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My DME story...
#1
After 5 weeks with my CPAP machine, I get a phone call from my DME. The woman is ranting at me for changing the settings. She then tells me that she's changed them back to the original settings via the cellular data modem. She was bitching because she said she couldn't get the compliance data with the settings changed part-way through the period.

In my usual assertive phone voice when faced with things like this, I started by saying that I called my nurse-practitioner at the sleep center and the setting change was done with her explicit approval. (From a constant 17 to a very conservative 15/17 AutoSet.) If the DME had a problem with this, they should take it up with the sleep center, not me. I then said that I had no problem reading compliance data from the machine with my bootleg ResScan software so there should be no problem getting a conformance report. If she couldn't do it, I'd print one out and hand it to her. I followed that with a rant that it's my health and she was not to ever, ever touch the machine again without my prior approval. She gave me some blah, blah, blah about being able to kill myself with the machine and that she was the trained "expert". Also, a concocted story that her firm was liable for those changed settings without a prescription. She confirmed that once she had a clean 30-day conformance report, I could return the cellular data modem. Since I'm doing the tweaking of settings under the supervision of the sleep center, I told her I'd make sure they faxed her an Rx any time the settings were changed. The next morning, I drove over to the DME with my SD card and the cellular data module in-hand. I'm now at least free from that nonsense.

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#2
You were straight on right about this Geoff, as you know. Compliance data is only concerned with how many hours a night over a specific period do you use the machine. Compliance does not care how you use it as long as it's turned on and attached to your nose.

I'm pretty allergic to the idea of anyone changing the settings on my machine without my knowledge. That's just trouble waiting to happen.

I'm glad you're done with the modem, now you need to be done with the DME. Get a copy of your prescription if you don't have it and order your stuff online. Be sure and tell the owner of the DME place that's what you're going to do because there are several really big fibs in her statements to.

...and about killing yourself with the machine? I suppose that could happen: Especially if it were dropped from a 5th floor window onto your head. Other than that? I'm not so sure.
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#3
Fifth floor would only incur severe cranial injury. It would require a drop from at least the sixth floor to kill.
If you don't believe me just have th person from the DME stand on the sidewalk...
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#4
And IF you could kill yourself with the machine (under normal use) then SHE MIGHT HAVE KILLED YOU BY CHANGING IT WITHOUT MEDICAL SUPERVISION AND INSTRUCTION.

For all she knows you are ALLERGIC (silly) the the previous settings and your doctor was worried you might kill yourself and so changed those settings.

I think I might have told here this, "YOU could kill someone changing those settings without a doctors order -- you don't know WHY they were most recently changed."

If she believe her claim then she would be force to at least entertain the idea that the reason her other clients don't continue using her services is that she has been KILLING THEM OFF by changing settings.
Sweet Dreams,

HerbM
Sleep study AHI: 49 RDI: 60 -- APAP 10-11 w/AHI: 1.5 avg for 7-days (up due likely to hip replacement recovery)

"We can all breathe together or we will all suffocate alone."
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#5
Hi GeoffD,
Good job for sticking up for yourself and taking charge of your therapy; keep up the good work.
trish6hundred
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#6
I don't think a DME needs your prescription with your settings on it .. all they need is the prescription for the machine itself. It is between you and your doctor what your settings are and due to privacy laws here in the US I'm not sure if they have the right to that information . They don't need that information for insurance compliance requirements. It would be interesting to hear a legal opinion on this !!

Good job sticking up for yourself more of us need to do this and DME's would have a different attitude.
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#7
The following is my understanding. When one gets a machine, in the USA, the DME must have a prescription for the machine and the pressure at which it is to be set. Once it is in the new owners hands, that person can either do the MD, RT, new settings loop or take matters into one's own hands. Nervous

Best Regards,

PaytonA
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#8
My own insurance provider directly told me that they do not care once diagnosed with SA if a GP or a SLeep doctor etc or a dentist for that matter wrote the prescription nor do they care if the patient changes their own settings, or a doc or DME does it.


I was told that the DME is on contract with them to be paid so much if they do the settings changes by a prescription which is why they are saying it has to be that way. But that by doing my own adjustments they and I would simply be saving money if I knew how to get into the machine and change them. Their only interest is the compliance and two fact to face with a Doc that states I needed the study done and that I am compliant and benefiting from the machine and that is a medical necessity.

I havent changed my own pressures yet though I very well know how too. With the bad virus moving about the friendly skies I will be moving everything to my local GP near my home from the Pulmonologist at the nearest hospital/sleeplab that handles it now with my DME. I have no interest in going near a hospital right now for anything other than a direct and immediate threat to life.

Thats just me though
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#9
Well my sleep doctor who is also my pulmonologists is not in a hospital so have no worry about seeing him.

Seems its all about the money !!
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#10
(10-17-2014, 10:37 PM)Whitewabit Wrote: I don't think a DME needs your prescription with your settings on it .. all they need is the prescription for the machine itself. It is between you and your doctor what your settings are and due to privacy laws here in the US I'm not sure if they have the right to that information . They don't need that information for insurance compliance requirements. It would be interesting to hear a legal opinion on this !!

Good job sticking up for yourself more of us need to do this and DME's would have a different attitude.

they would need a prescription or at the minimum the information on the pressure setting/s in order to complete the set up on the machine. After that, it is none of their business what happens to the pressure settings unless the client expects the DME personnel to change the settings. The DME only has to report compliance to the insurance company if the insurance company requires it. I wonder how many insurance companies actually get proof that the insured is compliant. Does the DME have to send them a print out of compliance or do they just verbally report to the insurance company that there is compliance. At any rate, that is all the DME needs to be concerned with as far as the insurance is concerned UNLESS the client expects the DME to change the pressure settings for them.
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