Newbie questions

[retired_guy]

Welcome aboard Hammer... 4 and 20 can be a little tricky especially when using a full face mask. So if you have any concerns at all come back with the numbers and we'll do what we can to help you out.

[surferdude2]

Hi Hammertime and

From the info in your profile area it looks like you got an S9 AutoSet. If so, you won't have much trouble getting it dialed in since it does all the hard work for you. There will be some little tweaks that you may find helpful for ironing out any kinks. Start a thread when that happens and you'll get plenty of help here. I found most of what I needed just by reading some of the old posts. This as a fantastic resource so stick around and learn what you need to in order to help yourself get a good night's sleep.

My best change to the S9 that I bought was to set the upper limit down to 16 instead of the factory default of 20. That allows the Mask Test mode of the machine to apply the lower pressure when doing the test and made it easier for me to fit the mask properly without having to strap it down painfully tight. I found out later that my pressure never needs to be above 13 so it's easy to keeps the leaks down and have the mask be comfortably fitted.

Good luck with the new rig and post back if you hit a snag.

[GeoffD]

The Aetna online information for all of this is pretty interesting:

Aetna seems to be paying 50% of their negotiated rate for this stuff and I pay the other half. The negotiated rate is a very small fraction of what the DME put on the invoice.

The S9 monthly rental was billed at $125.00. Aetna is paying $22.50 and says my co-pay is $22.50.

For the $400 humidifier, Aetna is paying half of $158.99
For the $7.99 filter, Aetna is paying half of $2.47
For the $69.95 headgear, Aetna is paying half of $19.97
For the $150 nasal mask, Aetna is paying half of $63.20
For the $100 heated tube, Aetna is paying half of $35.89

I'm expecting a $162.78 bill from the DME and then $22.50/month for the S9 AutoSet rental

An office visit to the Neurologist/sleep center where I'm seeing a nurse practitioner is billed at $333. Aetna pays $66 and I have a $40 specialist co-pay.

The first night in the sleep center was billed at $3,269.42. Aetna paid $1,995.62. I paid a $342.02 deductible
The neurologist review of the data was billed at $548.00. I paid $157.98 to hit my $500 cap on deductible.
The 2nd night at the sleep center was billed at $3,113.74. Aetna paid $2,226.32
The neurologist review of the data was billed at $588.00. Aetna paid $ 60.41

My conclusion: It would totally suck to be paying out-of-pocket at a non-negotiated rate. My total out-of-pocket looks to be my $500 deductible, $162.78 for the equipment, plus a year of $22.50/month equipment rental and periodic $40.00 co-pays for specialist office visits.