My original M-Series Auto was just retired in December 2014 when I bought a used PRS1 Auto (560) on another forum. That was followed by a PRS1 BiPAP Auto (760) purchased via local Craigslist, and upgraded with the heated hose retrofit kit. This machine has worked great since January 2015. With the auto bilevel, my AHI and RERA are much lower than with CPAP (more for RERA). I have some residual CA events but obstructive stuff is pretty limited, and I feel pretty good these days. I don't obsess over PAP therapy, but have paid more attention to data and results over the last year than I used to. It wasn't easy to check the Smartcard data anyway.
So the hard part was getting approval for the auto bilevel, when my original prescription was for auto CPAP. I have not had any sleep tests since 2008, but used the Respironics Encore data to document efficacy, and improved therapy with bilevel. I knew it worked better, but proof is needed for insurance. I recruited my primary physician as my sleep doctor, and provided him with written summaries of the bilevel benefits along with summary data from Encore. In order to qualify for bilevel his notes had to state I did not tolerate CPAP, which is a bit of a stretch, but therapy is improved with bilevel. I also wrote my proposed prescription information including machine type, humidifier, heated hose, mask, filters and supplies with insurance codes. I had his office submit the prescription to the new DME, Remworks.
Of course insurance denied the upgrade, but approved auto CPAP, which I declined. It took a couple more submittals by Remworks to finally get the approval for the auto bilevel, which came in today.
So, I set an appointment for noon, and after running some important errands (like changing oil, transmission fluid and picking up some beer), arrived for an appointment with the RT. I had a choice of the PRS1 760 or Resmed Aircurve 10 Vauto. I selected the Resmed (brand agnostic), and we reviewed settings and equipment. The machine was not originally set to auto mode and no climateline hose was included. We discussed it, and the RT found the DME form from the doctor had those items included and made appropriate changes. So, bottom line is, tonight will be a new machine.
I really appreciate my doctor for working with me and respecting my knowledge of my needs and incorporating those into my health record and prescriptions. Remworks is a new DME in the area and is owned by the BCBS affiliate Highmark. Great staff and an inviting comfortable store and service center, and they kept after it when Aetna originally denied the bilevel. The RT was very knowledgeable and had good empathy for patients. So, this is what a DME should look like today.