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Can and/or should I change any settings?
#11
RE: Can and/or should I change any settings?
haha yeah, I'm not worried about safety from changing my min pressure from 5 to 7 or 8, especially since I'm averaging around there or higher. Just don't want to get screwed with a bill to pay back the rental fee and get told to pay out of pocket if I don't need to.
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#12
RE: Can and/or should I change any settings?
Well since the doctor gave you a range and a representative at the DME told you to go to YouTube to learn how make a change.

Since you are “technically” staying within the prescribed range (7 or 8 is within the range of 5-15), I would think you would be fine. Plus you notified your doctor.

Here is the real DME catch-22, if the insurance company takes away the machine the DME loses revenue.

John
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#13
RE: Can and/or should I change any settings?
HonCoolRick - The DME is looking only for usage compliance. Most insurance companies require 4 hours per night and 70% of a 90-day period. Otherwise, it will be repossessed or you get a rental bill.
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#14
RE: Can and/or should I change any settings?
Simply call and ask your insurance company, " If I make some small changes to my settings that increase my comfort and prolong the period that I use the machine each night and also reduce my AHI, will you take my machine away?"

You likely will catch them off guard.

As noted your medical team cannot make therapeutic changes without a change in the prescription from your doctor. if THEY changed your therapeutic settings otherwise they could be discharged.
Fred Bonjour - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter 
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#15
RE: Can and/or should I change any settings?
im definitely hitting my compliance numbers, no worry there, only had like 3 nights in the last ~40 that I had under 4 hours, most are 7+ hours
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#16
RE: Can and/or should I change any settings?
The more I read here and in other forums, on reddit, youtube, all over... Its pretty universal that everyone agrees, insurance doesn't care what the pressure settings are, they only care about the hours of use...

I'm curious what I would have been told if I had asked the question in a different way. I asked "will my insurance stop paying or anything if I change the settings myself" and the answer was yes. But if I had asked a more open ended question like "Why shouldn't I change my own settings?" I wonder if that would have come up at all? What a shame i can't trust what a medical professional is telling me...
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#17
RE: Can and/or should I change any settings?
The respiratory therapist at a DME has virtually no meaningful control over therapy. The may be knowledgeable but their job is to setup machines, observe patient's results and compliance, and report to the doctor and implement his instructions. Other than that, they are under pressure to spend as little time as possible with patients while telling them to use the equipmet, sell more masks and equipment and manage records. Turnover is high for a good reason, and morale and attitude must be hard to maintain.

With that understanding is it any wonder they come off a bit short when a patient asks to change their pressure. The answer is automatically no because they are there to implement and enforce the doctor's orders. On the other hand, the patient has a number of rights too. You have the right of refusal for any therapy or medication, and can obviously modify your therapy, whether it is CPAP, medication, diet, weight recommendations, or a physical device. There may be good reasons you should or should not do that, but you can't have therapy withdrawn unless you create a hazardous situation. You even have the right to refuse to allow remote monitoring of your therapy, in which case you may have to call in a code or submit an SD card to enable compliance to be determined. You don't have to allow remote changes to your settings either. These are all services you can refuse or manage in an alternative way.
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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#18
RE: Can and/or should I change any settings?
FWIW I've changed my settings from day 1 on this ASV. The doc, DME, and insurance knew I changed it. I told them each I did so; note this statement specifically says I TOLD THEM not asked but that's me. The doc and his staff of PA's were a bit skeptical I knew what I was doing until OSCAR charts were used to say "my reason to change X was because this...". Every change I ever did, I could point to a chart I made and tell them why I edited settings. My ASV was 100% paid for by my insurance, without fighting them for one cent.

The RT at the DME had NO clue how to setup the ASV. She actually said some aspects of the script didn't make sense on plugging into the setup for my ASV, so she just GUESSED. That point convinced me that Dave was controlling his own settings period.
Dave

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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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