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Rice95 Therapy
#41
RE: Rice95 Therapy
(04-29-2021, 07:50 AM)Sleeprider Wrote: Rice95, I  have one further suggestion. Request your primary doctor take over the role of managing your CPAP therapy. You no longer need a specialist and can accurately identify problems and work to solve them. Your primary doc can continue to provide prescriptions as needed, and follow up on your therapy on an annual basis. It only involved asking if you're using your CPAP and how is is going.  You can save the time and cost of a specialist, and your copies of the sleep studies, and records of initial prescriptions and any doctor's notes from your specialist will suffice to renew machines and equipment for a long time.  I never saw a specialist after my first sleep study, and I certainly don't agree with the way your specialist pads his profits while getting his patients the bare minimum machine.  You can do this with a doctor you know and trust.  Get your records, and change your care provider.
Thank you for this advice. 
I’m new to this. My primary doctor did not refer me. I went straight to the ENT because I had a bad snoring problem. My ENT gave me a sleep study and I kept all my papers from that 1 night study. Then he told me I needed therapy and then I blew 1100.00 bucks on a less than sufficient machine. Then he pestered me for surgery and I told him I’ve had a deviated septum for 55 years and I wasn’t even the slightest bit interested in surgery. He also was pretty condescending to me and insulted my weight. I’m a thin guy and I’m 6’1” and I only weigh 162 pounds. He said he was going to ‘give me a sandwich’  with a straight face ... Uh boy ...that was rough 

When I give this guy the boot, is my primary able to write sleep related scripts and fully understand therapy ? 

Also when it’s time to renew my machine I’ll have a script that is 5 years old. Will I still be able to purchase a machine on my own without his input or control? He hasn’t been even a 1/4 of helpful as you all have been.
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#42
Smile 
RE: Rice95 Therapy
Thank you!!!
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#43
RE: Rice95 Therapy
To all the above questions, yes! You might even want to unload that story on your doctor. Believe it or not nearly every physician in the U.S. and elsewhere has more than enough expertise to put a "sleep specialist" to shame. I presume your doctor, is your doctor because you have trust and a relationship, and that is so much more important than any alleged credential from a "non-profit" credentialing organization (ASAA) that has no meaningful medical connection whatsoever, other than to give credibility to quack science, and enable insurance companies and Medicare to avoid costs. Specific to your story, you should have consulted your physician on any proposal by an ENT for surgery or medication, and personal insults are not a very good setting to establish faith that any physician has your best outcome as a motive. That sounds like a car salesman throwing your keys on the roof.

Any prescription written by any non-specialist doctor, PA or registered nurse is recognized as valid by any DME or provider of CPAP and respiratory equipment. That does not mean an insurance company has to approve compensation, but it generally does not make any difference. I have been referred to sleep studies, but not to the care of a specialist. My personal doctor has ALWAYS managed my care, not ordered my care. This is true of any specialty from dermatiloty, or urology to hematology, infectious disease, neurology, orthopedics, etc. Specialists are consultants to MY physician, not the managers of my care. One good physician to coordinate prescriptions, care and medical orders. You won't believe what kind of problems that can avoid as compared to distributing your care to multiple individual specialists.
Sleeprider
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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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#44
RE: Rice95 Therapy
Sleeprider

Since I had my machine ‘discounted’ by the insurance company, do they still have rights over my machine? On my next scheduled visit in a year , is my ent required to share my data with my insurance  that has occurred over the last year? If I sever my relationship with him will the insurance company demand proof of therapy ? I don’t know how this works.
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#45
RE: Rice95 Therapy
Most insurances require around a 13 month rental then you own the PAP. During that time you must show compliance usage 4 hours per day, 21 of 31 day month, with 3 months to get that 21/31 day and 4 hour mark. Then one must see the prescribing doc between 1 to 3 months after PAP dispensed. That's it for the PAP. And note except for the doc visit, it's all usage not treated success.

For supplies, some like the Lincare DME ask if you're using PAP then you get hoses, humidifier tubs, filters, mask cushions, frames, etc. Not everything every time, but typically based per 3 months. Other DME's ask other use type questions.
Dave

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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#46
RE: Rice95 Therapy
Thanks Dave. Its only been 3 months since I've started using it. I could have just bought it outright without the hangup of insurance compliance and paid a lot less for it. 



I have my chart attached from last night. Ive been doing great the last 2 nights with numbers around 1.3. Last night they jumped. 

I've been using a flat pillow and a collar faithfully each night. I suffer from stomach issues so my pressure now is still at 10.5. I'm also going to do away with the ramp eventually-----


My OA increased last night and I'm not sure why  if I'm following the guidelines?


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#47
RE: Rice95 Therapy
(04-29-2021, 08:01 PM)Rice95 Wrote: Sleeprider

Since I had my machine ‘discounted’ by the insurance company, do they still have rights over my machine? On my next scheduled visit in a year , is my ent required to share my data with my insurance  that has occurred over the last year? If I sever my relationship with him will the insurance company demand proof of therapy ? I don’t know how this works.

The problem is that we don't know what your coverage entails. I don't know what "discounted" means... it sounds like you paid a hefty amount for your machine. Make a list of questions and call your insurance.

Do you know if it's fully paid for? Is your ENT doctor still receiving payments/rental from your insurance? Find out exactly what your coverage is. What is still owed? Have you met compliance?

Your not going to get these answers from your doctor as I have a feeling he is still reaping the benefits of all this.
OpalRose
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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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#48
RE: Rice95 Therapy
(04-30-2021, 05:03 AM)Rice95 Wrote: Thanks Dave. Its only been 3 months since I've started using it. I could have just bought it outright without the hangup of insurance compliance and paid a lot less for it. 



I have my chart attached from last night. Ive been doing great the last 2 nights with numbers around 1.3. Last night they jumped. 

I've been using a flat pillow and a collar faithfully each night. I suffer from stomach issues so my pressure now is still at 10.5. I'm also going to do away with the ramp eventually-----


My OA increased last night and I'm not sure why  if I'm following the guidelines?

There is still some positional apnea.  See the clusters of OA on your graph.  You may have rolled on your back, or your chin slipped down even with the collar on.  

The only thing that may curb the OB is raising your minimum pressure.  We talked about that before, and the problem is you suffer with Aerophagia.  It's simply going to be a balancing act to find a pressure that will tackle most of the Obstructives and Hypopnea and yet limit the "swallowing of air".  

You seem to be doing everything you can for that.   I suggest sticking with current pressure or lower back down to 10 if you feel it helps.  Limit the Flex setting to 1 or off.  Keep using your collar and sleep slightly inclined.

Work on getting rid of the ramp.  Look at your graph... you experienced 1 OB and 1 CA during ramp time.
OpalRose
Apnea Board Administrator
www.ApneaBoard.com

OSCAR Chart Organization
OSCAR - The Guide
Soft Cervical Collar
Optimizing therapy




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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#49
RE: Rice95 Therapy
OpalRose

Discounted means insurance paid 1/2 for an over inflated machine price of 3200.00 

I’ll check on the details of my payments (they charged my card 1100.00 dollars
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#50
RE: Rice95 Therapy
(04-30-2021, 07:01 AM)Rice95 Wrote: OpalRose

Discounted means insurance paid 1/2 for an over inflated machine price of 3200.00 

I’ll check on the details of my payments (they charged my card 1100.00 dollars

You don't know how angry this makes me, so I can imagine how you feel. Sad

I would still check with insurance and get all the details and ask questions. Either way, I would think that machine is yours and they shouldn't ask for it back if you were to sever ties with the "good" doc. But it's not likely that even going elsewhere or looking for a different DME right now, that insurance would pay for a different machine. So we have to work with what you have.

I'm sorry you are going through this, but you are not alone.
OpalRose
Apnea Board Administrator
www.ApneaBoard.com

OSCAR Chart Organization
OSCAR - The Guide
Soft Cervical Collar
Optimizing therapy




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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