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why do some need a docs script for a machine?
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SuperSleeper Offline

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Post: #11
RE: why do some need a docs script for a machine?
(03-19-2014 10:09 AM)justMongo Wrote:  Mods, can we have strike through text to permit an edit to be so marked?

Not sure this is what you're talking about but I think we have that function already.

Just put the letter s in between two brackets [ ] before any text you want to strikethrough and a put /s in brackets after the text.

So this text becomes this text.

Here's what I actually typed to get the above line:

Code:
So this text becomes [s]this text[/s].

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03-19-2014 09:34 PM
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space45 Offline

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Post: #12
RE: why do some need a docs script for a machine?
I live in B.C. trust me when I say no script needed, and I live near the US border, so you know I am not to rural a area, 3 large cities within 2 hour drive, Vancouver is 4 hours. 2 sleep places in our small town, well one that is a sleep place and one that offers the same thing but sells med equipment as well. no sleep clinic where you send the night. that is a city trip

there is a testing place called IRS, they give you a recorder machine that looks at hart rate and o2 for 1 night, a doc looks at the data captured and charges IRS $50 for his opinion. IRS then contacts you with a combined quick verbal report of both IRS and doc , basically saying you need a machine or not, if you need one they set you up with a plain cpap that has a built in cell phone interface that IRS can call and adjust settings. they call you and ask how the night went and if they think it needed adjusting they phone machine and make some changes. you have a week, 2 max if they think it needed to try the machine. they have other machines setup the same way if you complain about breathing against the pressure, you take in the simple machine and get a higher end one.
then comes the sales pitch to get you to buy one of their machines, but the med supply store also sells them and they did not ask if I had any script, walk in and buy, there is some sort of trained guy there as well for same type of testing if your wanting but I could have just bought the machine over the counter with out any testing at all.

back east many things are paid for/ covered, some dental, child care, cpap machines and probably a host of other things, out west you pay pay pay, most of the time we are even paying for your stuff back east as we have been for the most part a HAVE province and had to send money to you guys back east to pay for you guys extra perks, here there is no free ride, I asked if anything would be covered my gov med insurance, nothing, zip, nota. so I do not know who you talked to, but I having ask the guys that would sell a boat load more machines if insurance did cover it, I am sure they are in the know, and yes I ask every one involved with cpap I came in contact with. the sleep study if ordered by a doc is covered, but unless your totally disabled you pay, or have some employer insurance or other extra insurance plan that covers cpap, the B.C. insurance plan for sure does not cover even a cent of cost for machine or supplies. trust me I have asked every one in the know
BTW the one day test that IRS does is free, anyone can walk in and they will run the test, I know, as I had them run a test on my wife, no doc involved, just asked if I could get my wife tested to see if she had apnea at all, she snores a tad, and does have times where she struggles to breath, then gasps. I bought a testing recorder machine for o2, hart and breathing, yes it tests more things then the IRS recorder machine does. will start her testing tonight.

if you are coming out west, you will see how the poorer side lives, health care has long wait lines, poor service, doc with attitude, BTW the specialist are the worst, I have waited over 1.5 years for a doc appointment, had to finely get my doc to push and get me in faster, not sure how long that wait would have been with out my doc pushing, MRIs, 8 month wait, and I was a rush job, not emergency, or life threatening, but still a specialist rush as he needed it done ASAP. you may be in for a shock by coming out west.


(03-19-2014 12:25 PM)SnuffySleeper Wrote:  
(03-18-2014 11:27 PM)space45 Wrote:  in Canada we can just buy a machine, they offer a testing service to see if you could be helped by buying one.

This is not true, as the rules for pap machines and acquiring them differ from province to province. Saying one rule is all of Canada is wrong.

In Ontario you need a prescription from a doctor with a sleep study done by a certified sleep lab. This may be because the Ontario government under the adp program pays for your Cpap machine or there are plenty of doctors and sleep labs in the urban areas of the province.

British Columbia works similar as I will be moving there shortly and looked into it. Some provinces (even more rural areas in ontario or bc) are more liberal with the rules as there's not enough sleep labs or doctors so they don't require a prescription, but that's only because of lack of sleep doctors and they don't want people driving hours to do sleep studies and doctors visits.
03-19-2014 11:30 PM
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Randy2 Offline

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Post: #13
RE: why do some need a docs script for a machine?
I have always assumed that this would have a lot to do with the way the insurance is set up. I would rather have my insurance pay for at least part of my treatment and require me to go through some red tape than to have to pay for everything out of pocket and get it faster.
03-20-2014 04:41 AM
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SnuffySleeper Offline

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Post: #14
RE: why do some need a docs script for a machine?
According to the British Columbia government website it says:

http://www.gov.bc.ca/meia/online_resourc...olicy.html

"Note: a medical need for a positive airway pressure device must be prescribed by a medical practitioner or nurse practitioner and the medical need must be confirmed by a respiratory therapist"

I called the Health Line for British Columbia and talked to them about my Cpap therapy, they gave me a doctor referral for when I move and local sleep labs in the area.

The company you mention "IRS" (after googling them) is a private respiratory seller, so they have one goal in mind. To get you to buy what they are selling. So just be careful they aren't giving you a bunch of half truths and mis information just to sell you an expensive machine and make some quick money off you. That is abundant in Ontario and one of the reasons the ontario government regulates the sale of Cpap machines.

This is all based on the provincial government mandates and funding so I can assure you no one province is funding another as you said. The systems are totally independent and health care is not run by the federal government so all provinces are independent systems as far as health care goes and why the rules change from province to province.
03-20-2014 07:19 AM
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space45 Offline

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Post: #15
RE: why do some need a docs script for a machine?
not sure what to say, I had a script to get the testing done at IRS, they are a private company but have certified respiratory therapist on staff, they also work with a doctor and have him go over there test results and questioner and forms I had to fill out. that report was sent back to my doc. so I should have been able to get a machine under insurance by what you have said yet every one I talked to said there was no way for me to get one even with my over qualification of needing one if you go by what the specialist doc and respiratory therapists said about my case. so if I do not qualify, who would?

I will be very pissed if I could have got one under insurance. why did my doc not say I could get one under insurance when I asked him?

ok looked into it further
*******************************************
Eligibility Criteria: October 1, 2012
October 1, 2012

Medical equipment and devices for medically essential needs are available to clients who are eligible for general health supplements. [For information on eligibility for general health supplements, see Related Links - Health Supplement Summary.]
***********************************************
so when you look it up

*******************************************
Health Supplement Summary

Overview
Effective: December 01, 2003

The ministry provides access to general health supplements for recipients and their families who meet eligibility criteria.

Health supplements are available under the Employment and Assistance Act and Employment and Assistance for Persons with Disabilities Act.
************************************************
so you need to be disabled or hurt on the job for the employment side of it like workmens compensation. ether way your disabled, this was what I was told I would have to be to qualify.
so if your disabled or hurt on the job to give you the sleep apnea then you qualify, otherwise your paying the bill from what I understand of what you sent and going by what I was told

(03-20-2014 07:19 AM)SnuffySleeper Wrote:  According to the British Columbia government website it says:

http://www.gov.bc.ca/meia/online_resourc...olicy.html

"Note: a medical need for a positive airway pressure device must be prescribed by a medical practitioner or nurse practitioner and the medical need must be confirmed by a respiratory therapist"

I called the Health Line for British Columbia and talked to them about my Cpap therapy, they gave me a doctor referral for when I move and local sleep labs in the area.

The company you mention "IRS" (after googling them) is a private respiratory seller, so they have one goal in mind. To get you to buy what they are selling. So just be careful they aren't giving you a bunch of half truths and mis information just to sell you an expensive machine and make some quick money off you. That is abundant in Ontario and one of the reasons the ontario government regulates the sale of Cpap machines.

This is all based on the provincial government mandates and funding so I can assure you no one province is funding another as you said. The systems are totally independent and health care is not run by the federal government so all provinces are independent systems as far as health care goes and why the rules change from province to province.
03-20-2014 06:46 PM
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c0reDump Offline

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Post: #16
RE: why do some need a docs script for a machine?
(03-20-2014 04:41 AM)Randy2 Wrote:  I have always assumed that this would have a lot to do with the way the insurance is set up. I would rather have my insurance pay for at least part of my treatment and require me to go through some red tape than to have to pay for everything out of pocket and get it faster.

I live in the USA and started CPAP about two months ago. Between my insurance company and myself, we paid out $1,709.79 on the red tape (most of the paying out was done by me): one PCP doctor visit, two sleep studies, each with a follow-up sleep doctor visit. That is the amount actually paid to the providers (they had billed $4,906 -- but the "insurance negotiated" rate knocked the cost down considerably).

Mind you that was to just get me the CPAP prescription only -- a prescription with a wide Auto range setting because they couldn't figure out the proper pressures -- it does not include the cost of an actual CPAP machine or supplies.

I researched this years ago and is why I went so long without treatment -- I've probably had severe OSA for a decade, and I couldn't afford the bribe price of the red-tape. The CPAP machines/supplies are quite affordable relative to the cost of the prescription.

Had I known years ago what I know now: I should have just purchased an auto-CPAP on the black market and to h3ll with the laws/regulations that make that purchase 'illegal'.
03-20-2014 09:38 PM
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archangle Offline
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Post: #17
RE: why do some need a docs script for a machine?
Why a prescription?

1) CPAP isn't rocket science, but it isn't that simple. Even with an auto CPAP machine, you don't get the best treatment (or maybe even successful treatment) without someone who understands apnea and CPAP determining the settings.

DIY CPAP may make you think you're getting good treatment, but not be fixing your apnea.

Some people here probably know more about practical CPAP and apnea than most sleep doctors. However, the vast majority of the Joe Sixpacks out there don't.

2) If you have central apnea or other complications, you may need a more complicated machine, such as bilevel or ASV.

3) Many people need help getting the right mask, solving problems with CPAP, etc.

Unfortunately, our medical system does a dismal job of doing all of the above, but there are valid reasons.

4) You might have some other serious medical problem other than apnea, or in addition to apnea. Trying to self diagnose and self treat may end up harming you.

5) Insurance probably wouldn't pay for it if it didn't require a prescription. (#*$&#@ you, insurance companies.)

6) However, by far the biggest reason, is the medical mafia wants to protect their profits for $leep te$ts, office visits, etc.

They should warn you about the risks, and then allow you to buy without a prescription, or paying a doctor for permission.

Get the free SleepyHead software here.
Useful links.
Click here for information on the main alternative to CPAP.
If it's midnight and a DME tells you it's dark outside, go and check it yourself.
03-21-2014 02:10 AM
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JimZZZ Offline

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Post: #18
RE: why do some need a docs script for a machine?
(03-19-2014 10:10 AM)justMongo Wrote:  My doc is a 3 minute wonder. I see him for 3 minutes and wonder where he went.
My DME wouldn't give me supplies because "I hadn't seen the doc in 60 months."
That's male cow dung -- an Rx is good for a year.
I'm off to see him in 20 minutes... waste of time.
justMongo, I share your opinion about sleep doctors. I have never seen mine...he is just a name that appears on the bottom of my titration study and presumably my prescription (I haven't been able to get a copy). When I go to the sleep lab, I visit with a PA who is a nice guy and likes to talk about the great outdoors. The DME clinician is only mildly interested in APNEA/CPAP. ALL my information and learning has been gleaned from the kind and knowledgeable folks on this forum.
03-21-2014 05:52 AM
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