Is it just me or is the whole wheelchair manufacturer customer dynamic all backwards?

[August West]

I was in the process of ordering a new wheelchair and had a question only TiLite could answer. The DME was refusing to initiate a conference call. I called TiLite directly and they said that they need an order number. I asked the DME for the order number. They refused to give it to me because they didn't want me working with TiLite. I got the local TiLite rep to find the order number and answer my question. The DME was so upset that I went around them that they cancelled the order.

I understand why they would be upset that I went around them. What I don't understand is why they would refuse to help. What choice did they leave me? They can't have it both ways. Totally unreasonable.

[funklab]

I was in the process of ordering a new wheelchair and had a question only TiLite could answer. The DME was refusing to initiate a conference call. I called TiLite directly and they said that they need an order number. I asked the DME for the order number. They refused to give it to me because they didn't want me working with TiLite. I got the local TiLite rep to find the order number and answer my question. The DME was so upset that I went around them that they cancelled the order.

I understand why they would be upset that I went around them. What I don't understand is why they would refuse to help. What choice did they leave me? They can't have it both ways. Totally unreasonable.

I am having similar difficulty with my DME. This is the first time around I’m getting the feeling that the DME actively doesn’t want me to get a chair. Ive said from the beginning with them that I know exactly what I want im not flexible about it, but I’m willing to pay whatever insurance doesn’t cover. Yet I have to fight them tooth and nail to get any progress.

i don’t really understand how they stay in business, unless they stuff enough people into high margin ill-suited choices quickly and so doing anything that requires thought or work (such as filling out an order form with actual options selected) isn’t worth their time.

at one point i called my insurance company and asked them if I could order a titanium chair (I know good and well that I can, and will have to pay for the upgrade out of pocket). The insurance rep said hold on, called my DME then called me back and said THE DME SAID I can’t get a titanium chair. I was literally at a loss for words for a long moment then politely asked them why the DME was telling BCBS what BCBS’s policy covered and how it worked. I had to argue with her patronizing “explanation” for a few moments before she actually looked at the policy and said “oh... yeah... you can get whatever you want you just have to pay for it”. So aggravating. I’m sure a titanium upgrade puts at least a couple extra bucks in the DMEs pocket, but they went out of their way to try and prevent me from doing it.

[August West]

I am having similar difficulty with my DME.

It's common. But I don't blame the DME entirely. I had a DME who was pretty helpful with private insurance but couldn't do much (or anything) for me with Medicare.

I?m getting the feeling that the DME actively doesn?t want me to get a chair... I don?t really understand how they stay in business.

They have more work and less profit with titanium wheelchairs. They have less more work and more profit with power chairs. The DME tried to talk me out a titanium wheelchair and into a power chair. DMEs are people first and DMEs second. Some people only care about themselves and have no empathy for others.

The insurance rep said hold on, called my DME then called me back and said THE DME SAID I can?t get a titanium chair.

Tail wagging the dog. It's hit or miss who you get on the phone. You have to walk a fine line between getting what you want and not pissing them off. It's an art... one that I am still refining. I have been waiting over 2 years for my wheelchair. Times like these it's hard to play nice. But you have to do it. I filed a complaint with Blue Shield that the DME wasn't letting me talk to TiLite and then they stopped returning my phone calls. Blue Shield was totally on my side on the phone. But the letter they sent was totally on the DMEs side. Right after then is when the DME cancelled my order. I don't know if it was because I went around them or complained to Blue Shield, maybe both. Either way, I am getting my wheelchair through a different DME. I still had problems. But I decided to use more honey and less vinegar. It's paying off.

Hard to do but they have the upper hand so you have to even when they totally disrespect you and treat you like they don't want your business but are just doing you a favor.

[NW-Will]

I agree the whole process is so horrible, you only think of getting a new chair when you really have to, which seems an insane way to run a business.

It would seem it would make more sense for the wheelchair manufacturer to hand hold you to the design of your new chair and then hand you off to the DME to deal with insurance crap.

Just so tired of this stuff.

You have to walk a fine line between getting what you want and not pissing them off. It's an art... one that I am still refining. I have been waiting over 2 years for my wheelchair. Times like these it's hard to play nice. But you have to do it. ....

It's paying off. Hard to do but they have the upper hand so you have to even when they totally disrespect you and treat you like they don't want your business but are just doing you a favor.

[funklab]

I have been waiting over 2 years for my wheelchair.

Me too! I started the process in November 2016. My insurance just changed at work with the new year, so I am starting the process all over again and hoping to find a different DME (the one I was stuck with before was the only one my insurance would cover as in-network). I'm starting out this time by visiting a PM&R doc for the first time in 6 years and the first ever I've had who has a fellowship in SCI, and I am doing so 100% and for no other reason than so that when I appeal to the insurance company they have to find one of their specialist who is a PM&R doc (I don't know if same specialty applies to fellowships as well, they might have to go even further).

Also I just learned something interesting from one of my bosses who used to be an insurance doc. Apparently (at least as of a couple years ago) if you continue to appeal you can eventually request an outside appeal and if they want to fight that they totally have to go hire someone who doesn't even work for them to look at the appeal, which would probably cost them more than whatever you're asking for (at least when it comes to wheelchairs).

If insurance companies want to up the stakes, I'm the kind of asshole to double down...

Oh, and NW-Will this is why you DON'T wait until you "really have to" and start the process as soon as 5 years is up. There's a good chance I'll have to buy my own chair for cash because it becomes unrepairable before insurance actually kicks in and pays.

[August West]

The 5-year rule is worst case. You can get a new wheelchair before 5 years if there is a change in your health or living situation that justifies it. In other words, start the process as soon as possible.