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Irritated


Posted by Nancy on February02, 2000 at 16:34:21:

Can I vent? I am just learning how this "game" is played. I was handed the Sullivan V and a passover humidifer the day I was diagnosed~30 minutes after. I had to choose by sight~between the Breeze and a face mask, cause "insurance won't do both", and now after a week of a COLD passover humidifier, I am learning that the treatment of choice (and studies have shown), that the heated is more comforable for those with nasal problems, which I have big time. That is documented with the sleep doctor, but he ordered cold. The dr's office got an RX from the doctor stating warm was medically necessary. So far, they are cooperative and helpful. I thought it was on it's way, and I get a call from the DME who tells me that there is "no way" the insurance co. will pay for ANOTHER humidifier, "that isi $355!", that they have already bought one (molded plastic in my eyes!) I asked the name of the person who told her they would not buy another one, and she stammered about and said, "well, they never do from past experience." I told her that we had contacted the insurance co., and they said with a doctor RX, they would and the run around continued and she said she has to have written authorization, etc. I was hoping I wouldn't have to be pro-active until time comes to purchase the right CPAP for my needs. Anyway, it is all caught up in paperwork, but what infuriates me, is that I have read overwhelming testimonies that the warm is more comfortable and the problems I'm having were reduced or solved with the correct treatment. They KNOW that because I got a letter from the doc. office today, asking me to send it to my insurance co., and it is a FORM letter stating all the reasons why warm humidity is better, and even an article re: same! WHY did they start with the cold in the first place if they knew people with sinus problems are better treated with warm? They see it as me causing trouble and not "taking what they gave me" and yet they knew it wasn't right in the first place! My husband & I think it is more the DME than the insurance because they haven't said they won't pay~yet. But the DME was not being my advocate to try to get what I needed. Just a phone call saying I already had one, and had I not persisted with the issue, I would have had to keep suffering with this POURING nose, constant sneezing and cough;not to mention the painful FROZEN nose every am around 3! I don't know where this will end up, but I can tell it is going to be a journey that takes documentation, knowledge and PLEADING to get what I need for this pesty disorder. I am hanging in there, but after a week of all of this, I feel more stressed than impressed that the people caring for this disorder are on MY side! Thanks for letting me VENT. Thankfully, my husband is 100% supportive of fighting for what I need. Do DME's, and insurance companies always work so "well" to protect their $$, or is this just a bad experience?

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