Hello Guest, Welcome to Apnea Board !
As a guest, you are limited to certain areas of the board and there are some features you can't use.
To post a message, you must create a free account using a valid email address.

or Create an Account


New Posts   Today's Posts

Initial Post: XhwMikey Treatment Thread
#1
Initial Post: XhwMikey Treatment Thread
Greetings,

I wanted to start a thread to introduce myself, and to have a place to add posts regarding my therapy and any questions I might have.

I was recently diagnosed with "severe" OSA (AHI = 45.4 3% rule; 39.4 4% rule).  My original (home based) test was in August of this year, and a follow up All Night Titration Polysomnogram was completed on November of this year.

The delay between the home test and the polysomnogram was due to a lack of communication from my sleep Dr.  In October, I was called by someone at the Sleep Dr's office asking me about the "results from my Titration Study".  I informed the caller that I had no idea what they were talking about, and that I had not acquired any results from my home sleep study.  It was then that I was informed that I had "severe OSA", and that I needed to schedule a "Titration study".  Nice.

Since then, I found this forum and began to educate myself about OSA.  Thank you for this awesome site.  Perhaps the most useful information has been about the shenanigans played by Insurance, the DME provider, and the Dr. (the three amigos).  Had I not been forewarned about the breadth and depth of the potential incompetence, I would have lost my mind by now.

The legitimate CPAP shortage (thanks Philips), COVID impacts, the supply chain mess and finally my ignorance have created the perfect storm of delays.  Subsequent to the Titration Polysomnograph, and after some prodding, the Sleep Dr's office faxed an equipment order to a local DME provider (for an "APAP 10-15") - a place called Timberlake.

I called Timberlake and explained that since I had met all deductibles and Out of Pocket maximums with my insurance, I would really like to have the equipment dispensed prior to January.  I was met with total indifference.  The next week I found out that my retiree health insurance from my company was going to change in January - an unwelcomed  complication.  I used that fact in another call to Timberlake to explain that if they wanted to make any money at all - they needed to obtain a machine and dispense prior to January.  I was met with indifference yet again.

Out of frustration, I called my insurance company (the current one) and asked for recommended local DME providers that are in-network and I was given three companies.  I called all three and only one - Lincare - claimed they had machines (I was told they were ResMed AirSense 11 Autosets (!) ).  I had read and heard about how bad Lincare was, so I was very skeptical about what I was being told.  Nonetheless, I felt that if there were a chance to get a machine before I turn into a pumpkin on January 1 - it was worth a shot.  Moreover, they are listed as a provider for my *new* insurance starting in January so there's that as well.

Called the Dr. to get them to redirect the Equipment order to Lincare, and they twiddled their thumbs for a week (I made multiple calls asking about the status).  After a discussion with the actual Dr (not office personnel), the Equipment order was finally faxed to Lincare (or so they said).  I called Lincare the next day and was told they had no idea who I was and they had no fax from my Dr.  After another call to the Dr to tell them no fax was received by Lincare, I was finally able to get verbal from Lincare that they had my Equipment order.  Later the same day, I got a call from my contact at Lincare telling me that my insurance says that Lincare is not a provider for my policy.  Huh  Wait...the insurance company that I called to obtain Lincare's name from, is now saying that Lincare is not part of their DME provider network.  Oh, and they *don't* have any machines...SMH...I guess *more* phone calls are needed to sort this out...

In the meantime...
I don't think I will be receiving my APAP machine before the end of the year, and I am resigned to having to pay out of pocket for my new machine (one way or another).

Therefore, I am seriously considering just acquiring a ResMed AirSense 10 Autoset from one of the online providers listed elsewhere on this site (~$1.1k).  

Aside from not recording ~$1k against my deductible for the new machine, are there any other downsides to just ordering on my own online?  

Assuming that waiting until whenever a DME provider gets a machine -and decides it's in their best interest to dispense it- that it's likely to be a ResMed AirSense 11 - would it be best to wait things out to get the newer model?

Could I use the DME for just for masks and other miscellanea having acquired the machine online?

<sigh>

Thanks for listening and providing assistance!

Mikey
Post Reply Post Reply






Donate to Apnea Board  
#2
RE: Initial Post: XhwMikey Treatment Thread
You can buy out-of-network and receive the reimbursement amount authorized for that, or have it apply to deductibles. Ask your insurance about out-of-network. As long as you have a prescription for CPAP and can demonstrate you are actively using and benefiting from the therapy, you should be able to use an in-network provider to obtain supplies. Many people were issued a machine and move, or bring their own and still qualify for supplies. The DME does not care and makes a profit on supplies.

Mikey, don't forget to use "The force". SearchTempest is your friend for finding much lower cost machines with low hours. You want a Resmed Airsense 10 Autoset or Aircurve 10 Vauto. I am seeing a "RESMED Air Sense 10 C-pap - $500 (san mateo). Pictures show this is actually an Autoset. Another one: ResMed Airsense 10 autoset Excellent Condition - $400 (sunset / parkside) appears to have about 450 hours. The best is cpap resmed airsense 10 almost new 137 hrs - $500 (Olympia, WA) That is really low hours. There is even an Aircurve 10 bilevel machine:R esMed Aircurve 10 CPAP Machine w/SD CARD, BAG WHITE, "only 8 hours" - $349 (West Auburn, WA). Again only 8-run hours, and if this is a Vauto as I suspect, it is an awesome deal.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


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.
Post Reply Post Reply
#3
RE: Initial Post: XhwMikey Treatment Thread
Thanks @Sleeprider I'll take a look at SearchTempest!

I'll post the results of the Lincare drama after I make a few calls on Monday (tomorrow).

Cheers,

Mikey
Post Reply Post Reply
#4
RE: Initial Post: XhwMikey Treatment Thread
Just wanted to post my sleep studies in case it's needed later.

Uh oh...don't see the attachments - must be doing something wrong.
Post Reply Post Reply






Donate to Apnea Board  
#5
RE: Initial Post: XhwMikey Treatment Thread
There are 3-steps to image attachment. Browse and choose, Open, and finally Add or Insert. It's the third step most people miss.You can even go to Preview to be sure it is there and then copy the link if it is there and insert as an image. Way too complicated, but it's what we do.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


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.
Post Reply Post Reply
#6
RE: Initial Post: XhwMikey Treatment Thread
Thanks SleepRider!

Trying again with the attachment...
Post Reply Post Reply
#7
RE: Initial Post: XhwMikey Treatment Thread
Thanks SleepRider!

Trying again with the attachment...

Again - no attachment.  Did all the things I think I'm supposed to - even read the Attachments help page.  Frustrating.  Is there some kind of post number limit (i.e., must have x posts before being able to upload attachments)?  Am I too new to post attachments?  Are .png files OK to be posted (I tried .pdf before and got nothing as well) - should they be jpg?


I'm using a iMac and Safari - is this compatible?  I'll try Firefox just to be sure...


Gonna be tough to post OSCAR data if I can't attach files to my posts...

Mikey
Post Reply Post Reply






Donate to Apnea Board  
#8
RE: Initial Post: XhwMikey Treatment Thread
Ok, new post coming in through Firefox on my iMac...

Trying to post sleep study ...

Ok, this time I got a "File too large" error message which I never saw using Safari...progress!



[attachment=37928][attachment=37928]

Success!  Sorry about all the residual attempts - just had to zero in on what works with my machine - I'm happy now Thanks
Post Reply Post Reply
#9
RE: Initial Post: XhwMikey Treatment Thread
Greetings,

I threw in the towel with my insurance company/DME provider.  I was informed (by the DME provider - Lincare) that even if a machine would show up prior to the end of this year, it's only a monthly "rental-to-own" over 9 months. So, I would (at best) get one month of coverage by my current insurance company.  Meh - who knows how long I'd have to wait for a machine to show up and for my place in the queue to pop to the top...

Still have no idea why insurance company stated to Lincare that they are not in network...I called and spoke to insurance company - they were mystified about the statement.  Lincare is in network to all flavors of UHC Health insurance.  I called Lincare back - the original contact was out today so need to wait until tomorrow until get full explanation from her. 

Meanwhile, I presume I still have OSA which is not being treated...

Insurance/DME = Dismissed.

I ordered a ResMed Airsense 10 Autoset from Supplier #1 - should be coming in a few days.  I should be able to apply for reimbursement from my retirement "FSA-like" thingy after I receive the unit and invoice.

I've installed OSCAR on my iMac and it seems to be working (such as it is sans data).

I ordered the ClimateAirLine hose as well and a supply of filters.  I'm gonna use the AirFit F20 that was used during my Titration Study which I got to bring home...Not sure if this is the best mask to use - but it's a start.

I'm apprehensive about getting started, but determined to push through (spO2 of 70% nadir on first sleep study is frightening/motivating to me).

Now that I know how to post attachments, I've included the Titration Polysomnogram below.  Looking forward to the journey - I think...

Thanks again!

Mikey
[attachment=37930][attachment=37931]
Post Reply Post Reply
#10
RE: Initial Post: XhwMikey Treatment Thread
It's encouraging that your AHI responds in a well-correlated manner to pressure, so CPAP will work. With a Resmed Airsense 10 or 11 in Autoset mode and using some EPR I think you will find the recommended pressures of 12-16 will be effective and comfortable with the exhale pressure relief and your AHI may be lower than the 1.4 obtained during your test. We can start with a lower pressure of 9 or 10 minimum and the machine will rise as needed, but these results look like they are going to be predictive of your needs. I think I have turned you onto SearchTempest which will give you some opportunities to reduce costs. You should be able to get supplies immediately, and when the DME gets its act together to find a machine you can accept that if your deductibles and coapy make sense.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


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.
Post Reply Post Reply






Donate to Apnea Board  


Possibly Related Threads...
Thread Author Replies Views Last Post
  Lorrubdb Therapy Thread: Fine-tuning therapy with Oscar Lorrubdb 337 6,425 5 hours ago
Last Post: Lorrubdb
Exclaimation [News] RECALL THREAD-- IMPORTANT PHILIPS DREAMSTATION & SYSTEM ONE USERS Sleeprider 2,136 193,855 05-20-2022, 05:21 PM
Last Post: btreger
  David Clark - Therapy Thread David Clark 139 3,391 05-17-2022, 06:50 PM
Last Post: David Clark
Arrow Your Personal CPAP Success Story - Post Here SuperSleeper 1,274 535,321 05-16-2022, 08:52 PM
Last Post: CurtA
  So many Central Apnea! Treatment emergent? Bricks 1 156 05-16-2022, 04:52 PM
Last Post: Sleeprider
  yankees123 - Therapy Thread yankees123 67 1,502 05-15-2022, 08:37 PM
Last Post: yankees123
  0xdec0ded [Therapy Thread] 0xdec0ded 6 276 05-15-2022, 06:00 PM
Last Post: 0xdec0ded


New Posts   Today's Posts






About Apnea Board

Apnea Board is an educational web site designed to empower Sleep Apnea patients.