Colorado Apnea Journey - Complex and Mostly CSA Questions

[SarcasticDave94]

My tale of folly regarding ASV order is probably similar.

[CLCCW]

Update: The DME company will not supply me or even seek approval for my ASV unless I sign a medical waiver (i.e. against their "titration protocol") and give them a credit card on file. (LOL they already have that for the APAP supplies/rental, but I didn't bring it up).

I fired them and will report them as a terrible vendor wherever I can.

I called a new DME company today. I have to start from scratch with all the documentation, but we will see if this works. If not, I am firing everyone and going rogue ASV.

[Sleeprider]

We have already discussed, that nothing in insurance or Medicare requires a titration test for ASV. The device is fully automatic and always works on default settings of minimum EPAP 4.0, Maximum EPAP 15.0 cm, PS min 3.0, PS max 15.0. Any adjustments we might suggest are to optimize comfort. I linked the wiki for dealing with a DME earlier. Stick with it.

[CLCCW]

We have already discussed, that nothing in insurance or Medicare requires a titration test for ASV. The device is fully automatic and always works on default settings of minimum EPAP 4.0, Maximum EPAP 15.0 cm, PS min 3.0, PS max 15.0.  Any adjustments we might suggest are to optimize comfort. I linked the wiki for dealing with a DME earlier.  Stick with it.

Yes, I leaned on it. Even got the Insurance rep on conference call. They don't want to fill my order w/o their "conditions". Hence, they are toast. Thanks for all the help, of course!

[CLCCW]

More on this saga...

After "firing" the initial DME company, I had records sent to a new company. All seemed to be much more professional. Even spoke to a rep who uses ASV, and "gets it." Took about 10 days for "qualification" procedure, and I got a call yesterday saying the unit was shipping, and to please fill out the rental agreement etc. However, when I looked at the rental agreement, they were about to ship me the AirSense 11, not the AirCurve 11 ASV!!! I already have that!!!

I called immediately to halt the process, connecting with a quite condescending rep who was impatient and bossy, who also claimed to not be a RT, or know too much, but still said "oh, this is going to have to go through the entire qualification process again. I'm sure we ordered what your insurance qualified you for.." yada yada.

I am supposed to hear from the DME company supervisor today to straighten things out. I also messaged my doctor team, who has been less than stellar in supporting me through this long morass. I called them out on it, suggesting maybe they didn't send the correct Rx, either.

IFFFFF this Rx goes through and I get the machine, I will change health care teams, too. Never been through anything like this. Ever.

More on the saga to come, as I find things out. I am going to write a story for AARP and our state AG about the shoddy care.

[SarcasticDave94]

Keep all those 3 amigos on a short leash. These 3 being doctor, DME, insurance. I literally called one of those 3 daily for over 2 months in trying to keep the ASV delivery moving along. I had a short span of a few days I could not check in and it was getting forgotten already. I do 100% feel you must be constantly complaining to them to make them submit in giving you the ASV.

[CLCCW]

Hopes not up now. Got a Docu-sign for the rental agreement for the unit, with the new DME company. Closer inspection revealed they ordered me an AirSENSE 11 (which I already have! WTF!). I called them right away and said, Don't Ship! This rep, then said, "Oh, an AirCURVE? That is just the portable CPAP." I had to educate the DME REP about what an AirCurve 11 ASV is!!!! She was supposedly a "manager". 

My lord, the incompetence... I finally landed a call with the branch coordinator who uses ASV and "gets it." They'd fix the paper work. Alas, it turns out : "I was informed that qualifying an ASV through insurance has a few more steps than CPAP." JFC. I don't think this will ever bear fruit.

I am going to write an article about this when all is said and done. 

In other news: the sleep lab that did NOT do an ordered ASV titration on me (they stopped at CPAP success because that is their "protocol") even though MD-ordered, is defending against my accusation that I did not get the ordered service and that I don't want to pay. They are so full of sh*t. My first titration, they did CPAP/APAP titration and for the heckuvit threw in an ASV titration, too. So hardly "protocol."

And I registered a complaint with the pulmonology practice about how little they care about what is going on with me, that they have never been proactive with anything. Their response? "We responded within 48 hours to every message." Clueless.

More to come in this saga. Have a nice weekend.

[SarcasticDave94]

Doesn't the fact that you have medical professional specialists on the case give you warm fuzzy feelings of joy and peace?

In 2017, the RT at the Apria DME handed me my ASV to go over how to use it. She mentioned she had to guess what settings she wasn't quite able to extrapolate from the script. Guess was the actual word used. I plugged in my shiny new ASV and reset it 2 minutes after plugging it in.

[Sleeprider]

Who is the insurer?

[SarcasticDave94]

Hmm, as in contact the insurance and get those failed medical groups removed from in-network? Certainly worth a shot.