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how to get a different CPAP after DME did their thing
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chuck taylor Offline

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Joined: Mar 2014

Machine: resmed s9
Mask Type: Nasal pillows
Mask Make & Model: swift Fx
Humidifier: resmed
CPAP Pressure: 10
CPAP Software: ResScan

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Sex: Male
Location:

Post: #1
how to get a different CPAP after DME did their thing
Anyone know or have any ideas how I can get an auto set CPAP after DME has already issued me the non data reporting and non auto set machine.

I'm on medicare.
Options I can think of:
A. take a chance that the DME's home office will authorize the exchange of resmed escape for a resmed S9 auto set.

B. Tell the sleep doctor I want to purchase the CPAP myself and ask the sleep doctor to issue me a prescription and turn in the ResMed escape to the DME.

C. Use the Resmed Escape for the required month for Medicare compliance. Then go back to using my old S8 Autoset for a year. Then sell the ResMed escape and apply purchase to a ResMed S9 Autoset.

Do I really have to keep it for a year before I can sell it? If they want it back before the year is up can't I give them the AutoSet that I've purchased?

Any help from someone who's been down this road before or any knowledge of how they operate will be much appreciated.
Thanks
03-14-2014 02:04 PM
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justMongo Offline

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Machine: ResMed VPAP Auto (S9)
Mask Type: Full face mask
Mask Make & Model: ResMed Mirage Quattro
Humidifier: ResMed H5i
CPAP Pressure: 18 IPAPmax - 11 EPAPmin, PS=5
CPAP Software: Other Software

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Sex: Male
Location: Калифорния

Post: #2
RE: how to get a different CPAP after DME did their thing
A. take a chance that the DME's home office will authorize the exchange of resmed escape for a resmed S9 auto set.
*** Not likely to happen as they have met their obligation; and maximized their profit by giving you the least expensive machine that meets your Rx.
B. Tell the sleep doctor I want to purchase the CPAP myself and ask the sleep doctor to issue me a prescription and turn in the ResMed escape to the DME.
*** That will work.
C. Use the Resmed Escape for the required month for Medicare compliance. Then go back to using my old S8 Autoset for a year. Then sell the ResMed escape and apply purchase to a ResMed S9 Autoset.
*** That works; but it will be a year without the new machine.

Do I really have to keep it for a year before I can sell it? If they want it back before the year is up can't I give them the AutoSet that I've purchased?
***Technically it's a rental for 13 months; ergo, not yours to sell. I am not a lawyer; but, I believe that would be an unlawful conversion of property.

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.
(This post was last modified: 03-14-2014 03:14 PM by justMongo.)
03-14-2014 02:19 PM
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trish6hundred Offline

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Posts: 6,430
Joined: May 2012

Machine: Resmed S9 AutoSet for Her
Mask Type: Full face mask
Mask Make & Model: Fisher & Paykel Simplus
Humidifier: H5i Heated Humidifier
CPAP Pressure: 10 - 7-20 Cm H2O
CPAP Software: Not using software

Other Comments: I started CPAP in 2008. Totally blind since birth.

Sex: Female
Location: Missouri, USA

Post: #3
RE: how to get a different CPAP after DME did their thing
Hi chuck,
WELCOME! to the forum.!
You might try the second choice you mentioned and see how that gose.
Hang in there for more suggestions and best of luck to you.

trish6hundred
03-14-2014 02:45 PM
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robysue Online
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Posts: 1,222
Joined: Oct 2013

Machine: PR Dreamstation BiPAP Auto
Mask Type: Nasal pillows
Mask Make & Model: Swift FX
Humidifier: PR Dreamstation humidfier
CPAP Pressure: min EPAP = 4; max IPAP = 9;
CPAP Software: SleepyHead EncoreBasic EncorePro

Other Comments: Papping since September 2010

Sex: Female
Location: Buffalo, NY

Post: #4
RE: how to get a different CPAP after DME did their thing
(03-14-2014 02:04 PM)chuck taylor Wrote:  Anyone know or have any ideas how I can get an auto set CPAP after DME has already issued me the non data reporting and non auto set machine.
It's going to be hard ....

There's a user on another forum named JanKnitz who has written extensively about this issue. She has a blog, Mask Arrayed, and one of her entries is Help! I'm stuck with a brick

I'd start there.

Quote:I'm on medicare.
Options I can think of:
A. take a chance that the DME's home office will authorize the exchange of resmed escape for a resmed S9 auto set.
Ain't gonna happen unless you have the doc on board with your request for a full data machine.

Quote:B. Tell the sleep doctor I want to purchase the CPAP myself and ask the sleep doctor to issue me a prescription and turn in the ResMed escape to the DME.
This would work. But Medicare might then refuse to pay for any of your supplies in the future.

Quote:C. Use the Resmed Escape for the required month for Medicare compliance. Then go back to using my old S8 Autoset for a year. Then sell the ResMed escape and apply purchase to a ResMed S9 Autoset.
You could do this, but there's a lot of time and money involved. Besides which, why would you want to stick somebody else with the brick?
03-14-2014 03:17 PM
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zonk Offline

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Posts: 7,908
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Machine: A10 AutoSet
Mask Type: Nasal mask
Mask Make & Model: Activa LT
Humidifier: Integrated /ClimateLineAir
CPAP Pressure: 9/13
CPAP Software: ResScan

Other Comments: CPAP since Nov 2010

Sex: Male
Location: Australia

Post: #5
RE: how to get a different CPAP after DME did their thing
Medicare does not care about efficacy data, they only care that the machine record compliance data and compliance guidelines are met so they can pay for the machines. Medicare pay the same amount for the machine (E0601) from low end CPAP machines to top end Auto CPAP (Bi-level machines E0470). DME (lousy ones) does care, they make few extra dollars by flogging low end machines

You should be talking to your doctor, he should care enough to prescribe data capable machine so he can review the data and tell whether the therapy is working or any adjustment is needed

Ask him to specify the machine on the prescription, example:
S9 AutoSet, pressure range 8-12 ... dispense as written
(This post was last modified: 03-14-2014 03:59 PM by zonk.)
03-14-2014 03:57 PM
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Doc J Offline

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Posts: 199
Joined: Dec 2013

Machine: ResMed S9 AutoSet
Mask Type: Nasal pillows
Mask Make & Model: ResMed AirFit P10
Humidifier: resMed H5i Dumped and dry daily
CPAP Pressure: 10-15
CPAP Software: ResScan SleepyHead

Other Comments: Knowledge is King and this is the place to find it! Thanks everyone.

Sex: Male
Location: Central Nebraska

Post: #6
RE: how to get a different CPAP after DME did their thing
I didn't gain the insight of the fact I had been sold a crappy machine till I came here(about six months in). I had met the 90 day compliance and at 8 months bought a used S9 auto set. I went to the DME to see what was left to bill on my original machine and by this time it was one month. I told them I wasn't using it I had found better and she said my original wasn't that great of a machine. So I have a back up if I should have problems (until I find another S9 auto set which I see as the way to go). By the way I'll get my supplies online, and if I have to get a copy of my prescription I will.
Good luck, your ahead of the curve by knowing the difference and wanting the best.
Doc J
03-14-2014 06:38 PM
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PaulaO2 Offline
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Posts: 8,064
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Machine: S9 Autoset
Mask Type: Full face mask
Mask Make & Model: F&P Simplus
Humidifier: H5i
CPAP Pressure: 14-20
CPAP Software: SleepyHead

Other Comments: Ehlers-Danlos Syndrome, Hypermobility Type; chronic sarcasm

Sex: Undisclosed
Location: western NC, USA

Post: #7
RE: how to get a different CPAP after DME did their thing
The way I understand it, and the way it was a year ago, was if the CPAP is still within the rental period, it can be exchanged for another. Medicare will be paying the same for it either way. As long as it is another CPAP and not being exchanged for a bilevel or ASV, it should be no problem as for as Medicare goes.

The DME may say your doctor needs to approve it. I don't know if that is true or not. You could be assertive and say you know they get paid the same amount of money whether it is the Escape or the Autoset. You want data capabilities. If you do need a doctor's approval, the Elite is data capable and is a good machine, it just won't be an autoPAP. Some older sleep docs are not up to date on their reading and still believe autoPAPs to be useless.

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.
03-14-2014 09:26 PM
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chuck taylor Offline

Members

Posts: 10
Joined: Mar 2014

Machine: resmed s9
Mask Type: Nasal pillows
Mask Make & Model: swift Fx
Humidifier: resmed
CPAP Pressure: 10
CPAP Software: ResScan

Other Comments:

Sex: Male
Location:

Post: #8
RE: how to get a different CPAP after DME did their thing
thank you all for your insight and help.
It all makes sense now.
I will try going through the sleep doctor 1st, as they did diagnose me with severe apnea.
"Mask arrayed" will be interesting.
If anyone else has had similar experiences with DMEs, your input will be welcome.

Thank You
03-14-2014 10:28 PM
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me50 Offline

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Machine: resmed S9 VPAP Auto
Mask Type: Nasal mask
Mask Make & Model: Wisp and Silicone Head gear
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CPAP Pressure: 18/8
CPAP Software: SleepyHead

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Sex: Undisclosed
Location: USA

Post: #9
RE: how to get a different CPAP after DME did their thing
(03-14-2014 02:04 PM)chuck taylor Wrote:  Anyone know or have any ideas how I can get an auto set CPAP after DME has already issued me the non data reporting and non auto set machine.

I'm on medicare.
Options I can think of:
A. take a chance that the DME's home office will authorize the exchange of resmed escape for a resmed S9 auto set.

B. Tell the sleep doctor I want to purchase the CPAP myself and ask the sleep doctor to issue me a prescription and turn in the ResMed escape to the DME.

C. Use the Resmed Escape for the required month for Medicare compliance. Then go back to using my old S8 Autoset for a year. Then sell the ResMed escape and apply purchase to a ResMed S9 Autoset.

Do I really have to keep it for a year before I can sell it? If they want it back before the year is up can't I give them the AutoSet that I've purchased?

Any help from someone who's been down this road before or any knowledge of how they operate will be much appreciated.
Thanks

get your script from your doc and make sure that you got what is on the script and then I would ask for another script and get a better machine.
03-14-2014 11:52 PM
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JimZZZ Offline

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Posts: 370
Joined: Dec 2013

Machine: ResMed S9 AutoSet
Mask Type: Full face mask
Mask Make & Model: Fisher & Paykel Simplus
Humidifier: ResMed H5i (not using)
CPAP Pressure: 9 - 14
CPAP Software: ResScan SleepyHead

Other Comments: CareFusion PureSom Ultra Chinstrap

Sex: Male
Location: Western North Carolina

Post: #10
RE: how to get a different CPAP after DME did their thing
It depends on what the doctor ordered and whether the DME faithfully fulfilled the doctor's prescription. In my case, the doctor's prescription was for a straight CPAP with no requirement for data recording except basic usage for compliance monitoring. Fortunately for me, my DME's policy is to provide a ResMed S9 AutoSet regardless of the prescription. Because the doctor ordered CPAP, not APAP, the DME disabled the AutoSet feature. After a little struggle with the doctor and the DME and a lot of help from this forum, I got the AutoSet enabled and tweaked the pressure range to suit my needs. Now I am cruising along with excellent numbers as evidenced from my SleepyHead reports. My only advice is to really search and read this forum and be persistent in getting what you need and deserve.
03-15-2014 06:53 AM
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