Frustrated with Apria Healthcare

Apria provides F with his enteral and respiratory supplies.  For the most part we have had great success with the enteral department with Apria.  We've had a couple of problems with our last two orders being accurate, but that was easy to work with.  Respiratory department on the other hand is frustrating and aggravating.

When we initially went on service with Apria to provide our nebulizer and suction supplies they just randomly sent out an order of supplies.  There was no call to inquire about what items we actually needed or what brand or type.  They just packed and shipped an order to us.  We received way too many suction canisters.  F uses a vented yankauer and we were sent unvented.  I ended up donating a lot of the supplies to a doctor who does medical missions.

I try to be very frugal with our supplies.  Not because I HAVE to make them last longer, but because I feel so wasteful if I don't.  I don't think I need to replace a functioning suction canister weekly.  We are not above washing them if they are still good.  I think we make it a habit to throw it out quarterly or when we are just unable to clean it to our standards.  Suction tubing is another story.   So are the small pieces to the suction machine.  Those are changed not cleaned.  Our nebulizer kits are washed and sanitized and we have many of them we rotate through.  I feel as a society we are a wasteful bunch of consumers just for the sake of convenience.

I thought I had it worked out with a contact at Apria.  I sent them photos and item numbers of specific items and they located them for us.  That put us in the position to receive accurate orders with accurate quantities.  REcently I sent my contact an email requesting to place an order for respiratory and suction supplies.  He then forwards it to another individual.  Her reply to my email was that she had shipped our suction and nebulizer kits.  I didn't even tell her specifically what I needed.  I received 4 suction canister kits and other items that I did need.  One item that was new I merely had asked if they could provide.  It was an aerochamber with mask for an inhaler.  I think almost two weeks later I send her a message asking about it.  Her response was it's been shipped.

The order arrives and I receive ANOTHER four suction canister kits and four nebulizer masks with the aerochamber.  Now I have 8 suction canisters. We might actually use four maximum a year!  The nebulizer kit masks don't even fit the nebulizer kits that were sent.  Seriously, Apria, you send me supplies I can't even use AGAIN!  The aerochamber is crappy.  It doesn't fit and the mask falls off tossed in the trash.  What a waste of my insurance dollars.

When I sent the contact at Apria an email asking for an explanation regarding the addition of these unnecessary items.  Her response was she'll credit our account and requested me to send her a list of the items.  My response was if she'd had any care and concern about sending us the correct order in the first place she'd have asked for the list before she sent anything to our home.  I'm so aggravated with them.

This is a problem for me.  Apria is a large company.  From what I understand they are one of the largest in the US.  If they are this wasteful of my insurance dollars how wasteful are they of other's insurance dollars?  With the rising cost of health care and insurance premiums why is this company being so wasteful and careless with these medical supplies?

I should mention I wrote to their corporate office regarding this situation when I we first had this problem with the supplies last year.  You know I NEVER received a reply from them.  I doubt I would if I tried to address it this time.  Customer service is clearly not a priority for them, or at least in our situation and the billing issues are another story...

Learning the Process... the Early Years

I was just having a conversation this morning with R, The Hubby, about our early years with F. Being young and naive and not having a darn clue about what might lay ahead.

When F was young, between the ages of one and three he was growing quite quickly. We didn't think about how we'd bathe him when he outgrew the infant tub or where he would sit when he was overflowing out of his bouncy seat. It didn't come to mind until he no longer fit.

F received PT and OT during those years through CCS MTU. He saw therapists at least monthly, and yet, these questions were never asked of us how we did accommodate daily living activities. It was when we had problems with fit that we then asked questions. It was pretty frustrating to need a piece of equipment and then have to wait to work the process of authorization and approval.

I tried to learn very quickly to start making a list of questions for therapists and clinics. Questions like "how will I move him into the bathtub when he's too big?" or "how do I know when his wheelchair needs adjusting, what might that look like?" I tried very hard to make sure I planned. I started to ask a lot of questions to plan for the future.  In the early years I had to rely solely on the vendor we used and/or catalogs available.  The internet was just beginning to take on shape and there was little information.  Now if you have an idea of what you need you can find several products that meet your needs to get ideas.

Then here was the process off authorization and approval. I tried to get to know the process of CCS (California Children's Services) Many individuals don't realize that CCS authorizes Medi-cal to pay for eligible items instead of a TAR (treatment authorization request). Then if you have private insurance and CCS, you would need the denial  or copayment  from the private insurance for CCS to pick up the cost or balance. It's helpful to know the order of things private insurance first, CCS, Medi-cal, Regional Center.  The Regional is the last opportunity of funding if you have denials from all other coverages. This can help you so don't get the run around for your referrals and/or authorizations.  It can be a lot of work, but it will make your life easier and less frustrating. It amazes me how many people who don't take the time to know the process, because they don't have the time, don't want to make the time, or just don't want to be bothered.  They will purchase privately and in my opinion these are funds you have funded personally by health insurance premiums or tax dollars.  It's already your hard earned dollars, make them work for you.

It's wise to learn about your insurance policy.  Know your DME or durable medical equipment coverage.  Does it have a yearly maximum.  Are these types of items covered: specialty formulas, incontinence supplies,  orthotics and splinting, etc.?  It's also very helpful to know the process required by your insurance company for referrals, networks providers, etc.  If you know the policy and what you have access to, it can be helpful when you meet with doctors.  If you know that you have a referral coordinator get to know them. Sometimes authorization is as simple as the language on your prescriptions.  The language can make all the difference.  

Some families with CCS don't know this because they are new to the system, but  they can have a chart review done by the doctor as requested by the therapist.  I'm not sure if I am wording this correctly, but as I recall, it wasn't necessary to get orders for equipment by going to a CCS clinic.  I could call or meet with the therapist.  She would make the recommendation to the doctor.  The doctor would review the chart and recommendation and write the orders.  

Just learning to navigate a health care system can be time consuming, but if you take the time to figure it out you can save yourself valuable minutes in the long run or you can get items or services because you've taken the time to get to know the process.  I am continually saddened when I hear about children being underserved or without equipment because their families don't understand the process.  Sometimes it's due to a language barrier other times it's just they didn't realize that they could get the information if they had only asked the questions. 

CCS and the Regional Centers are available in California.