A Comedy of Errors ... or How I got my AutoSet

[CKJ411]

I understand the difference. It has a "mode" setting, which is currently set to CPAP. It's possible I've misunderstood what the tech was saying, but I seem to remember him switching the mode off auto and onto CPAP. I'll have to mess with it later and see. I could have been totally wrong though, new stuff for me.

[Gabby]

Don't worry, no time at all and you will no what is what. It can all be a bit overwhelming at first.
The Elite is a good machine and you are able to download a programme and see what is happening to you as often or as little as you like, so be thankful for that.
Good luck on your journey.

[ImaSurvivor]

SleepyDreamCatcher, your post made me laugh out loud and totally my day! Good for you and congratulations. Job well done! Good luck with your therapy.

[SnuffySleeper]

Congratulations SleepyDreamCatcher especially on getting the right machine!!!

Gabby: After a false start I went into my DME and wanted the AutoSet and not only was he an arrogant prick whose office I will never go to again, he actually wrote right on the prescription NOT to give me an auto set unless I wished to pay extra out of my pocket. He was really hostile and just kept saying over and over that the machines were all equal to one another and although I nicely argued with him, it was apparent I was not getting anywhere with him and if anyone can stand up for herself, it is me........some DMEs are just awful. Next time I will interview them first and only then when I find someone that will give me one will he become my doctor.
And unfortunately some health plans just won't pay for them, at lest here in Canada but from all I have read, they have a much easier time getting the Auto Set in the United States than we do here. Perhaps it is the same in Australia. ;-(

Actually I should mention my brother in law has a good health plan here in Canada and even in his case, he still had to pay extra for the Escape!!! Like you I to believe I will have to buy one outright.


So the Elite also records data and u can use software with it?
I thought only the AutoSet did that?

You're going to have a rough time in Canada thinking like that. We are not entitled to Autosets here because we have free sleep studies and titration tests and can see a sleep doctor anytime, I am sure you can raise a stink at every Vendor in your area until one is manipulated into giving you one, but that seems like a lot of work with little return.

I know the forum culture here is to demand an AutoSet because they cost the same, but that seems only because insurance companies do not distinguish between Cpap and Apap in America. Maybe because the insurance company has to pay for sleep studies and if they all just used Apap with wide open settings then insurance companies would save money in the long run, as they would not have to pay for titration studies every 6 months.

My example. I have an elite and my doctor is scheduling me for a titration/sleep study test every 6 months. That's the culture in Canada, that the pressure should be set by doctors and sleep studies instead of a machines algorithm.

The doctor in Canada writes apap or cpap on the prescription, and the vendor has to dispense the prescription as written by law, there is no grey area like in the states about cpap or apap, it's what ever is written by the doctor. The vendor HAS to fill the prescription as stated.

So well Americans can focus on manipulating DMEs to get an Autoset because of the same insurance pay codes, we can't do that here. You would have to ask your doctor and the DME would have no choice but to give you an autoset if it's on the prescription.

[PaytonA]

In the U.S. as I understand it, it is the law also that the DME dispense the prescribed equipment as written. The ambiguity comes in when the doc just prescribes a CPAP which is a general term for all the varieties of CPAP including auto CPAP, bi-level CPAP, uni-level CPAP, CPAP with and without reported efficacy data and so on. As far as I know, no doctor writes "APAP" since this is a shorthand designation that is commonly used for auto-titrating continuous positive airway pressure.

Best Regards,

PaytonA

[skram]

You're going to have a rough time in Canada thinking like that. We are not entitled to Autosets here because we have free sleep studies and titration tests and can see a sleep doctor anytime, I am sure you can raise a stink at every Vendor in your area until one is manipulated into giving you one, but that seems like a lot of work with little return.

I know the forum culture here is to demand an AutoSet because they cost the same, but that seems only because insurance companies do not distinguish between Cpap and Apap in America. Maybe because the insurance company has to pay for sleep studies and if they all just used Apap with wide open settings then insurance companies would save money in the long run, as they would not have to pay for titration studies every 6 months.

My example. I have an elite and my doctor is scheduling me for a titration/sleep study test every 6 months. That's the culture in Canada, that the pressure should be set by doctors and sleep studies instead of a machines algorithm.

The doctor in Canada writes apap or cpap on the prescription, and the vendor has to dispense the prescription as written by law, there is no grey area like in the states about cpap or apap, it's what ever is written by the doctor. The vendor HAS to fill the prescription as stated.

It's even more complicated than that, it depends on which province you are in.

Here in Nova Scotia, after my sleep study, my doctor wrote the prescription for a CPAP, with little else written on it. The sleep centre put me on an Autoset right away for my trial period. It was what they had ready for me when I got to there for my appointment. (before they saw my Rx or even knew what I have for a health plan/insurance). Note however, that my sleep study was an "at home" one and I didn't do a titration. In fact the few people I know around here who went on CPAP didn't have titrations. I think the norm here is to use an Auto machine instead and do a 30 day trial period to determine the pressure range. Maybe to replace the extra cost of the titration with the cost of the machine - that would also move the cost out of the health system and into the insurance plans (or patient's pocket if no plan like my father-in-law).

[SnuffySleeper]

It's even more complicated than that, it depends on which province you are in.

Yes, definitely. Each province has it's own rules. There was a previous thread where we identified the requirements for Apap mandated by the government in Ontario. It included min pressures and a difference of pressures sleeping from side to supine position. These were the guidelines doctors have to abide by to prescribe Apap, was an interesting read.

[SnuffySleeper]

In the U.S. as I understand it, it is the law also that the DME dispense the prescribed equipment as written. The ambiguity comes in when the doc just prescribes a CPAP which is a general term for all the varieties of CPAP including auto CPAP, bi-level CPAP, uni-level CPAP, CPAP with and without reported efficacy data and so on. As far as I know, no doctor writes "APAP" since this is a shorthand designation that is commonly used for auto-titrating continuous positive airway pressure.

Best Regards,

PaytonA

In a perfect world Resmed would only make one S9 Model (autoset) and it would make life easier for everyone.

I would be interested to know the wholesale costs of the units from Resmed. They can't be all the same or else Resmed wouldn't bother making different models the Autoset could just do everything the others can. Someones got to be making more money off certain models.

[SuperSleeper]

As far as I know, no doctor writes "APAP" since this is a shorthand designation that is commonly used for auto-titrating continuous positive airway pressure.

Yep. That's why I often write "Auto-CPAP" here on the forums rather than the more loose term of APAP. Auto-CPAPs (APAPs) are also CPAPs - both are Continuous Positive Airway Pressure, but one auto-adjusts, the other doesn't. I've been tilting at that windmill for years to no avail.

See this page for clarification:

http://www.apneaboard.com/APAP.htm

[SnuffySleeper]

The prescription I saw for an Autoset said "auto-cpap" on the pad, yes.

The way doctors write is a mystery. I know here different vendors have different forms the doctor has to fill out. So depending ont he vendor the doctor fills out their particular form.