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how to get a different CPAP after DME did their thing
#1
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
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#2
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.
[Image: pBt22Od.jpg]
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#3
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
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#4
(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?

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#5
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






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#6
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
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#7
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
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#8
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
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#9
(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.
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#10
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.
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