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How to move forward?
#1
It is great that I found this board. So much great information. Wish I knew about this a few years ago. Here is my story and new issue.

I did my first sleep study about 2 years ago. I think a pretty standard story. Tired all the time, falling asleep at meetings etc. Did the sleep study, Used insurance to get my CPAP machine and all was good until recently when I can feel that I am not getting a good night sleep again.

Took the machine into a local place that specializes in these and asked them to help me out. They read the card and tell me that my machine does not tell them much other then the number of hours used. He said my insurance is good and should have paid for a elite model which would have the data I need.

I used the medical supply company recommended by the doctor when I had the sleep study. This is different from the local place I recently asked for help. So I called the medical supply company that gave me the CPAP and they say someone will call you back. I am still waiting.

So my issue is how do I move forward here? Do I just adjust the machine myself, get a different machine or go back to the doctor? I feel like my insurance probably paid for a more expensive machine but made money by giving me a cheaper model. I have the Resmed S9 Escape.

I would appreciate any comments. thx
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#2
(04-23-2015, 11:25 AM)scottwood2 Wrote: It is great that I found this board. So much great information. Wish I knew about this a few years ago. Here is my story and new issue.

I did my first sleep study about 2 years ago. I think a pretty standard story. Tired all the time, falling asleep at meetings etc. Did the sleep study, Used insurance to get my CPAP machine and all was good until recently when I can feel that I am not getting a good night sleep again.

Took the machine into a local place that specializes in these and asked them to help me out. They read the card and tell me that my machine does not tell them much other then the number of hours used. He said my insurance is good and should have paid for a elite model which would have the data I need.

I used the medical supply company recommended by the doctor when I had the sleep study. This is different from the local place I recently asked for help. So I called the medical supply company that gave me the CPAP and they say someone will call you back. I am still waiting.

So my issue is how do I move forward here? Do I just adjust the machine myself, get a different machine or go back to the doctor? I feel like my insurance probably paid for a more expensive machine but made money by giving me a cheaper model. I have the Resmed S9 Escape.

I would appreciate any comments. thx

The first thing I would do is get a copy of the original script your doctor wrote for your machine if you don't have the script. The same insurance code is used for cpap machines whether it be the escape (brick), elite, auto; another code for vpap of all kinds and another code for ASV machines of all types. EX: If your script said cpap with all supplies and mask of your choice, the supplier will most likely give you the least expensive machine to maximize their profit because they get paid the same amount for the escape, elite, autoset. So get your script and make sure that you got what your doctor ordered.

As far as the first supplier not calling you back, maybe they aren't calling you back because they didn't fill your script according to the doctor's order or they filled it just like they were supposed to but don't want to deal with it. Unless they filled your script wrong, they most likely will not do anything after 2 years and probably won't anyway unless you can get the script and prove they filled it wrong.

What do you mean you aren't getting a good night sleep anymore? What is happening to make you feel that way? Are you waking up a lot? Snoring? Same symptoms you had when you first had your sleep study and got your escape? It would be helpful to know what you are experiencing. Maybe you just need to increase your pressure a little bit but I can't say for sure because all you said is that you aren't getting a good night sleep which could be caused by a lot of things such as stress, etc.

So, get your original script and tell us more about what is going on when you are sleeping.
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#3
I am sorry that you got screwed over by your original medical supply company. If I had not had a primary care physician who I think felt guilty that he missed the sleep apnea, I probably would have gotten a brick too. As it was, I got a good machine that had just become one generation behind.

What I would do in your position is first push back at your original supplier. Second, I would see if your doc could make a case for replacing your machine with a better one due to it being a medical necessity for your health and being cheaper than a new titration. Possibly insurance would then pay for their share.

Then again maybe a new titration would be a good start if your insurance will help with it. If it showed that a change was required, it might justify a new machine.

Failing anything else, I would start shopping for one online to get the best price that I could and pay for it myself. I would go for the Resmed Airsense 10 Autoset or the Philips Respironics equivalent version. You will need a copy of your prescription for this.

Those are my thoughts.

Best Regards,

PaytonA
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#4
(04-23-2015, 11:25 AM)scottwood2 Wrote: So my issue is how do I move forward here?

That's kind of hard to say from here Scott, without more information. As ME said, ask your doc for the original results. That will give you some idea of what pressure you needed at the time.

What is your pressure now?

Ask your doc for a copy of, or a new prescription for a machine and masks etc. You'll need this. Go visit our on-line suppliers and look for a good, used machine with full auto capabilities. If you can, buy that thing, then with the software you can begin to figure out where you are and where you need to go.

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#5
Definitely get a copy of your Rx. You might even carry a copy in your wallet. Should you find yourself in a hospital, that Rx would guide their respiratory therapists.

What Me50 said about how suppliers maximize their profits is true in my experience.
I was given a machine that I believe was used; and could not provide quality data.

After 5 years, I personally elected to use my Rx and pay out-of-pocket to get my present machine.
In my personal opinion, and based on my experience, auto is the way to go for most people
Combine an auto with software to track one's therapy; and it's a winning combination.
Last night I slept 8.3 hours and had an AHI of 0.3

Like others who use auto machines, I have honed the pressure window for optimal results.

If you decide to take my route; investigate the online supplier's list.
You can find open box, zero hour, auto machines for much less than the "retail" price.
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#6
Thx for the replies.

My sleeping pattern is more like I had before the sleep study. Waking up at night more. I have had bloody noses but I think that only seems to happen if I run out of water during the night. Mainly tired and falling asleep during the day.

I replaced my mask and tried a chin strap. I don't think the chin strap is working very well. keeps coming off. My other half said that I started lightly snoring at night now. I used to wake the house up with my snoring before the machine.



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#7
scottwood2,
It is hard to advise you not having any data to go on, but it probably wouldn't hurt to move your pressure up one number, and see how you feel.

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#8
(04-23-2015, 11:25 AM)scottwood2 Wrote: So my issue is how do I move forward here? Do I just adjust the machine myself, get a different machine or go back to the doctor? I feel like my insurance probably paid for a more expensive machine but made money by giving me a cheaper model. I have the Resmed S9 Escape.

I would appreciate any comments. thx

I would move mountains to get an "AutoSet", either S9 or AirSense 10, nothing else would do Smile

You're not the only one found themselves in this position
If you're not getting the appropriate help from your doctor or DME and have some spare cash, buy the machine online
Supplier #2 is reputable source for used and new machines
Suppliers List: http://www.apneaboard.com/forums/Thread-...plier-List
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#9
Hi scottwood2,
WELCOME! to the forum.!
Check out this link, it has lots of great information as to which machines to buy and which ones to avoid: http://www.apneaboard.com/wiki/index.php...ne_Choices .
Hang in there for more answers to your questions and much success to you as you continue and move forward with your CPAP therapy.
trish6hundred
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#10
Sorry you got screwed by the first DME. I would've done the same thing if I hadn't found this forum first, so I count my blessings every night. I would definitely pay a visit to my doc, and see what he says first. If there's nothing he can or will do. I would request the original script and pay a visit to Supplier #2. There are good deals to be had.
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