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Apnea's Adventures in Insurance Wonderland
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DariaVader Offline
Apnea Board Facebook Editor
Monitors

Posts: 1,819
Joined: Nov 2014

Machine: Resmed S9 AutoSet
Mask Type: Nasal pillows
Mask Make & Model: Airfit P10 for Her
Humidifier: H5i humidifier with ClimateLine heated hose
CPAP Pressure: 8-15
CPAP Software: SleepyHead

Other Comments: diabetes II, Thyroidectomized, Primary Immune Deficiency, and the list goes on :P

Sex: Female
Location: Oregon

Post: #21
RE: Apnea's Adventures in Insurance Wonderland
on the mycigna website, you can select
  1. "Find a Doctor, Dentist or Facility"
  2. then select the "Hospital, Pharmacy Or Facility" tab.
  3. enter your zip
  4. Search for "Durable Medical Equipment / Supplies / Respiratory Therapy Equipment"


This should tell you what your in-network providers are

هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه
Tongue Suck Technique for prevention of mouth breathing:
  • Place your tongue behind your front teeth on the roof of your mouth
  • let your tongue fill the space between the upper molars
  • gently suck to form a light vacuum
Practising during the day can help you to keep it at night

هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه
04-27-2015 03:56 PM
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Mark Douglas Offline

Advisory Members

Posts: 513
Joined: Apr 2015

Machine: Sys 1 (60) RemStar BiPAP Auto with Bi-Flex 760P Auto Bi-Level (Variabl
Mask Type: Nasal mask
Mask Make & Model: PR Wisp
Humidifier: PR Sys One heated
CPAP Pressure: RiseTime 3 Fxd E-9.0 / I-11.5
CPAP Software: SleepyHead EncoreBasic

Other Comments: Hashimoto's thyroiditis.

Sex: Male
Location: SW Ohio

Post: #22
RE: Apnea's Adventures in Insurance Wonderland
(04-27-2015 03:56 PM)DariaVader Wrote:  on the mycigna website, you can select
  1. "Find a Doctor, Dentist or Facility"
  2. then select the "Hospital, Pharmacy Or Facility" tab.
  3. enter your zip
  4. Search for "Durable Medical Equipment / Supplies / Respiratory Therapy Equipment"


This should tell you what your in-network providers are

Thank You!

I use my PAP machine nightly and I feel great!
Updated: Philips Respironics System One (60 Series)
RemStar BiPAP Auto with Bi-FlexModel 760P -
Rise Time x3 Fixed Bi-Level EPAP 9.0 IPAP 11.5 (cmH2O)
04-28-2015 08:11 AM
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Mark Douglas Offline

Advisory Members

Posts: 513
Joined: Apr 2015

Machine: Sys 1 (60) RemStar BiPAP Auto with Bi-Flex 760P Auto Bi-Level (Variabl
Mask Type: Nasal mask
Mask Make & Model: PR Wisp
Humidifier: PR Sys One heated
CPAP Pressure: RiseTime 3 Fxd E-9.0 / I-11.5
CPAP Software: SleepyHead EncoreBasic

Other Comments: Hashimoto's thyroiditis.

Sex: Male
Location: SW Ohio

Post: #23
RE: Apnea's Adventures in Insurance Wonderland
April 28, 2015 1100hrs.

Called sleep Docs practice and talked to their respiratory tech to try to find out what they thought about people like me (techies) who wanna be involved in depth with the nuts and bolts of their therapy. I asked because of allergy and sinus issues and large changes in geography would an auto machine be best? He said straight cpap pressure would be set for worst case scenario-sleeping on back for 95%. He explained I would probably not want an auto machine and as long as AHI under five all is good. The auto induced pressure changes upset most people. I could turn over and the machine could surge to a higher pressure. At the end it was "I have been doing this for thirty yrs and my experience is people who want to micromanage their settings end up driving themselves nuts."

I'm thinking this is not someone who would appreciate my in depth involvement. Over the years I had some accounts where they knew what they were doing and were of great help to me and ins others not so much. I see this both ways but ultimately My health is more important to me than him.

Friday I will buy a machine. Next decision is buy a new autopap with 2 yr warranty or a used vpap with 90 days that can do anything statistically I am likely to need and has an algorithm possibly less likely to induce CSAs . Dollar cost about the same.
I am done with cigna/ins route. I was going to pursue just to see what happens but I have enough info at this point. cigna will send me to carecentrix who will send me to crapria and I don't want to go down that rabbit hole... I would buy from sleep Docs pet DME but as noted previously the vibe wasn't good.

My conclusion aligns with several expressed here. If you are technically and financially able to do so save yourself some heartburn and go buy a machine outright and get on the path to better health. Supplier #10 has a blog entry comparing self pay to ins pay that might be useful.

I may not be smart enough to do this myself but with help from y'all I won't be alone.

Thanks

I use my PAP machine nightly and I feel great!
Updated: Philips Respironics System One (60 Series)
RemStar BiPAP Auto with Bi-FlexModel 760P -
Rise Time x3 Fixed Bi-Level EPAP 9.0 IPAP 11.5 (cmH2O)
04-28-2015 10:37 AM
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Homerec130 Offline

Advisory Members

Posts: 444
Joined: Mar 2012

Machine: Philips/Resperonics BiPAP auto SV Advanced System One (950P)
Mask Type: Full face mask
Mask Make & Model: ResMed Quatro FX
Humidifier: Philips Respironics System 1
CPAP Pressure: 6-16
CPAP Software: SleepyHead

Other Comments: But it is a dry heat.

Sex: Male
Location: Tucson, AZ

Post: #24
RE: Apnea's Adventures in Insurance Wonderland
I had my DME (Symbius Medical) send me a 6 foot hose with some unknown doo-hickey on it. I called them and asked about it, providing them with the model number as well as the fact that the use by date had passed. Once we verified my info, her first question was do you need a new hose tomorrow and if not, how do you want to do this. I told her seeing as we have already billed the insurance company, go ahead and send me a correct hose and don't worry about expediting it. (Didn't tell her I still had a couple of spares). she then told be I could do what I want with the hose, either toss it or use it for some project. Very pleasant conversation, got it taken care of. Next day. FedEx showed up with the new hose. Only thing with this company is they are slow to bill the co-pay I have with my insurance. Smile

Homer
04-28-2015 01:57 PM
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Mark Douglas Offline

Advisory Members

Posts: 513
Joined: Apr 2015

Machine: Sys 1 (60) RemStar BiPAP Auto with Bi-Flex 760P Auto Bi-Level (Variabl
Mask Type: Nasal mask
Mask Make & Model: PR Wisp
Humidifier: PR Sys One heated
CPAP Pressure: RiseTime 3 Fxd E-9.0 / I-11.5
CPAP Software: SleepyHead EncoreBasic

Other Comments: Hashimoto's thyroiditis.

Sex: Male
Location: SW Ohio

Post: #25
RE: Apnea's Adventures in Insurance Wonderland
April 28, 2015 1600.

Saw GP/PCP today and he agrees he has heard absolutely Nothing good about crapria.
He will write me Rx for the machine I decided upon - refurb PR System One 60 Series BiPAP Auto with Humidifier.

Good:
No compliance requirement. I am highly motivated so is moot.
I am really impressed with GP/PCP knowledge of the subject and I agreed to email him data download at 2 week intervals until we are both happy with my results.
No crapria access to my credit card!
No risk of my finding good set points only to have them undone by remote control.
No asking nanny my I please have????
No wondering what the next odd charge or denial might be.

Not so good:
Cost. But then what is all this medical mafia BS doing to my stress level?
No sleep doc professional support.
I could hurt myself? Possibly. I drive a car and sex is the 100% cause of death but have no plans to stop either one at this time.
Reduced warranty. Just another of life's risks.


Had I followed my instincts emboldened by comments here and just went and purchased a machine 3 weeks ago when I first joined this board I might have been three weeks to the good health-wise by now.

I use my PAP machine nightly and I feel great!
Updated: Philips Respironics System One (60 Series)
RemStar BiPAP Auto with Bi-FlexModel 760P -
Rise Time x3 Fixed Bi-Level EPAP 9.0 IPAP 11.5 (cmH2O)
04-28-2015 03:24 PM
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iSnore Offline

Preferred Members-2

Posts: 148
Joined: Apr 2015

Machine: Phillips-Respironics DS560TS REMstar Auto
Mask Type: Nasal pillows
Mask Make & Model: ResMed AirFit P10
Humidifier: Phillips-Respironics DS6T Heated Tube
CPAP Pressure: 9-13 A-Flex 2
CPAP Software: SleepyHead EncoreBasic

Other Comments: SYSTEM ONE resistance set to X1 for P10

Sex: Male
Location:

Post: #26
RE: Apnea's Adventures in Insurance Wonderland
Just pointing out you can get a zero hour New, Open Box Respironics System One DS760 BIPAP Auto w/ Heated Humidifier with 2-year warranty for $879 from Supplier #2. That's the same price as 1800's refurb.
04-28-2015 07:04 PM
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Mark Douglas Offline

Advisory Members

Posts: 513
Joined: Apr 2015

Machine: Sys 1 (60) RemStar BiPAP Auto with Bi-Flex 760P Auto Bi-Level (Variabl
Mask Type: Nasal mask
Mask Make & Model: PR Wisp
Humidifier: PR Sys One heated
CPAP Pressure: RiseTime 3 Fxd E-9.0 / I-11.5
CPAP Software: SleepyHead EncoreBasic

Other Comments: Hashimoto's thyroiditis.

Sex: Male
Location: SW Ohio

Post: #27
RE: Apnea's Adventures in Insurance Wonderland
Thanks!
I'll print it and take w me and see what they say.
As is my first time <snicker> to buy I do want hands on help and so far they have been everything the others have not. Also are 0.8 mile from PCP which might be a good thing. I'l post a review as to how they work out. Surely better than craprica. I literally can find no positive comments about those people! Nothing!

I use my PAP machine nightly and I feel great!
Updated: Philips Respironics System One (60 Series)
RemStar BiPAP Auto with Bi-FlexModel 760P -
Rise Time x3 Fixed Bi-Level EPAP 9.0 IPAP 11.5 (cmH2O)
04-28-2015 09:46 PM
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Sleeprider Offline
Wiki Editor
Advisory Members

Posts: 3,317
Joined: Dec 2014

Machine: Resmed Aircurve 10 Vauto
Mask Type: Nasal pillows
Mask Make & Model: Resmed Airfit P10
Humidifier: Resmed Climateline
CPAP Pressure: Auto Bilevel 18/9, PS 3
CPAP Software: ResScan SleepyHead EncoreBasic

Other Comments:

Sex: Male
Location: Where they make Respironics

Post: #28
RE: Apnea's Adventures in Insurance Wonderland
Mark, just ask away. It's the same machine I've been using and experimenting with. There are a number of ways to get your initial pressure titration. Page 10 of this document is the Philips Respironics recommended titration protocol that you can do yourself by observing data. It may take a few nights, but it will work: http://www.sleepdx.respironics.com/PDF/Titration-Protocol.pdf

Biflex is the speed at which the IPAP/EPAP pressure changes occur. Biflex of 1 is a fast pressure change and what I prefer, 3 eases the pressure changes so they are not as noticeable.

______________________________________________
Organize your SleepyHead Data
Post your SleepyHead Data from Imgur
Robysue's Beginner's Guide to Sleepyhead
04-28-2015 10:15 PM
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Mark Douglas Offline

Advisory Members

Posts: 513
Joined: Apr 2015

Machine: Sys 1 (60) RemStar BiPAP Auto with Bi-Flex 760P Auto Bi-Level (Variabl
Mask Type: Nasal mask
Mask Make & Model: PR Wisp
Humidifier: PR Sys One heated
CPAP Pressure: RiseTime 3 Fxd E-9.0 / I-11.5
CPAP Software: SleepyHead EncoreBasic

Other Comments: Hashimoto's thyroiditis.

Sex: Male
Location: SW Ohio

Post: #29
RE: Apnea's Adventures in Insurance Wonderland
Thank you very much!
I hope I don't drive you bonkers w questions. Wink

I use my PAP machine nightly and I feel great!
Updated: Philips Respironics System One (60 Series)
RemStar BiPAP Auto with Bi-FlexModel 760P -
Rise Time x3 Fixed Bi-Level EPAP 9.0 IPAP 11.5 (cmH2O)
04-28-2015 10:27 PM
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