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+--- Thread: Which DME? (/Thread-Which-DME)
Which DME? - Snorzz - 01-18-2018
My Doc says I have to pick a DME. They gave me a list of 13 DME's, and my Aetna rep said the following 3 were approved by them: American Home Patient, Lincare & Preferred. He was nice, not pressuring at all but in response to my questions said that Lincare was the largest of the 3 & more likely to have the equipment on hand that I might need. Any advice?
Lots of help on another thread, and yes, I will try to get my hands on the CPAP early and start using it on my own. Don't know if I can though, as my Doc said they have to start out w/brick CPAP, required by insurance, but that she would see that I ended up w/ the Airsense 10Autoset Auto CPAP. So don't know if they will hand out the machine I want w/o titration night (which I dread & probably will be weeks away). We've had an ice storm here in E. TX, which shuts everything down for a day or two as no one has the equipment to deal w/icy roads. Hopefully can make appts/inquiries today.
RE: Which DME? - Walla Walla - 01-18-2018
I would call your insurance and ask if a brick CPAP is required. I have my doubts about that. The insurance usually pays the same amount for either. It's the DME's who want you to have a brick so they can make more profit. I think your Doctor might have the wrong information about the insurance.
RE: Which DME? - SarcasticDave94 - 01-18-2018
Based on my experiences, insurance does not care nor prefer one CPAP over another. In your case, what I'm meaning is whether it's a brick or not. To the insurance, they're going to be at or near the same price also. My insurance, and most likely everyone else's, only require the device choice to be what's on the script. Any CPAP for a CPAP script. And any BPAP for BPAP. And so on. Brand is not their concern either, unless script specific.
RE: Which DME? - Gideon - 01-18-2018
I suspect what will be required is an E0601 CPAP machine which includes the following. (E0601 is the "code" that is used for a CPAP machine.)
Note that Auto CPAP machines are includded.
Machine Type (choose 1) [[1]]
- CPAP or APAP E0601 (Do Not Use) (If you order by number (E0601) or the generic description of CPAP you will very likely get a non-auto, non-data capable brick, not good. THIS is what typically gets you in trouble.)
- ResMed AirSense 10 AutoSet (Fixed CPAP, Auto CPAP) (best choice) (E0601)
- ResMed AirSense 10 AutoSet for Her (Fixed CPAP, Auto CPAP) (best choice) (E0601)
- ResMed AirSense 10 Elite (Fixed CPAP) (E0601)
- Philips Respironics DreamStation Auto CPAP Machine (DSX500x11) (E0601) (S11 is MAachine only, H11 is Heated Humidifier (best choice), T11 is Heated Humidifier and Heated Tube (best choice))
- Philips Respironics PR System One REMStar 60 Series Auto with Bluetooth (DS560BT) (older model) (E0601)
Fred
RE: Which DME? - Melman - 01-18-2018
I use Lincare and am very satisfied but I suspect satisfaction varies depending on the local office. My only other experience was with Apria. It was awful.
My prescription was for E0601. Apria wanted to give me a brick. I switched to Lincare and they provided a Resmed Airsense 10 Autoset without having to be asked.
RE: Which DME? - SarcasticDave94 - 01-18-2018
(01-18-2018, 02:04 PM)Melman Wrote: I use Lincare and am very satisfied but I suspect satisfaction varies depending on the local office. ...
That would be my experience also. Your personal experience will vary dependant on particular location. FWIW my DME is Apria, of whom mostly receives less than favorable patient reviews. The corporate level by my experience was less than average, but locally it's better than average.
RE: Which DME? - kiwii - 01-18-2018
(01-18-2018, 07:16 AM)Snorzz Wrote: ...Don't know if I can though, as my Doc said they have to start out w/brick CPAP, required by insurance, but that she would see that I ended up w/ the Airsense 10Autoset Auto CPAP.
Snorzz, this does not sound right (to me). Please be sure to speak to your insurance company yourself.
This is an excerpt from the board's wiki page for optimizing therapy, but I think it is especially pertinent:
Quote:
- You have the most power on getting the right machine by knowing what you want to get and expressing this to both your doctor and your DME BEFORE you have agreed to receive/pay for it
- Realize three things
- It is YOUR therapy.
- It is YOUR money, you are paying for it either with insurance money, deductibles, or your own money.
- YOUR most leverage occurs before you actually purchase/rent your machine.
Most DMEs {Durable Medical Equipment Suppliers) have a financial interest in the transaction, which pays them the same whether a basic "brick" or a premium full-efficacy data machine is dispensed. Meeting the minimum requirement of the prescription is the only mandate for a DME, and the uninformed patient who goes in to receive a machine will receive the machine that best serves the DME (financially), while meeting the minimum requirements of the prescription. Data is important. You should control your own therapy, and most suppliers fail to help you to do this. The "trained health care specialists" are constrained by the prescription from a short and as such, typically inaccurate sleep study, titration study, or the default settings of an auto machine.
RE: Which DME? - Sleeprider - 01-18-2018
Ask the doctor for the prescription, and request that he specify the Resmed Airsense 10 Autoset. Insurance will be no problem, and it's not your doctor's problem anyway. Get the script, go to any DME and have it filled.