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What To Expect From Your Local Durable Medical Equipment Provider
These are compliments of rjjayrt, a DME RRT who has been gracing cpaptalk's forum w/his patience and presence:
What To Expect From Your Local Durable Medical Equipment Provider
1. DME should explain to the patient what their insurance requirements will be.
2. Should discuss the cost schedule based on coding, and what the patient will be responsible for.
3. Should provide the patient with dispute resolution options.
What To Expect From Your Local Durable Medical Equipment Provider's Registered Respiratory Therapist
1. The RT should have a discussion with the patient concerning Diagnosis (make sure the patient understands what the diagnosis is), and treatment (explain what Cpap, bipap, fully data capable, auto titrating mean)
2. Discuss the available machine options. If the patient wants an auto titrating machine the RT should be agreeable to pursue with the physician the ability to do so.
3. Once a machine is decided on discuss and demonstrate all functions of the machine. Show the patient a demo download and explain what each value means.
4. Discuss with the patient their sleep habits, if they sleep on their back or stomach, if they're a mouth breather or nose breather. Find out if the patient is claustrophobic or not.
5. Based on #4 discuss the available mask possibilities, let the patient try the mask on while under pressure.
6. After a mask is decided upon, demonstrate proper donning and removal of mask.
7. Assuming you've discussed and demonstrated everything in a way the patient understands, you should be able to have the patient setup their machine, apply their mask, set their humidifier and start therapy. If the patient has problems or is hesitant repeat instruction until patient can complete the task from start to finish without error.
Before the patient leaves discuss known problems with cpap, discuss with them the problems they may have over the next few days or so and discuss with them ways to avoid the problems or ways in which to deal with the problems.
8. Ensure the patient understands accessory replacement schedule, cleaning procedures and most importantly has a way to get in touch with you if there's a problem.
9. Finally make a follow up schedule with the patient so downloads can be done to check progress. I suggest one at 1 week, at 1 month and again at 6 months.
And I would suggest printing these out and taking them to your next local apnea support group meeting!
What To Expect From Your Local Durable Medical Equipment Provider
1. DME should explain to the patient what their insurance requirements will be.
2. Should discuss the cost schedule based on coding, and what the patient will be responsible for.
3. Should provide the patient with dispute resolution options.
What To Expect From Your Local Durable Medical Equipment Provider's Registered Respiratory Therapist
1. The RT should have a discussion with the patient concerning Diagnosis (make sure the patient understands what the diagnosis is), and treatment (explain what Cpap, bipap, fully data capable, auto titrating mean)
2. Discuss the available machine options. If the patient wants an auto titrating machine the RT should be agreeable to pursue with the physician the ability to do so.
3. Once a machine is decided on discuss and demonstrate all functions of the machine. Show the patient a demo download and explain what each value means.
4. Discuss with the patient their sleep habits, if they sleep on their back or stomach, if they're a mouth breather or nose breather. Find out if the patient is claustrophobic or not.
5. Based on #4 discuss the available mask possibilities, let the patient try the mask on while under pressure.
6. After a mask is decided upon, demonstrate proper donning and removal of mask.
7. Assuming you've discussed and demonstrated everything in a way the patient understands, you should be able to have the patient setup their machine, apply their mask, set their humidifier and start therapy. If the patient has problems or is hesitant repeat instruction until patient can complete the task from start to finish without error.
Before the patient leaves discuss known problems with cpap, discuss with them the problems they may have over the next few days or so and discuss with them ways to avoid the problems or ways in which to deal with the problems.
8. Ensure the patient understands accessory replacement schedule, cleaning procedures and most importantly has a way to get in touch with you if there's a problem.
9. Finally make a follow up schedule with the patient so downloads can be done to check progress. I suggest one at 1 week, at 1 month and again at 6 months.
And I would suggest printing these out and taking them to your next local apnea support group meeting!
Views: 235
Replies to This Discussion
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Permalink Reply by Judy on
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So check w/your insurance and see if you have the option of another local DME provider. Why stick w/this babe if others are available via your insurance?
Meanwhile, ask her why she doesn't take advantage of the Resmed, Respironics and Fisher & Paykel free replacment policy.
If you are comfortable w/the Opus other than the mouth leaks you can TRY making your own chin strap w/the leg cut off one of your wife's opaque panty hose tights.
As Ann Landers always said: "People can't use you as a door mat unless you let them". YOU are the one paying for this, whether thru insurance or out of pocket, YOU are still the one PAYING. It is YOUR health, it is YOUR therapy, it is YOUR life. There is no sense in letting some "employee" give you this kind of run around!!!
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No that is not normal at all, we have inventory on hand in our office (brand new) even if we had to order a bipap it would be ordered overnight. You will have to stick with them as far as the machine unless it is a rental at which case you should check with your insurance company one to see if they are charging you for a loaner and two to see if its a rental and if you can change companies. Most of our bipaps at least have a 2 month rental period at first to make sure the patient is able t use the machine. You really need to let the insurance company know what is going on. Good luck.
Carl Speas said:thanks for your concern. my problem with the rt at the dme is her lack of concern. she does not seem willing to allow me other options as far as masks are concerned. she wanted me to wear a full face mask, i refused because we tried this 2 years ago and the mask ate my nose up from top to bottom my eyes swelled shut my whole face swelled up. it took six weeks for my nose to heal after getting off the mask. her attitude is no full face mask no service. must be her favorite mask . so i walked away from the machine and had very extensive surgery that did not work. then i had a dental appliance made that did not work either. so now i am on bipap this time because they discovered i have complex sleep apnea. i am sure there are good dme and rt out there but i have bad luck so far. as far as seeking a new one i do not know how the insurance company works that. i figured i probably could not change until the machine is paid off. 1 year.
i do have a question for you. is it normal procedure to give a client a used machine for the first month while yours is being ordered? it has been 7 weeks and i am still using a loner machine.
sheila Herring said:I have a DME company and I am a respiratory therapists. Have you tried changing to another company for your supplies and help. A trach is pretty drastic. We have pt. all the time that got a machine from a company and have problems like yourself and we help them out. 2 months is not that long yet so be patient with yourself it can take months to adjust. I would be happy to try and answer any questions you might have and see if I can help you through this site.
Carl Speas said:this week i tried to contact my dme. it was like looking for a needle in a hay stack. when i finally reached her you could tell she could care less. i am less than 2 months on bipap had some questions. she was totally clueless. i went to see my doctor the same day, he told me from now on to contact him the dme was not knowledgeable enough to answer questions. she does well to sell equipment. he told my sleep apnea problem was so bad he did not want me to take advise from her. he also told me that if i cannot adjust to my machine and mask my only option from here on was a trach. sugrery nor dental appliance has worked so i must wear this machine. so far have not done the best, but i am going to keep at it awhile longer.
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Permalink Reply by Banyon on
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Carl Speas said:she wanted me to wear a full face mask, i refused because we tried this 2 years ago and the mask ate my nose up from top to bottom my eyes swelled shut my whole face swelled up. it took six weeks for my nose to heal after getting off the mask. her attitude is no full face mask no service. must be her favorite mask .
Are you aware that there are specific medical conditions that require a full face mask (including the "hybrid" types)? The choice between a nasal interface and a full face interface has to do with your therapy and should have nothing to do with the DME's preferences.
I am sorry that you have been through so much.
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Judy said:I won't get into Patient Responsibilities because I have a husband who still for some unknown reason blindly accepts and never questions his doctor. I don't understand that type of person and never will.
The majority of patients would never be able to stand up to my personal list of Patient Responsibilities and they/we would probably antagonize 95% of the medical profession.
IMO, this forum is not for the majority of the sheep - they don't come here and if they stumble in, they don't stay long. The forum is for those who desire to take personal responsibility for their own therapy and health. You might do a very good service by posting your personal list of Patient Responsibilities here. You might even convert some sheep.
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Where are you located. I want to switch to your company.
My DME has been responsive but not proactive -- and I think that a bit of the responsiveness was because I was forearmed with so much forum information before walking in the DME's door. I give mine a c+ maybe a B-
sheila Herring said:I am a Registered Respiratory Therapists who owns a dme company. We only do cpaps,bipaps, ASV, etc. We go to the pts. home do all the things on this thread except we do a phone follow-up in 3 days, 30, days, 60 days, and a letter every 90 days for supplies. We do either a 2 week or 30 day download depending on the physician. A week download really does not give you a fair chance to adjust to the therapy. But your provider should be available to help you adjust and help with mask issues.
Jan said:Wondering how many on have worked with a DME or RT who complies with the list that started out this thread? Not me.
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Our company is in North Carolina and while we are not perfect I think most of our pts would give us a good grade.
Jan said:Where are you located. I want to switch to your company.
My DME has been responsive but not proactive -- and I think that a bit of the responsiveness was because I was forearmed with so much forum information before walking in the DME's door. I give mine a c+ maybe a B-
sheila Herring said:I am a Registered Respiratory Therapists who owns a dme company. We only do cpaps,bipaps, ASV, etc. We go to the pts. home do all the things on this thread except we do a phone follow-up in 3 days, 30, days, 60 days, and a letter every 90 days for supplies. We do either a 2 week or 30 day download depending on the physician. A week download really does not give you a fair chance to adjust to the therapy. But your provider should be available to help you adjust and help with mask issues.
Jan said:Wondering how many on have worked with a DME or RT who complies with the list that started out this thread? Not me.
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Permalink Reply by Mary Z on
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I am really lucky that I have a good DME. He is an RRT and the more I learn here to talk about, the more he ups his level of explanation/expertise. So far he's been right on, as I said the more my own knowledge grows the more time he takes with me explaining and demonstrating things. I do need to let him know how deeply I want to go into basics and beyond. He has so many patients who could care less, who won't ask for his help if they are having problems when it is so easy just to quit.
I'm sorry there are so many folks whose DMEs don't have the knowledge or don't want to take the time. My first DME only cared that I knew how to clean the machine and I didn't know other questions to ask as I was brand new to CPAP. We learn so much here that DMEs don't think to tell us and we didn't know to ask. Do I turn the machine off when I use the bathroom? What can I do for my nose getting red when a FFM is the only option? How do I get the readout from the LED screen? These are some of the things I've learned here that I would not necessarily have known to ask the DME.
I'm also lucky that my sleep doc has his own techs to download machine data during my visit so he has the latest readout with him when he sees me.
Maybe we should all tell our DMEs about sleepguide so they can know what the newbies need to know and what kinds of things we discuss and would want more information about.
Mary Z.
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