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[Equipment] Doc won't prescribe the CPAP I want
#11
actually, if you are buying it yourself, any CPAP rx is good for an APAP. It's only when you want a DME to supply the machine for the rate agreed upon with your insurance that there is any issue. Shop DMEs... some of them (like mine) only issue APAP no matter what the rx.
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
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#12
(10-06-2015, 03:44 PM)grumbledore Wrote: I am covered by Federal BCBS, but am willing to skip insurance coverage and buy on-line, including paying for a home test kit and a new on-line prescription, just to get a device that suits me.


I would talk to your doctor one last time, explaining why you want an APAP. If she doesn't agree, then it's time to find a new doctor and you should tell her that.

If you end up not using your insurance and buy outright, check out Supplier #2 for new open box machines. Also, several of the online suppliers have discounted the
PR System One line of pap machines.


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#13
What a great forum this is! So much good information from so many friendly people. Thanks
Here's an update. I called the doc's office to ask for my sleep study report and was told there is a note on my file saying that I needed to talk to the doc for that to happen, and that, besides, HIPPA rules prevented them from fulfilling such requests over the phone because I could be some impostor Oh-jeez (even though I said they could mail it). The receptionist said the doc would be in the next day and took my phone number. I never received a call back. I did some more research and the next day I call back to tell them to expect a request for my prescription from an on-line CPAP supplier because I wouldn't be using the local DME store the doc wanted me to use. The receptionist took the msg., then tells me that I can, after all, pick up a copy of my sleep study report, but it would cost me $20 to cover copying costs "per state regulations". Huhsign I said I'd pass.
So, bereft of paper copies of my prescription and sleep study results, I am waiting to see if the on-line route will get me the machine I want.
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#14
(10-06-2015, 04:33 PM)kaiasgram Wrote: You're not nuts -- you're doing your research up front so you won't get stuck with a machine that doesn't afford you the data you want to keep your therapy on track. Good for you.

You don't need another sleep study. If you haven't already, get a copy of your prescription. And your sleep study. If you want to use your insurance, you might be able to get a more with-it doc to write you a new Rx specifying the Autoset with a range of pressures. Any of your doctors (even a dentist) can write a CPAP Rx. So can a nurse practitioner. They would probably want to see a copy of your sleep study report before writing a new Rx for you.

OR: If you prefer to private pay (bonus: skip all the insurance compliance hassles), you can use your current Rx with an online retailer and you shouldn't have a problem getting the Autoset. The thing is, prescriptions are written as billing codes. Whether it's straight CPAP or an APAP, the billing code is E0601. So a DME can certainly give you an APAP with your current Rx, though most won't because they make less profit when they supply an APAP -- insurance pays DMEs the same for CPAP and APAP. However, unlike most of the DME's that deal with insurance, the online suppliers are not motivated to give you the cheapest machine possible. Quite the opposite. I'm pretty sure that Supplier #1 on the Supplier list above will give you an Autoset with your current CPAP prescription as long as it specifies E0601. Give them or online supplier of your choice a quick call to confirm this.

So you have a couple of ways to go with this.

Why would the doc stubbornly refuse to write the Rx specifically for APAP? Some really don't know that much about machines and the differences among the various models. In some cases the doc has a relationship with the DME supplier (or is the DME supplier), so has the same $$$ motivation to issue the least expensive machine possible.

Thanks so much for the encouragement and most excellent information. I have followed through on these tips.
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#15
(10-07-2015, 01:01 PM)OpalRose Wrote:
(10-06-2015, 03:44 PM)grumbledore Wrote: I am covered by Federal BCBS, but am willing to skip insurance coverage and buy on-line, including paying for a home test kit and a new on-line prescription, just to get a device that suits me.


I would talk to your doctor one last time, explaining why you want an APAP. If she doesn't agree, then it's time to find a new doctor and you should tell her that.

If you end up not using your insurance and buy outright, check out Supplier #2 for new open box machines. Also, several of the online suppliers have discounted the
PR System One line of pap machines.

That's good to know! I'm trying an different tack with the doc, and hope to get some form of cost relief from insurance by simply submitting a claim directly, instead of letting the professionals do it "for me".
(10-07-2015, 12:22 PM)DariaVader Wrote: actually, if you are buying it yourself, any CPAP rx is good for an APAP. It's only when you want a DME to supply the machine for the rate agreed upon with your insurance that there is any issue. Shop DMEs... some of them (like mine) only issue APAP no matter what the rx.

Good to know! Thanks! I am trying a different DME supplier; should know next week how that goes.
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#16
(10-06-2015, 04:36 PM)justMongo Wrote: Welcome
Get the doc to write the Rx on paper for you.

Check out Supplier #2 (see list above) for their open box specials.
You can get the 10 series Autoset from them for $789 US.
FAX what your doc writes to #2 and ask if they'll accept it for the machine you wish.

Thanks for that! I didn't know about the Supplier List. Nice feature. Good rules about posting links too - very sensible. ApneaBoard has it's act together!
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#17
(10-06-2015, 04:39 PM)zonk Wrote: Hi grumbledore and welocome
Maybe the doctor doesn't have the balls to write the script for AutoSet but inform him that insurance only care about hours using the machine and pay the same money for a brick or AutoSet, same billing code 0E601

The doc need to brush up about the new machines capabilities, AirSense 10 CPAP is basic entry level machine and does not provide full data on the machine LCD sleep report or detailed data on the SD card like its cousin AirSense 10 Elite
Of course the AutoSet is preferable as can be used either CPAP or AutoSet modes (2 machines in 1)
If push comes to shove, AirSense 10 Elite is fixed pressure full data capable machine and is second best

Thank you much for the skinny on insurance and for clearly laying out the difference between the different cpap models. You are right about the doctor not being quite up to date; when I asked her if she was prescribing was the Airsense 10 Elite, she said, "No, you're confused, the Elite is a Respironics model."
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#18
(10-06-2015, 05:04 PM)zonk Wrote: Quote: she is prescribing a start pressure of 4, increasing to a constant 6.
Reasons I want an autotitrating machine:

That will be Ramp start at 4 and gradually climb to 6 after Ramp period end
6 is on the lower end of pressure scale, you can do quite well with fixed pressure machine but make sure its Elite model, not CPAP model
Not having Autoset is not the end of the world

Thanks for straightening me out on the technical verbiage, zonk - I'm still climbing the cpap learning curve! Thanks also for putting my mind at ease about my options.
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#19
(10-06-2015, 05:07 PM)trish6hundred Wrote: Hi grumbledore,
WELCOME! to the forum.!
Hang in there for more responses to your post and much success to you as you start your CPAP therapy and with getting the machine you really want.

I'm glad to be here! :grin: This is a great community y'all got here with this Forum.
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#20
(10-06-2015, 06:09 PM)cate1898 Wrote: Hi grumbledore! I've just done lots of research into this very subject. I would like the autoset for similar reasons to you, but am not able to get one. However, the AirSense 10 Elite provides full data unlike the AirSense 10 CPAP which only gives you the hours used for compliance reasons. I will be getting an A 10 Elite model.

Good luck!

Good golly, why does it have to be this hard? I do hope that the A 10 Elite does the job for you. It's still a mystery what I will end up with...
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