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Seeing Sleep Doc next week
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Peter_C Offline

Advisory Members

Posts: 1,308
Joined: Sep 2013

Machine: System One DS960HS
Mask Type: Full face mask
Mask Make & Model: Mirage Quattro "MED"
Humidifier: Attached
CPAP Pressure: Auto mode-script is:15/3/3
CPAP Software: EncoreBasic Other Software

Other Comments: Severe obstructive sleep apnea 1999/Just got an ASV machine

Sex: Male
Location: Akron, Ohio USA

Post: #1
Seeing Sleep Doc next week
Let's see?? (am bad on dates), I bet it's been 5-6 years since I've seen my sleep Doc. He's a practical guy that has specialized in this field for many, many years and unlike many of the horror stories others have posted, I've been very happy with him since the beginning of my OSA treatment.

With him, it's all about the results. He says you're a big boy, you know when you need to see me (Law says he must see me yearly to get new scripts for anything, but otherwise there is no need unless I need him). So I am suddenly on 'Medicaid' til July, then will be on 'Medicare' - so I called yesterday to leave him a message, and they called back within 90 minutes with an appt for next week.

My expectation is to go in, show him a few recent reports, bring him up to speed on my med list, talk about Pain MGNT vs OSA - and (hopefully) get a script for a new machine (S9 Autoset - correct?).

Am hoping to just fax the new script to [url=http://www.apneaboard.com/forums/Thread-CPAP-Supplier-List]Supplier #1[/url] and let them deal with Medicaid? Does anyone have experience with both [url=http://www.apneaboard.com/forums/Thread-CPAP-Supplier-List]Supplier #1[/url] and will they handle the whole Medicaid bit, or must I get a local DME to do it? I've dealt with [url=http://www.apneaboard.com/forums/Thread-CPAP-Supplier-List]Supplier #1[/url] in the past on a cash-only basis, so have no idea if they bill Medicaid/Medicare or not?

Anything I'm missing here? Will be the first sleep Doc visit in years but am not expecting any issues, mainly chasing a new machine. Wish to upgrade to a nicer/newer model.

*I* am not a DOCTOR or any type of Health Care Professional. My thoughts/suggestions/ideas are strictly only my opinions.

"Only two defining forces have ever offered to die for you. Jesus Christ and the American Soldier. One died for your Soul, the other for your Freedom."
05-21-2014 11:25 AM
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trish6hundred Offline

Advisory Members

Posts: 6,430
Joined: May 2012

Machine: Resmed S9 AutoSet for Her
Mask Type: Full face mask
Mask Make & Model: Fisher & Paykel Simplus
Humidifier: H5i Heated Humidifier
CPAP Pressure: 10 - 7-20 Cm H2O
CPAP Software: Not using software

Other Comments: I started CPAP in 2008. Totally blind since birth.

Sex: Female
Location: Missouri, USA

Post: #2
RE: Seeing Sleep Doc next week
Hi Peter_C,
If I'm not mistaken, the online companies, (such as Supplier #1 on the list,) either send you a link to a form on their site, or a pdf of the form, via e-mail regarding how to deal with your insurance, I don't think they deal with that directly.
Hang in there for others who know better about this.
Good luck to you at your Dr. apointment. Hopefuly, you will get a prescription for a newer machine.

trish6hundred
05-21-2014 11:38 AM
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retired_guy Offline

Preferred Members-2

Posts: 2,744
Joined: Jan 2014

Machine: ResMed S9 Autoset
Mask Type: Nasal pillows
Mask Make & Model: Resmed Airfit P10
Humidifier: ResMed
CPAP Pressure: 10.6/14, EPR 3
CPAP Software: ResScan SleepyHead

Other Comments: Is it bedtime yet?

Sex: Male
Location: Beautiful, albeit very wet Oregon Coast

Post: #3
RE: Seeing Sleep Doc next week
(05-21-2014 11:25 AM)Peter_C Wrote:  Anything I'm missing here? Will be the first sleep Doc visit in years but am not expecting any issues, mainly chasing a new machine. Wish to upgrade to a nicer/newer model.

Try to get one with four doors and a sunroof.

Also, call the online suppliers and ask them how the medicare thing works.
05-21-2014 11:42 AM
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jaycee Offline

Preferred Members-2

Posts: 115
Joined: May 2014

Machine: S-9 Autoset
Mask Type: Full face mask
Mask Make & Model: Quattro Air Large
Humidifier: 5i
CPAP Pressure: 9-13
CPAP Software: ResScan

Other Comments: RT at a DME

Sex: Male
Location:

Post: #4
RE: Seeing Sleep Doc next week
I don't do anything with billing at my company, but if I understand correctly, to get your supplies billed to Medicare/Medicaid all you would need would be:

1) An RX from your doctor (it doesn't actually need to be a sleep doctor, it can be any doctor, or with some insurances a PA or NP).
2) A copy of your PSG (sleep study without PAP) showing that you do infact have sleep apnea.
3) Medicare will need a copy of office notes from your doctor that mentions CPAP and that you are benefiting from it.
05-21-2014 11:45 AM
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Peter_C Offline

Advisory Members

Posts: 1,308
Joined: Sep 2013

Machine: System One DS960HS
Mask Type: Full face mask
Mask Make & Model: Mirage Quattro "MED"
Humidifier: Attached
CPAP Pressure: Auto mode-script is:15/3/3
CPAP Software: EncoreBasic Other Software

Other Comments: Severe obstructive sleep apnea 1999/Just got an ASV machine

Sex: Male
Location: Akron, Ohio USA

Post: #5
RE: Seeing Sleep Doc next week
I may well just let my sleep doc's office handle (like they did before) it. They have everything, as they've done my entire work-up and all my various studies, etc. Why try to save medicaid $$$ - as long as I get a *new* machine (check the total hours).

So I don't goof? The correct Model I want is??? "S9 AutoSet"?

*I* am not a DOCTOR or any type of Health Care Professional. My thoughts/suggestions/ideas are strictly only my opinions.

"Only two defining forces have ever offered to die for you. Jesus Christ and the American Soldier. One died for your Soul, the other for your Freedom."
05-21-2014 11:57 AM
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robertbuckley Online

Preferred Members

Posts: 99
Joined: Mar 2013

Machine: Resprionics BiPAP Auto SV Advanced
Mask Type: Full face mask
Mask Make & Model: ResMed AirFit F-10 Full Face
Humidifier: Resprionics System One
CPAP Pressure: EEP 15; PS 4 - 10
CPAP Software: SleepyHead EncoreBasic

Other Comments:

Sex: Male
Location: New York, NY

Post: #6
RE: Seeing Sleep Doc next week
You have to be careful with Medicaid/care. Depending on where you are located they will only cover when equipment is ordered through an approved supplier that is on their list, having gone through a bidding process.
05-21-2014 01:12 PM
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PaytonA Offline
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Monitors

Posts: 3,005
Joined: Dec 2013

Machine: ResMed S9 VPAP Auto
Mask Type: Full face mask
Mask Make & Model: Resmed Mirage Quattro
Humidifier: H5i(distilled-top up)
CPAP Pressure: VAuto MinE14.0 MaxI 20.6 PS4.0
CPAP Software: ResScan SleepyHead

Other Comments:

Sex: Male
Location: Orange County,California

Post: #7
RE: Seeing Sleep Doc next week
If you want the newer version of your current model I would get the S9 VPAP Auto. The Autoset does not give you bilevel and I notice that you are using a PS of 7 which is more than the 3 you can get with the EPR on the Autoset. It is my understanding from the reading that I have done that the S9 VPAP Auto uses the same algorithm that was developed for the Autoset. Someone please jump in here if I am wrong

Best Regards,

PaytonA.
05-21-2014 04:53 PM
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Peter_C Offline

Advisory Members

Posts: 1,308
Joined: Sep 2013

Machine: System One DS960HS
Mask Type: Full face mask
Mask Make & Model: Mirage Quattro "MED"
Humidifier: Attached
CPAP Pressure: Auto mode-script is:15/3/3
CPAP Software: EncoreBasic Other Software

Other Comments: Severe obstructive sleep apnea 1999/Just got an ASV machine

Sex: Male
Location: Akron, Ohio USA

Post: #8
RE: Seeing Sleep Doc next week
Yup - the models confuse the heck out of me. I do want/need to stay with a bi-level machine, so the "S9 VPAP Auto" is the current model for me, unless the sleep doc decides to pursue ASV issues. Thanks~!

*I* am not a DOCTOR or any type of Health Care Professional. My thoughts/suggestions/ideas are strictly only my opinions.

"Only two defining forces have ever offered to die for you. Jesus Christ and the American Soldier. One died for your Soul, the other for your Freedom."
05-21-2014 09:37 PM
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