Medicare only cares that you are being compliant and using the machine. They see the use only in the hours it has been used. they could care less that the machine is actually doing you any good.
I doubt the DME even notices you change anything. To them, you are Patient Number $ out of how many?
I'd not even get the doc to get the DME to change it. As long as the doc okays the change, do it yourself.
Apnea Board Moderator
Breathe deeply and count to zen.
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The modem for the most part only sends hours used nothing about your settings. The only time the DME would know that is when you take the machine in to your DME for its yearly cleaning and check-up.
My Doctor actually instructed the DME to provide the "provider's" manual so that I could make changes. Got fairly complex sleep problems besides the obstructive and central apneas, and the Dr. wanted to be able to work with me proactively by me sending her data reports as well as subjective/clinical feelings, and making adjustments to see what the results were. They (the doc and the DME "therapist" sent out with the machine) had some words, and I stood my ground in demanding the manual. End of story is Dr. trumps DME. All that said - this board is the best, as it has almost all the manuals you might need. As for Medicare - they don't care as long as you are using. Think of changing the settings in the same way you might a drug - where a doctor might say - double up on the number of pills and see if that helps, or cut the pill in half and see if you react better.
As others have said, medicare cares about compliance, while to the DME, you're part of the cash flow. I've found that if you are compliant and below and AHI of 5, neither cares about anything else.
However...If you have a good relationship with your GP, it can be worth having a short discussion with them about some freedom to track and adjust your machine...mine has been very supportive of my being proactive to get the best treatment for me. After all, I'm the one who benefits most from better treatment and know when things aren't working.
For example, my previous DME didn't seem to care that my AHI was over 1. I have UARS and my sleep disruption number is about 9x my AHI....just my events aren't long enough to register as full-blown events...so I had the equivalent of an AHI of 9. By being proactive, I've gotten my AHI down to sub 0.2 consistently, which, even with my multiplier for non-registering events, puts me into a far better treatment and sleep scenario. My GP applauds my efforts and my results and supports them 100%.
If the GP will support you, then even if Medicare or the DME has issues, you've got someone to back you up.