First DME visit, not sure what to think?

[katiemo]

Well The DME contacted me today, as my titration was Saturday night. I requested a fully data capable machine and even told them the 2 models that were acceptable to me, they proceeded to tell me those are specialty machines,... WTF???? I had contacted the DR's office earlier and of course the Dr is out until next Monday, however his nurse did make a note for him about my full data request, so he will see it when he goes to do the RX.

[Mtnviewer]

Do you HAVE to deal with a DME? Why not just buy online from the likes of cpap.com or cpapauction.com (if you're paying for it out of your own pocket}. CPAP.com has lots of mask info, fitting info and guides (which is what I used to get a very good fitting mask), plus videos to help guide you. You'll get the machine that you want, and no hassles. With so many of us at this forum having horrible if not just poor DME experiences, why even bother dealing with them? I went the route that I'm suggesting to you and am THRILLED with the results and I never have to deal with a DME to rip me off. Even if you have insurance to pay for it, you can still buy online from cpap.com.

Take charge of your own therapy and out of the hands of greedy morons, which you will do anyway after the DME hoses you.

[katiemo]

I have pretty decent insurance and my out of pocket is only going to be 75.00-80.00, so I need to use my insurance. I do have a choice of about 7 DMEs so I won't set back and take to much.

[jdm2857]

Let me guess that your two machines are the Respironics M-Series Pro and the ResMed S8 Elite II. These are not specialty machines. They are straight CPAP machines, with exhalation relief and full data capabilities.

Do not accept anything less. Find the best DME of the bunch, and fight with them if you have to.

[katiemo]

Let me guess that your two machines are the Respironics M-Series Pro and the ResMed S8 Elite II. These are not specialty machines. They are straight CPAP machines, with exhalation relief and full data capabilities.

Do not accept anything less. Find the best DME of the bunch, and fight with them if you have to.

You got it right on the machines I requested!!! I know from reading here that they are not specialty machines at all. She did ask me what I wanted full data for, I told her point blank I want to make sure the therapy is working. I did not let on I will be getting the software

[taberge]

Well this is how the CPAP game is played out if you don't know by now.

The insurance company could care less what your machine is as long as it does not exceed the fixed cost they have set to be billed by the DME. It does not matter if they DME gives you the crappiest machine or the best machine, the insurance only cares if it is less the the fixed cost and if you are in compliance with your therapy. NOW, the DME cares very much about what machine they stick you with because the difference between what they bill the insurance and what it actually cost them to give you a machine is pure profit for them. So it is in their interest to give you the machine that cost the least but yet fills the prescription of the doctor. So, it is in your best interest to get the doctor to specify the machine you want in the prescription. If the doctor does not want to do this, it is time to find a new doctor. I hope that you did see a doctor that is actually accredited in treating sleep disorders, because if so they usually demand a data capable machine. You may not get an APAP machine because of the cost, but they should at least be able to accomodate a data capable CPAP machine.

Personally after all the research and the post read here, the insurance companies should abandon the titration studies and just give the patients an APAP machine and let the machine do it's own thing. My insurance got billed $2000 twice and for $2000 you could but like 2 machines on CPAP.com easy.

[Terminator]

Stick to your guns!

[Mtnviewer]

If you have a choice of 7 DME's, then why not just make CPAP.COM your 8th choice? What would the insurance company care if they don't care which of 7 or 8 you buy from? You get all the advantages of a DME but without the hassles and the insurance company might save some money. As I understand it, CPAP.COM will provide the same paperwork, the difference is that YOU send it in to your insurance company. Maybe there is something else that needs to be done, but call CPAP.COM and they'll walk you through the process.

[Agape=Love]

This site is amazing it gives me great insight, I applaud all the participants that take their therapy seriously. Unfortunately it disturbs me about the negative threads in regards to DME's. (which is well deserved) As I have owned a DME and worked with two national DME corp. I have left several opportunities (high paying positions) because of their position of seeing patients as numbers on spreadsheets and reduce people to profit margins. This field of medicine completely changed my life as it gave me the opportunity to actually fix people's health problems with out compounding them with drugs.

Personally after all the research and the post read here, the insurance companies should abandon the titration studies and just give the patients an APAP machine and let the machine do it's own thing.

You hit the nail on the head with this one! I have been fighting for this model since 1999 and it bankrupted me. (The AASM nearly threw me out of a conference for bringing this model up) The sleep labs will hold on to their "Gold Standard" as long as they can. However down but not out I have been working again at developing a home diagnostic model with the Embletta (Embla) and PDX (Respironics) to determine apnea. Once apnea is discovered then place patients on APAP for the duration. In my opinion patients should not even bother with CPAP. The lab tech is trained to adjust/titrate a CPAP pressure to relieve the most severe event. But patients are not having that event all night long if they did they would be dead! So why/how should they tolerate a fixed pressure when the technology is available to auto adjust when the event appears. And we wonder why CPAP compliance is less then 50%.

As far as insurance companies abandoning the titration study. This is where is gets tricky. When I had proof by research (out of my own pocket) that a home diagnostic model works with APAP with a subject group of 150 people I thought the Insurance companies would quickly abandon the "gold standard" (I was offering the service from start to finish for a third of the price of just a split night study in the lab) What I found was "ivory tower" sleep docs who sit on the insurance companies medical boards (Medicare) who determine what method will be used have a vested interest in sleep labs. Now that they can no longer suppress this technology they will completely discourage anyone with ambition to use this model by offering $120.00 for the home test while their labs still collect 3-4k per split night study when the tests are accomplishing the same thing!

This is leading companies (I wont mention) that will ship diagnostic equipment to homes via mail to carve out a niche and squeeze out profit. This is exactly their plan. This model will fail without patient support. And when it does they will say see it's not reliable.

I understand the support for CPAP.com and I am aware that they created this forum and applaud them for it. However most people are not as savvy as most here and their is the need for personalized care in the home. Unfornatly DME's have failed to keep their end of the bargin and has help in the success of cpap.com. But we need sleep professionals in the homes to help with this process. I am hoping a new attempt at a home program which puts a professional in the home will have success this time around..

Im sorry I get long winded... But when it comes to sleep apnea I get very passionate about it .

Agape!