12-10-2012, 04:53 PM
(This post was last modified: 12-10-2012, 04:57 PM by 2Tim215.)
You need to emphasize that CPAP machines that are made for "Entry Level" patients do not have the ability to handle your changing needs over the next 5 years. Also point out to the insurance company that the price between a ResMed Escape (straight CPAP) and a ResMed AutoSet which can be used as a straight CPAP but available for Auto use if the time arises, is less than 100.00 difference in price! And even offer to pay the difference as you are not only concerned about your future needs but want a machine where your therapy can be monitored with the data available from the S9 ResMed AutoSet where the Straight CPAP cannot which in the long run may actually cost the insurance company more from new Sleep Studies etc. Also ask your Doctor, not the DME to write the prescription for "S9 ResMed AutoSet" and "DAW" dispense as written! I would also point out to the insurance company that some DME's are known to advocate for straight CPAP's as they know under the E0601 insurance code the Autopap is covered and can be used as a CPAP until your needs change and the DME gets to pocket the difference at your potential health risks if they convince the insurance company to only allow straight CPAP machine! Hope this helps. I wouldn't give up, as to speak to a supervisor at your insurance company and keep these notes in front of you when making the call! Hope it works out well for you, don't give up!
Finger Lakes Region, NY