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HELP! PLEASE
#1
HELP! PLEASE
I got my CPAP and humidifier yesterday. I'm not real happy with the recommendations of the Sleep Center . The pressure wakes me up. I had no events at 14-15 which I can handle. Aside from that, I think I got low balled on the CPAP. I was told I was getting a ResMed S6 and you can see that I was given a lower end model.
I need to have an APAP. I think that will resolve the pressure problems. I also want reporting so I can review my progress.
I think I would like a PR System One REMstar Auto CPAP with A-Flex.
Could anyone suggest how I can do this. I pay alot each month for health insurance and I'm 66.
Thanks
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#2
RE: Basic CPAP
Hi big1dog, welcome aboard
The sleep center people are on per with used car sales people, they get the same amount from your insurance regardless what they give you but they pocket larger sum dispensing cheaper end machines. The doctor should wrote a script for the machine of your choice and note "dispense as written" on the script but there is a conflict of interest if the doctor is also involved in the scam. It wont hurt talking the doctor to get the sleep center exchanging the machine and really you don,t want stuck with this machine for the next 5 years

You can always get another machine on-line (Supplier #2 is recommended) but try get those rip-off merchants exchanging the machine
Suppliers List http://www.apneaboard.com/forums/Thread-...plier-List






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#3
RE: HELP! PLEASE
Hi big1dog,
WELCOME! to the forum.!
What zonk said.!
Hang in there for more answers to your question and best of luck to you with your CPAP therapy.
trish6hundred
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#4
RE: HELP! PLEASE
Big Dog, I was told by my that I had 30 days to make changes on the equipment. Where you need to start is by asking your sleep doctor to write another RX, specifying the equipment you want. They may not be overjoyed at your request, but be polite and patient and hopefully you will get a new RX.

The DME can only give you what is specified on the RX. The doctor or DME may say something about how much medicare or insurance will pay, but tell them you want to do it anyway. Just be persistant. My understanding is that medicare/insurance pays for whatever the doctor prescribes. Sad thing is that there is only about $100 difference in the cost between a "brick" and a good machine. Good luck!!!
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#5
RE: HELP! PLEASE
Thanks for the replays. I can't tell you how rippered off by the DME company I feel. I have had a complete lack of commutation from my Doctor also. Sleep Study and 10 days late I'm getting a call to deliver the machine. No choice no discussion nada. I hate to beat this drum but, as a senior I feel complete taken advantage of. There ought to be a law or two.
Wondering where to start? My Doctor, my Insurance Company, DME company or Medicare.

That being said, some suggestions as to what a "good machine" would be.

Second night went ok, still too much max pressure. Nostrils a bit sore.
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#6
RE: HELP! PLEASE
(03-30-2014, 11:52 AM)big1dog Wrote: I hate to beat this drum but, as a senior I feel complete taken advantage of. There ought to be a law or two.
Wondering where to start? My Doctor, my Insurance Company, DME company or Medicare.

It's the existing laws/regulations that actually created the environment for this to exist. You, as the consumer, are completely out of the loop. Everything is decided between your doctor, ins. company, and the DME's -- you are just the person that does the paying (not the decision making).

DME's want to sell low end "bricks" because they get the same amount of money from your insurance company whether the give you the lowest basic model, or the high-end data capable machine -- so, of course, to maximize profit -- they push the low end machines.

If you can: work with your insurance company to allow you to purchase whatever machine you want (and from whomever you want) and get reimbursed from the ins. company for the benefit amount. This means that if your ins. benefit is only $500, and you want to buy an $800 machine: you'd make up the $300 difference out of pocket.
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#7
RE: HELP! PLEASE
You can read this:
http://www.apneaboard.com/wiki/index.php...ne_Choices

You can also find out where the supplier is located and take it back yourself vs waiting on the phone call.

In the meantime, call your insurance. If you have something other than Medicare, you probably have a good chance of reaching someone and getting some answers.

No matter who you call about this (doc, supplier, insurance), write down when you called, who you spoke to, what was said, and the outcome of the conversation. Keep a log of it so you can refer back and say "When we talked on the 29th, you said such-and-such but now you are saying...." "Yes, you did say it, because I've kept a log of all the phone calls. I contacted you on the 29th at 2:14pm..."

Amazing what can happen when you catch them with their pants down.
PaulaO

Take a deep breath and count to zen.




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