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update on wifes compliance issues
#1
So had a nice long visit with my wives DME today - they are insisting that my wife is not compliant with her machine, because she has used it 37% of the time this month -- and according to them - every month for the first 3 month, you have to use the machine 70% of the time - so you get it march, you take your card in April 1, may 1, and June 1 - and those three readings all have to be over 70% for insurance to pay - interesting

So I went to me DME - and got a totally different story - they say you have 3 months to use you machine 70% of the time for 30 days - so you have to use your machine at lest 21 days in the first 90 days, and you meet compliance - this is what was given to us from me DME, and this is in the contract from my DME - so I am going to assume, this is the way it is done.

My wives DME also said that the S9 Escape, and the S9 Auto are basically the same machine - and the only difference is that they S9 auto apparently, starts out at a low pressure - and if you have events, it raises the pressure - and it never goes back down in pressure - and the next day, it is just auto-set to the pressure you where at the night before LOL - I really had to bite my toung to keep from telling them how stupid they where LOL - I have the S9 auto-set, and I know how it works.

Unfortunately, I found out that my wife is stuck with her S9 escape unless she pays out of packed for an auto-set - so we will never really know how she is doing at night - unless I set-up my machine for a couple of night, and read the data is gives - with a different SD card though
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#2
Contact Supplier #2 in the supplier list and see if they will trade with you. You will most likely have to pay out of pocket but not as much as before.

With Medicare, I *think* you get 13 mos during the "rental" (where they could have bought me 3 of them by that time) and at any point during that, you can get another machine since they pay the same price no matter what machine. Other ins. may do this as well. But, if your ins. company said they aren't going to pay for the machine, why is she stuck with it?
PaulaO2
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#3
(06-26-2012, 05:23 PM)w7sot Wrote: and the only difference is that they S9 auto apparently, starts out at a low pressure - and if you have events, it raises the pressure - and it never goes back down in pressure - and the next day, it is just auto-set to the pressure you where at the night before LOL - I really had to bite my toung to keep from telling them how stupid they where LOL - I have the S9 auto-set, and I know how it works.

That's complete and utter BS and I'd run far and fast from any DME that doesn't know how the product they sell works.

In fact, I did exactly that. The DME that my doctor sent me to originally told me something of the same. After 3 months on an m-series auto, when they were trying to force me to accept a fixed CPAP, that was the almost the exact statement they made to me. "The APAP only adjust upwards, it doesn't go back down afterwards..."

"Oh? Really? And yet, that's exactly what all the documentation for it says it does, as well as my experience in using it. Tell you what, I'll return your machine tomorrow, after I go to a new DME, thanks..."

They weren't pleased. :-p


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#4
Just one more reason, that as a consumer/patient you should be your own biggest self helth advocate and educate yourself with as much information as possible about any health related issues that you may run into.
Yesterday is history; Tomorrow is a mystery; Today is a gift; Thats why its called "The Present".
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