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Can use some advice on what to expect and what to do first.
#11
RE: Can use some advice on what to expect and what to do first.
You can go to any DME of your choosing. If you are using some form of insurance for payment, you need to find one that is in your network, or else you will be picking the complete tab.
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#12
RE: Can use some advice on what to expect and what to do first.
(09-27-2020, 04:24 PM)Canuck 2 Wrote: I do not understand why they would not give a person what they want. 

Perhaps it's similar to a pharmacy refusing to dispense the name brand medication when they have the generic readily available for super cheap to them. I don't really know.

But for sure it's because they can make more money off the transaction by selling you the cheaper model. DMEs are a for-profit business.
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#13
RE: Can use some advice on what to expect and what to do first.
(09-27-2020, 05:40 PM)Hydrangea Wrote:
(09-27-2020, 04:24 PM)Canuck 2 Wrote: I do not understand why they would not give a person what they want. 

Perhaps it's similar to a pharmacy refusing to dispense the name brand medication when they have the generic readily available for super cheap to them.

How True, just a good way to simplify it as you mentioned!
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#14
RE: Can use some advice on what to expect and what to do first.
Call your health insurance customer service and ask which DMEs are in-network near you. Start close, and as necessary, increase the circle further away. Over basic example: Hi this is Biff at XYZ insurance. Hi I'm Dave. OK Hi Dave, can I get address phone number etc. Sure, it's XYZ and 1234567890. Great, got your info. How can I help? I'm looking for a DME near my home zip 12345. I need to get a CPAP. OK hang on Dave. tap tap....OK we have x y z that's in town, state. Here's addresses and numbers. Thanks Biff.

Yes Dave is probably kwazy but you get the point. I did that to get my ASV in '17. My health insurance at that time had national DMEs and those were on top. Then we get info for regional/local. What you need to do is call Biff or whoever at the insurance, get 3-6 contacts for DMEs, look 'em up on Google. Then map them, and call. Sort through the contact list for possibles and cross off liars like you just met. Of that list, have at least 2 you like. Call your most liked and ask about issuing the AutoSet and your mask choice(s). Establish a grade system, liars and ones that excuse not giving you an AutoSet fail. Others will pass and these that have passing grades get your business. Having at least 2 to work from means if one fails, you still have a possible. If you cross all off, call Biff and get a new list. Repeat the whole thing. Continue it until you have a good feel for the DME as a good biz relationship.

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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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#15
RE: Can use some advice on what to expect and what to do first.
E0601 is the valid code for an AutoSet, also for the Elite.

The DME is a for-profit organization.  They get paid, by your insurance, the same for either the Elite, or the AutoSet.  The Elite cost them less.  Which one do they make more money on?  Your cost is the same for either.  Believe me, there is more than enough profit in this that it will make very little difference to them.

You also got advice to change your DME.  This DME will, based on their response, always try to give you the cheapest replacements, which often will not be the same quality as the OEMs.  

You have the right and ability to choose a different DME, the prescription is valid for a AutoSet as well as an Elite which is NOT cited on the prescription as well.  The AutoSet would be set to CPAP mode, Pressure=7, EPR=3 Full Time, but there is no way it is not valid for an AutoSet.

Stick to your guns and insist on the AutoSet.  You will have this device for the next 5+ years.
Fred Bonjour - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter 
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#16
RE: Can use some advice on what to expect and what to do first.
SarcasticDave has good advice for finding a DME that takes your insurance.

I went a different route, but with the same idea. I looked on Yelp for DMEs ("medical supplies", "CPAP supplies", etc. - I typed in several things), and called them to find out if they sell CPAP supplies. (I was thwarted by one that told me they do sell CPAP masks, but when I went in to the store I realized they sell CPR masks. LOL Ugh.) Then I asked if they take my insurance. And then I asked them some questions, which helped me get to know them pretty well. If they were clueless or curt, then I crossed them off my list.
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