will have anything but Medicare and supplement. My last two Medicare supplements said the monthly rentals would continue as long as I had the machine. They would never pay it off. The DME insisted that wasn't true, but I don't think they looked at the paperwork on the plan benefits. I just ordered a new Wisp, I take advantage of the three month replacement. I like to keep a spare hose and spare mask on hand. Typically these are the used ones I just retired. It will be interesting to see if it continues to come with all three sizes of mask. I replace the mask cushion and white filter every three months, the whole mask and tubing every three months, the chin strap and the humidifier water chamber. That last on- the humidfier water chamber I didn't know I could get every six months.
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I have ben using one of my cushions for 3 months now. I think I will just see how long I can actually use it without leaks before I replace it. I wonder if it is OK that I do not replace the tubing but about every 6 months???? I hate the new ones as they are so stiff at first. Takes a while to "break" them in. Also the head gear still seems fine after three months so I am just keeping all the new parts for when I need to replace something. And besides the new whole mask kit I have three other cushions waiting in the wings. So glad the Wisp came along. Oh, one more thing. I had always used the humidifier and two months ago stopped. I have so much less nasal congestion now. Not sure I understand why but it is one less thing to take care of (filling, daily cleaning etc) So have not missed using it at all.
Mary Z said:I agree Ginny, it does come out of all our pockets. I too have Medicare with a Humana supplement and insurance with my partners work. This is the only year I will have anything but Medicare and supplement. My last two Medicare supplements said the monthly rentals would continue as long as I had the machine. They would never pay it off. The DME insisted that wasn't true, but I don't think they looked at the paperwork on the plan benefits. I just ordered a new Wisp, I take advantage of the three month replacement. I like to keep a spare hose and spare mask on hand. Typically these are the used ones I just retired. It will be interesting to see if it continues to come with all three sizes of mask. I replace the mask cushion and white filter every three months, the whole mask and tubing every three months, the chin strap and the humidifier water chamber. That last on- the humidfier water chamber I didn't know I could get every six months.
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The reasoning behind changing the tubing is that it may develop small holes or tears which causing leakage. I am careful with my tubing and don't have any animals or children playing with the tubing. I don't feel like they have to be changed that often. I bought the generic low weight tubing oop from CPAP.com. I really like the reduced weight with the Wisp mask. I have always changed mask cushions every three to four months as I find they break down. That's interesting about the humidifier- I use mine to combat nasal congestion, but the humidity may be making the congestion worse. I'm going to try the machine without the humidifier tonight.
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I was really surprised when the congestion improved without the humidification. Yes, I use the lighter weight tubing too. Do you have trouble getting the bends and kinks out of them???? I have one favorite that is broken in and I hate to change it out. LOL
Mary Z said:The reasoning behind changing the tubing is that it may develop small holes or tears which causing leakage. I am careful with my tubing and don't have any animals or children playing with the tubing. I don't feel like they have to be changed that often. I bought the generic low weight tubing oop from CPAP.com. I really like the reduced weight with the Wisp mask. I have always changed mask cushions every three to four months as I find they break down. That's interesting about the humidifier- I use mine to combat nasal congestion, but the humidity may be making the congestion worse. I'm going to try the machine without the humidifier tonight.
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My light weight tubing does not have a tendency to kink. It just hangs down from the stand and comes back up to the bed. I tried a hose hanger, but bought the cheaper travel model and it just wasn't up to the task.
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I just use a large rubber band and safety pin to attach i tho the sheet. It doesn't exactly kink, but rather seems to have almost bends that don't quite ever go away. I have one that doesn't but all the others seem to. The best one says "slimline" on it.Did you try to not use the humidifier?
Mary Z said:My light weight tubing does not have a tendency to kink. It just hangs down from the stand and comes back up to the bed. I tried a hose hanger, but bought the cheaper travel model and it just wasn't up to the task.
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Permalink Reply by RockRpsgt on
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Companies like this will have to pay in the end. Medicare is taking no prisoners in their effort to reform medicare fraud.
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It really burns me up that they are doing things like this. Monday I am going to lok up th eMedicare complaint number and give them an ear full.
RockRpsgt said:Companies like this will have to pay in the end. Medicare is taking no prisoners in their effort to reform medicare fraud.
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Ginny, they are probably not doing anything against the law- though it may seem like fraud to us it may be an accepted practice. I would rather change DME's. Have you talked to the manager. They don't want to lose your business, so the manager might be able to help.
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Permalink Reply by Louise on
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Ginny, I so agree with your DME frustration. I still haven't gotten billing for my original Wisp. I've since gotten one cushion & am calling this next week about another new one & frame. I too don't like not having extra parts. I am totally satisfied with my new Wisp. Can you explain a little more about the rubberband pinned to sheet for tubing?
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