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New Machine - smmedlin - 11-30-2013

Back Story:
many moons ago I used a respironics remstar pro c-flex for around 6 years before it died. Being cheap and not remembering how much it helped I waited a couple of years to replace.

Current:
Took a new sleep study and picked up my new S9 autoset ResMed. Looks to be an awesome machine. However I have a few questions. The DME supplier really locked this one down, I know how to get in and change things, however they are having to send compliance information to my insurance co. for 3 months.

1. I noticed the have the mask set up as a pillow and I use a full face, I assume this changes the leak rate settings, is this a big deal?

2. I am set at a 12, however it is set up as a straight cpap not utilizing the autoset features, is there a reason not to use the features available in this way?

3. I do plan to contact the DME and Dr. before changing, however are there normally issues if the user changes settings during compliance period?

Thanks


RE: New Machine - me50 - 11-30-2013

(11-30-2013, 05:06 PM)smmedlin Wrote: Back Story:
many moons ago I used a respironics remstar pro c-flex for around 6 years before it died. Being cheap and not remembering how much it helped I waited a couple of years to replace.

Current:
Took a new sleep study and picked up my new S9 autoset ResMed. Looks to be an awesome machine. However I have a few questions. The DME supplier really locked this one down, I know how to get in and change things, however they are having to send compliance information to my insurance co. for 3 months.

1. I noticed the have the mask set up as a pillow and I use a full face, I assume this changes the leak rate settings, is this a big deal?

2. I am set at a 12, however it is set up as a straight cpap not utilizing the autoset features, is there a reason not to use the features available in this way?


3. I do plan to contact the DME and Dr. before changing, however are there normally issues if the user changes settings during compliance period?

Thanks

#2 The DME has a prescription from a doctor with the settings on it according to your sleep study. The 2 sleep studies I had listed the recommended pressure setting even though I have an autoset. I change my settings myself. The autoset is helpful b/c our breathing varies and so does the needed pressure. In other words, you are currently getting a pressure setting of 12 constantly whether you need it or not. Also, what if you need a little higher pressure?

#3 I changed mine during the compliance period. All insurance cares about is whether you use it according to the guidelines and if you (or anyone) doesn't, then they will not purchase the machine. FYI, when I had BCBS, they purchased it outright without checking for compliance but my current insurance is renting it.


RE: New Machine - zonk - 11-30-2013

(11-30-2013, 05:06 PM)smmedlin Wrote: The DME supplier really locked this one down, I know how to get in and change things, however they are having to send compliance information to my insurance co. for 3 months.
Hi smmedlin and welcome to the forum
You need to make sure they did not lock showing efficacy data (Sleep Quality) otherwise the machine only report usage, hours using the machine each night but not a big deal for them as they,re only concerned in compliance data that machine used at least 4 hours a day 70% of the time so insurance pay for the machine. But efficacy data concern you and the doc, for showing efficacy data ... "Sleep Quality set to ON (not usage)

The S9 calculate unintentional leak (mask plus mouth leak) = total leak less mask vents leak (intentional leak)
It does make a difference, for example at 12 .. Swift LT nasal pillows intentional leak 33 L/m and Quattro Air full face mask is 41 L/m.

Default setting for mask setting is "Pillows". If not using nasal pillows ... change it to your mask type




RE: New Machine - PaulaO2 - 11-30-2013

Definitely change the mask type as it will report the leak rate different.

You could also just contact them and ask what they will be looking at. Do they want just the hours or will they be looking at the AHI and other data. More than likely they don't care and only want to see the hours. If they wanted to see the rest, they'd want to see it for longer than 3 months. More than likely, they won't even notice that you've changed anything.

But on the other hand, it is only for 3 months. You could instead just wait it out. Read up on the machine, get the manual, download the software (all of which is available here). Then in 3 months, do what you want.


RE: New Machine - alby_c - 11-30-2013

I am only 4 months on the journey so take this as you will.
I agree with change the mask type, but it only appears to affect reporting - I have changed masks - when I had colds - to a full face and forgot to set it back to pillows for a week and they still worked with great AHI.

Can you tolerate the set pressure and is your AHI in a good place?
If yes, then certainly wait it out. let them put the tick in the box and then sort it.

If you are having issues with the pressure - bad AHI, too many centrals, etc, then get it changed to an auto range.
I found at my prescribed pressure my centrals were over 5. I set a range - which the machine sits at the low end of 90% of the time and my total AHI is now regularly under 0.5. It gets to the prescribed pressure about every 3rd day, or if I have hit the turps. YMMV of course.



RE: New Machine - smmedlin - 11-30-2013

Thanks

I decided to go ahead and set it up for autoset. I dont believe the DME will really care as long as I meet the criteria so they can charge insurance. I did change the mask setting as well.

Thanks for your input.


RE: New Machine - me50 - 11-30-2013

(11-30-2013, 10:12 PM)smmedlin Wrote: Thanks

I decided to go ahead and set it up for autoset. I dont believe the DME will really care as long as I meet the criteria so they can charge insurance. I did change the mask setting as well.

Thanks for your input.

what did you set your pressure range as?


RE: New Machine - archangle - 12-03-2013

I think the mask type may have some minor effects on EPR/bilevel and how well it regulates your pressure at your nose as it changes between inhale and exhale.