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Should I accept ResMed Elite or push for AutoSet?
#1
Hi, fellow Papers!

The doctor's office called today to tell me that they had the results from the titration study and they wanted to know what DME to send it to. I asked how the prescription is written and the lady from the doctor's office said it just said "CPAP with a pressure of 8." I told her that I had the sleep technician note on my titration study that I wanted an Auto machine. She said she really didn't know anything about CPAP machines but that I "could get whatever machine I want from the DME." From everything I've learned here, I KNEW that wasn't right!! I told her that I wanted the script to specify a ResMed S9 Autoset and she said that she didn't think they ever specified a specific make or model on the prescription (although she'd already told me that she didn't know anything about CPAP and asked me what ResMed was, so how would she know what the prescriptions usually said?). Next I called the DME and talked to the Respiratory Therapist. When he got the fax from the doctor's office, he confirmed that it just specified a CPAP with humidifier at a pressure of 8. I told him that I wanted full data efficacy as I had discussed with him a few weeks ago. He said he could get me the ResMed S9 Elite, but I couldn't get the ResMed S9 Autoset without a new prescription from the doctor specifying the auto with a range of pressures instead of a set pressure.

I already know that the Doctor's office is closed on Monday. My question is whether I should call there on Monday and try to get a new script for the Auto, or should I accept the Elite? I checked the ResMed site and the two machines are identical except for the "auto" feature of the autoset. I don' t know what the odds are that the doctor will write me a script for an auto when the sleep study specified a setting of 8 instead of a range. Am I being too picky? If you think I should push for the auto can you give me some idea of the points to bring up with the doctor as to why the auto is a better choice when he thinks I only need a standard CPAP with a set pressure?

Thanks for your thoughts and advice!

Roxy
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#2
RockABye, the only difference is the auto vs fixed, if you think you can tolerate that pressure the whole night which isn't that high, go with the Elite.
If you don't stand your ground.
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#3
Elite can only be set to deliver one constant pressure all night long while Auto-PAP can do that plus auto mode .. two machines in one

Better to have, and not need, than to need, and not have
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#4
Eh, really, unless you have other health issues, or if you have complicated sleep apnea, or if you expect to have communication issues in the future with the sleep doc, go with the Elite.

Otherwise, try to the the Autoset. The script doesn't have to say what specific machine to get, but it does need to say "APAP with range of x to x" (or something like that) before the DME can fill the order.

But Zonk is right. An APAP is the best of both worlds. You can run it in regular CPAP mode and be just fine then switch to APAP mode when you feel the need.

If you choose to go that route, ask the DME what the wording needs to be. Write it down and repeat it back to him.
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#5
DME can set the AutoSet to fixed pressure of 8 and dispense to you, thus filling the prescription exactly as written. DME CAN give you an AutoSet, but doesn't want to because they'll make a few more bucks giving you the cheaper machine. Insurance doesn't keep them from dispensing the AutoSet either because it is the same billing code for the AutoSet as the Elite.

You could try to reason with your Doc and explain that you want keep an eye on your therapy and be able to optimize it and possibly adjust it to respond to any changing pressure needs and an AutoSet would make that process much easier - that kind of talk might cause problems for you though. I don't know your Doc or what kind of relationship you have.

If you don't think you can convince the Doc to specify AutoSet and dispense as written then you might just have to call around to DMEs to find one that will dispense an AutoSet set at a fixed pressure of 8. Nothing is stopping your current DME from giving you an AutoSet except greed or ignorance (might not know it can be put in CPAP mode).
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#6
My prescription was for a CPAP set to 13 and I received the S9 AutoSet. I talked to the DME and told them I wanted a machine with a humidifier and with the ability to go the APAP route if I wanted. The DME told me that it didn't matter what machine they issued, they all have the exact same insurance code from the lowest entry level machine without a humidifier to the highest level machine with all the bells and whistles and every thing in between. She also told me the the cost to the insurance company is the same for all machines. I asked my insurance provider if I could purchase my machine from an on-line store as the price was about half and they told me no, it had to come from a DME if they were going to reimburse me for the out of pocket expense. Going with the DME the machine ended up about half of what it would have cost me on the web. I think I would shop around for a different DME or at least let the DME know you are going to shop for the machine you want. The S9 Autoset can be set up as a straight CPAP machine, it just has some other functions that don't get used in that mode.
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#7
Explain to your doctor that the S9 will adept to your needs and last 5 times longer than a regular CPAP. I was titrated out at 8 during my sleep study, but with my auto, it usually goes to 11 before leveling out, some spikes through the night have brought it up to 19!

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#8
My scrip was for a no auto machine but the DME did give me a auto which I wanted. It was good that I got a auto as I started out at a pressure of 11 and after 2months due to high AHI numbers my doctor changed me to auto mode setting of 11-15. So having the auto worked out the best.
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#9
I started with the Resmed Escape, which is the worse one, but about two months ago I managed to get an Autoset. It makes a huge difference.
My pressure set at 8 on the first machine, but on the Autoset they put in a range of 5-15. Mine never goes above 11 but the great thing about this machine is that it adjusts the pressure to fit your breathing needs.

I have watched my AHI get better and better. The better I do on the machine, the less pressure is required. The less pressure you have the easier it is to breath. My 95% pressure is generally around 7-8. BUT on the occasional bad night, I notice the machine cranks up the pressure until I am breathing clear again. SO, if you can finagle an Autoset, you will be much happier, in my newbie opinion.
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#10
My DME would not give me the auto machine with a fixed pressure on the prescription. The doctor's office modified the prescription to say S9 AutoSet with a from/to range. Your pressure is 8 so have them write 7.4 to 8 on the prescription. Worked for me. Of course, you have the option to change the settings when you get it. I decided to leave mine as set until the first followup dr. visit.
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