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DME and accepting machines.
#1
Hello all,

First time poster.  I was recently diagnosed with Apnea and I am awaiting for my machine to be delivered.  I have read the list of machines that are good and bad.

I asked my DME what machine I will be getting an the response was "Respironics 220/260 or a Dreamstation."  Now it appears I want the Dreamstation because it looks like the other 2 are discontinued.

I asked for the Dreamstation Auto and the DME responded with "if your script says auto, we will deliver an auto.  If it has a setting we will deliver a CPAP."

At this point I believe I have a prescription that reads "CPAP 8 CM."

Would it be worth telling my DME that I do not want a manual and request an auto?  I am pretty sure I would get more benefit from the auto as it is more flexible from what I understand.

Also, are there any consequences for refusing a specific machine?

Any advice is appreciated.   Thank you.
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#2
You've done your research.  Do not accept a machine you do not want.

With that said, the DME won't honor your request for an Auto machine unless the script says
Auto cpap, patient choice or the script lists a pressure range.

Call your doctor first, tell him/her that you want an Auto Cpap and to write a new script that states Auto cpap, patient choice or ask him/her to actually list the machine by name.

Just know that insurance pays the same amount to DME regardless if it is a cpap or apap.
The DME just makes more profit by issuing a cheaper machine that is not data capable, if they can get away with it. You will have to start with your doctor.
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#3
Ask your sleep doctor to prescribe the machine of your choice. This link will help you decide which machine to ask for.

As for the DME, are they the only equipment providers your insurance accepts? If not, I would find a different one immediately. Their attitude indicates they are willing to provide you with out-dated equipment and totally ignore your wishes in order to increase their bottom line. They will be difficult to work with at best.
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#4
Thank you for the prompt replies.

The DME is coming today so I don't have time to contact the doctor.  Unfortunately, I have been traveling a ton so far this year and haven't been able to follow-up with the doctor.  With that said, if the DME brings one that is unacceptable today I will refuse and follow-up with the doctor to request the specific one I want.

Thank you again for the advice.
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#5
Since you are willing to turn down an unacceptable machine, why not call the DME and tell him your plans. At the very least it may save you both some time. Who knows, they may to go ahead and honor your wishes if they see how serious you are. Remind them that an auto can be set at a fixed pressure which would honor the prescription if that is what is prescribed.
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#6
I did tell the DME guy that I wanted the DreamStation Auto out of the ones he said I could possibly get.  I said I would refuse any other models that I thought were unacceptable.  So I guess we will see how it goes.  Thank you.
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#7
The model they are offering does not even offer efficacy data. You have a choice of DME. It would be easiest to ask the doctor for an Auto CPAP prescription because you want to participate in your therapy, see the efficacy data, and realize that pressure need vary with sleep stage, position and health. Even if you accept a CPAP, the Dreamstation pro 400 series will give you full data, and has the ability to run a 30 day auto-trial.

If your deductibles and copays are relatively high, keep in mind you can simply purchase a Dreamstation Auto for $435 on Amazon. You can continue to get masks from the DME, or a Resmed Airfit P10 with 3-cushion sizes is available for $65. It's not worth being pushed around by someone that will charge $2000 to your insurance no matter what you get.
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#8
Hi jokinawa,
WELCOME! to the forum.!
I hope you get the machine you really want.
I wish you good luck as you start your CPAP therapy.
trish6hundred
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#9
I agree with advise you are getting from the various postings.  Do not settle for what you do not want.  The DSME is just a vendor.  It appears that your doctor was not precise enough.  I had the same experience with my doctor's prescription for a ASV machine.  He  wrote the Rx in such a way, without naming,  that only prescribed a Phillips machine.  I called the doctor's office and they corrected the prescription to reflect the machine I wanted-the ResMed ASV model.  This is something you have to live with for a long time.  For goodness sakes, get what you want., and be persistent.
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