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ResMed S9 Autoset or Elite??
#1
I got my perscription today and the first place I went to had only one machine, that was on the "do not buy list" so I left. But she told me I could not get the Auto machines because my perscription didnt say that...
my perscription says... "CPAP (E0601)@7cm H20" I have BCBS of Alabama. Does anyone know if this is correct, or can I get the ResMed S9 Autoset with this??
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#2
The AutoSet can be set to CPAP mode (constant pressure), so the prescription is sufficient to dispense an AutoSet - but, that doesn't mean the DME will agree to do it. If the DME said they can't provide an AutoSet because it does not conform to the Rx, then the DME is feeding you a line of ****. If the DME said they can't provide an AutoSet because the insurance company will not pay, then they are feeding you a line of ****. If the DME said they don't want to give you an AutoSet because it is more expensive and they get paid a flat fee so they make more money by dispensing a cheaper machine, then they are being honest and up-front with you.
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#3
Carolynn, I have Anthem BCBS and they bought me an Autoset. If the DME is giving you grief, go back to the sleep center/doctor who wrote the script and get a new one. Or better yet, get them to do what my doc did. His script showed that the machine was my choice as long as it was set to the prescribed level.
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#4
To avoid any confusion, ask the doctor to specify the machine on the script and dispense as written
The script would shows something like this:
S9 AutoSet, CPAP pressure 6-9 (later you can change CPAP @7) H5i humidifier & ClimateLine, cleanable tub, mask of choice
cleanable tub - Part No: 36800 [Image: ResMedH5iCleanableTub.JPG]

Also ask the DME about mask return policy so you can return mask and try another with the allowable 30 days period
The right mask and good mask fit is essential for effective treatment

The model name (AutoSet) shown next to stop/start button
[Image: img_usage.jpg]


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#5
What Zonk said. Make the turkeys get you an Autoset. It's just a more flexable machine than a straight CPAP. It isn't THAT much more money either. $50?
Worth every penny.
Wink
"With ordinary talent and extraordinary perseverance, all things are attainable." - Thomas Foxwell Buxton

Cool
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#6
The DME is legally required to deliver whatever machine he dispenses set for manual CPAP at 7 cmH2O. An S9 Elite will do this. An S9 AutoSet can also be set to do this, but it will cost him more money, and he will only be paid a fixed amount by insurance.

He has a right to refuse to sell you the more expensive machine if your prescription doesn't require it. (or to simply refuse to sell you anything.)

He can legally sell it to you, but his management may forbid it. Some DMEs are dishonest, stupid, or both. He may actually think it's illegal.

If your doctor writes a prescription that specifies an auto pressure range, he can only dispense you an Auto machine.

Find out who's "in network" for your insurance and shop around for one who's willing to sell you an AutoSet at the in-network price.

There's also an S9 Escape Auto. Avoid that one, it has a lot less data. Don't let anyone fool you by calling it an "S9 Auto." It will be labeled next to the power button.
Get the free SleepyHead software here.
Useful links.
Click here for information on the main alternative to CPAP.
If it's midnight and a DME tells you it's dark outside, go and check it yourself.
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#7
I agree with arcangle, except it's not okay by me to cheat people and pocket the difference in insurance dollars.
That is deceptive and it's fraud.

Peace, Love and Carrots.

=^.^=
"With ordinary talent and extraordinary perseverance, all things are attainable." - Thomas Foxwell Buxton

Cool
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#8
Thanks so much for all of this input... I did go by another place that I do like and it is close to home. He also said insurance, BCBS-alabama, needs to see Auto on the script and suggested I call the doctor back to rewrite it so that is what I am trying next. He was out of the office today but the receptionist said to call back tomorrow and they would rewrite it.. I guess that would be the easiest so I'll try that first. I am prepared to walk away again and keep looking.. this forum has helped so much! Thank you
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#9
Hang in there Carolyn, don't let them give you any wooden nickles!

Big Grin

Sleep-well
"With ordinary talent and extraordinary perseverance, all things are attainable." - Thomas Foxwell Buxton

Cool
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#10
YAY! just came home with the Resmed S9 Autoset! The DME was very helpful! This forum was SOOOOO helpful in educating me in all areas.. If I had not stumbled upon this, I would have gone home with one of the machines that does almost nothing. THANKS so much for all of the help. Now on to figuring this whole thing out and making sure I have the right mask too.
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