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[Equipment] Does your provider unbundle your mask kit?
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DariaVader Offline
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Posts: 1,815
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: #11
RE: Does your provider unbundle your mask kit?
My DME (Providence) gives me the whole mask with all the different pillows need them or not. However, like parkerdt, I also have Cigna... 2016 maybe interesting!

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
09-13-2015 05:45 PM
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Adoniscmj Offline

Advisory Members

Posts: 168
Joined: May 2015

Machine: Resmed AirSense10 Autoset for her
Mask Type: Nasal pillows
Mask Make & Model: Resmed Airfit P10
Humidifier: Integrated
CPAP Pressure: 6 to 9
CPAP Software: ResScan SleepyHead

Other Comments:

Sex: Male
Location: Everett, Washington

Post: #12
RE: Does your provider unbundle your mask kit?
(09-08-2015 01:47 PM)vpescado Wrote:  So something that I noticed when I re-upped my supplies for my CPAP:

My mask comes as a kit with a small, medium, and large nose-pillow. My insurance allows me 6 nose pillows per 3 months, so I get another five along with it.

I realize that my supplier is removing the small and large pillows from the kit (obviously so they can sell them to someone else).

But this seems wrong as:
1) When I got my kit the first time, they gave me all three in the kit as well as the 5 extras .
2) They are invoicing my insurance company (and me) for the full kit based on the manufacturer's item number.

Like I said, this seems wrong to me (and possibly fraudulent).

When I asked my sales rep, she claims that they are required to remove the small and large pillows as otherwise I would be getting 8 pillows and my insurance wouldn't allowed that (but again, they left them in the first time, and they are still invoicing for the full kit).

Is this a standard practice? Should I switch providers? Should I contact my insurer?

Get a new supplier, as the package should be sealed for sterility and they come with three sizes. The DME is making money off of selling them to someone else. Not cool in my opinion. When I bought my latest mask it came with the mask , headgear, and S, M, L nasal pillows. When I buy replacements they come in a sealed bag labeled from the manufacturer. I would insist they give you the complete kit or I would take my business else where.
09-13-2015 06:46 PM
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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: #13
RE: Does your provider unbundle your mask kit?
I have a Quattro FFM mask and my provider sends me a new one every three months complete with headgear. It is in a factory sealed container and if I listen carefully, I can hear the rush of air when I open it. Hardest part of the next mask is refitting it as the headgear hasn't stretched over my fat head. My filters, though, do come in a small plastic bag that is tied off. Everything matches the paperwork.

If you really have questions, check your shipping paperwork and get a copy of your EOB (Explanation of Benefits) to see what the billed to the insurance company.

Homer
09-14-2015 11:27 AM
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cate1898 Offline

Advisory Members

Posts: 776
Joined: Aug 2015

Machine: PR System One 560BT Auto
Mask Type: Nasal pillows
Mask Make & Model: P10's/backup-DreamWear
Humidifier: PR attached
CPAP Pressure: 8.5 - 13. A-Flex 3
CPAP Software: SleepyHead

Other Comments: Began CPAP Therapy Sept. 11, 2015. Hx Hypertension, Post Graves Disease, chronic migraines.

Sex: Female
Location: Southern Ontario//SW Florida

Post: #14
RE: Does your provider unbundle your mask kit?
I wonder if the suppliers that are giving you the pillows in your size only are reselling them individually. For me to buy a whole package of the nasal pillows I am currently using, the Swift FX it costs me around $200 or more from the DME. I was looking at our Canadian Amazon site to see what replacement nasal pillows for my Swift FX would be and here is a link to the cheapest ones: [link removed]

I think if all the extra nasal pillows get sold separately like this the vendor's can make a lot of money. However,I wonder who has been handling these prior to reaching the end user? And how sanitary can they be??


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09-14-2015 03:42 PM
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ginzo Offline

Advisory Members

Posts: 227
Joined: Aug 2015

Machine: ResMed Airsense 10 Autoset
Mask Type: Nasal pillows
Mask Make & Model: Res Med Airfit P-10
Humidifier: Humidair S with heated hose.
CPAP Pressure: 10.0-13.0
CPAP Software: ResScan SleepyHead

Other Comments: I'm a mouth breather!!!

Sex: Male
Location: North Port, FL

Post: #15
RE: Does your provider unbundle your mask kit?
I just found out my new DME is trying to bill me on top of what they receive from my insurance agreed rate (Aetna 80/20). I pay 20% of the "agreed" rate, not what they bill. I also have an incentive account with money in it to cover my 20% should I choose not to pay out of pocket. On DR. visits, I just pay the co-pay, on DME and such, I just let it come out of the incentive account. I just got an invoice for 9.00 and some change after they received payment, and co-pay from account from Aetna. (Got that invoice from Aetna in the mail also. I DON"T DO PAPERLESS JUST FOR THESE PURPOSES. Scan, e-mail and wham, problem solved.

Aetna will be receiving a call from me in the morning.!Dielaughing
(This post was last modified: 09-14-2015 07:07 PM by ginzo.)
09-14-2015 07:07 PM
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parkerdt Offline

Advisory Members

Posts: 256
Joined: May 2015

Machine: ResMed A10 AutoSet
Mask Type: Other
Mask Make & Model: WISP, Nuance
Humidifier: Climate Hose and included humidifier
CPAP Pressure: 9
CPAP Software: SleepyHead

Other Comments: I alternate between WISP and fabric Nuance - like both!

Sex: Male
Location: Mebane, NC

Post: #16
RE: Does your provider unbundle your mask kit?
Interesting stuff. My last mask with the single XL cusion was definitely factory sealed, and labeled appropriately. Thus my belief that the manufacturers packages can vary depending on if it is time for a Full Mask or just a Frame and Headgear. I'll know at 6 months. In any case no extra wrong-sized cushions for me, at least not so far.

Dave
09-15-2015 07:32 PM
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