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doctor says complex insurance says use a bipap s/t
#1
is there any bipap other than an ASV type that will possibly handle central/complex apnea

i think the DME is trying to impose some medicare rules on my insurance while ignoring that my doctor says the bipap failed and to use an ASV
and my insurance rep is clueless and believing everything they tell her 

is there any bipap s/t that claims to help complex/central apnea ??
#2
Did your sleep doc give you script for the ASV machine? The DME can only give you a machine that is prescribed by your doctor.
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 OPINIONS ONLY AND NOT NECESSARILY STATEMENTS OF FACT.
#3
(04-28-2017, 07:04 PM)PollCat Wrote: Did your sleep doc give you script for the ASV machine?  The DME can only give you a machine that is prescribed by your doctor.

I have an Rx for an ASV machine.
I have a write up justifying it.

My DME is trying to snow my insurance rep saying i have to fail the first bipap for 21 days
then fail on an S/T machine before I can get an ASV.

Initially my insurance rep said all that my plan required was medically necessary and the doctor say bipap failed.
I got that justification and the Rx.

Now the DME is feeding them medicrap procedures or trying to impose their own DME rules onto my insurance plan.
The insurance rep was asked for the rules in writing and two different ones told me that there were no written rules for compliance and that
all I needed was for it to be medically necessary and justified which the board cert sleep doctor did. 
Now they are finally saying their medical department will give me the written rules.  
I wonder if they will agree with what the two service reps told me. 

Now they are listening to the DME and say they won't pay for it without another sleep test with yet another machine and who knows how many more hoops and roadblocks they will try. I hope that is a bluff.  When I see the real rules I suspect that I will get the ASV unless they are totally different from what I had been told before.  

The bipap was a TOTAL FAIL.  It either kept me from sleeping at all, else when I got so tired and fell asleep anyway it jolted me awake as if I was slammed into a brick wall and the air had been sucked out of the mask.  I had to breathe through mouth until I can relax enough to try RAD again and as soon as I fall asleep the brick wall torture is repeated.  NO mas!!  3 strikes and that machine is out.  Not being tortured for some bureaucrats rule.
I will do without anything before I use that device gain. 

Now I may not be the brightest person but I am not about to be tortured and get no sleep for 4 hours 21 days in a row to prove that machine failed.
THE DOCTOR SAID IT FAILED.  I have complex/central apnea.  His Rx said to use an ASV not an  S/T.

My question is there anything but an ASV that can treat complex/central that they could justifiably ask me to try first.


#4
I would change DMEs right now if not yesterday. They are an equipment supplier, no more no less.
#5
The A10 ST is a BiPAP and is, according to the Resmed website, considered a non-invasive ventilator. Meaning its function is to help you breathe in addition to treating sleep apnea. The ST-A has alarms while the ST does not.
http://www.resmed.com/us/en/consumer/pro...vices.html

While we don't mind helping folks who come here, we also encourage users to help themselves. I am encouraging you to go to the manufacturers websites and/or use Google to educate yourself on the machines out there and what they can and cannot do. I understand your frustration at your supplier. What I don't understand is why you are still with them, why you don't look this information up yourself, and why you continually question the answers you get here. We can only do so much and are only willing to do so much before we give up.

I am closing this thread since it is so similar to the one you already have. Should you feel it is in error, please let me know via PM.
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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