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Should I accept ResMed Elite or push for AutoSet?
#11
I have been lucky. I got an S9 Autoset from the DME without a fight. But I was prepared to fight.
I would personally accept nothing less than an S9 Autoset.
Repeat after me, if you can't dispense a Resmed S9 Autoset with an H5i humidifier I will have to find a DME who can.
As has already been stated they use the same billing code and the same payment to the DME, so the better more expensive machine means less profit to the DME.that is their problem it should not be yours.
Stand your ground even if you have to change DMEs. Also any doctor or dentist can write your prescription. If necessary shop the doctors you know, even your neighbors to get the prescription you want.
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#12
Thanks for all the feedback. It confirmed my gut feeling, which is that I need to push for the autoset. I really appreciate your comments. Thanks so much! I'm calling the Doctor's office on Monday. If I can't get him to change the script, I'll change DMEs and find one that will issue the autoset. Thanks again!
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#13
I will add my 2 cents worth in stating you should push for the S9 Autoset. Sleep-well
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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#14
I questioned my sleep technician prior to my titration about the different machines. I knew the respiratory therapist was coming to my room early the next morning with a machine and I knew from reading here I wanted an AutoSet so I didn't have to mess around down the road with getting a new RX for an auto machine and making trips to the DME for any tweaks in pressure settings which is in a neighboring town and I work in yet another neighboring town. Makes a lot of traveling in winter weather for me. She explained to me if your determined pressure is relatively low then generally auto machines are not prescribed and the auto machines are more expensive. She also explained that my DME was able to adjust things remotely if need be. I was prescribed pressure 10. When the respiratory therapist was explaining my machine he commented pressure 9 was the cut off and with my pressure need of 10 he said "you are right there". I think making a point I just made it in with an AutoSet.
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#15
Most insurance in the US follow Medicare's product codes. All CPAP and APAP have the same code. Bilevel have a different code and ASV (for central apnea treatment) have another code. So a CPAP and an APAP cost the same thing to the insurance. However, the supplier loses money if they have to provide you with an APAP so they tend to not want to sell you one.
PaulaO2
Apnea Board Moderator
www.ApneaBoard.com


Breathe deeply and count to zen.

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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#16
(11-29-2013, 01:32 PM)PaulaO2 Wrote: Most insurance in the US follow Medicare's product codes. All CPAP and APAP have the same code. Bilevel have a different code and ASV (for central apnea treatment) have another code. So a CPAP and an APAP cost the same thing to the insurance. However, the supplier loses money if they have to provide you with an APAP so they tend to not want to sell you one.

Exactly right, Paula! BCBS has already confirmed for me that the machines are billed by the CPAP code, so I know what the DME is up to. The easiest solution is for the Doc to write a new script, but if I get caught in the middle of their little war, I intend to make it clear to the RT at the DME that I know that the billing code is the same for the autoset as the Elite, and continue to push for the autoset.

Last night I was doing some research online to try to find reviews about some of the DMEs in another nearby city in case I have to change DMEs. I couldn't find anything on a lot of them, but the ones that did have reviews were NOT favorable. How do you find a reliable and cooperative DME? It seems like they are a rare commodity!


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#17
Sadly, they are. Mostly it is word of mouth. There should be a CPAP group in your area. The sleep clinic may know of one. You can always ask the folks that attend that where they go and where they don't.

And if you do go, take a few of these along:
http://www.apneaboard.com/forums/Thread-...dout-Flyer
PaulaO2
Apnea Board Moderator
www.ApneaBoard.com


Breathe deeply and count to zen.

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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#18
(11-29-2013, 08:17 PM)PaulaO2 Wrote: Sadly, they are. Mostly it is word of mouth. There should be a CPAP group in your area. The sleep clinic may know of one. You can always ask the folks that attend that where they go and where they don't.

And if you do go, take a few of these along:
http://www.apneaboard.com/forums/Thread-...dout-Flyer

Paula, I'm SO glad you mentioned that! I had forgotten that the tech at the first sleep study mentioned that they have a sleep apnea support group that meets once a month. I'll have to call the sleep lab on Monday and ask them for the contact info! Thanks for the reminder!!

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