DME Funny

[TheTwinsMom1]

I currently have a Resmed Autoset II. I called two weeks ago to my DME to ask about upgrading my machine to the S9. I was told they don't yet carry that model in stock so I could not upgrade.

Today I go for my follow up visit with my sleep doctor and I was telling him about my rain out issues. He said what machine you have? I told him and he was like..hmmm, I told them you need a heated hose model. So he writes out a brand new script for the S9, with humidifier and heated hose and faxes it to the DME.

I call the DME to make sure they can fill it and find out "Yup they have it in stock, we can swap yours out Monday"

Hmmm...Why when I call do they not carry it, yet when my doctor requests the machine by name, they suddenly have one.

I am so happy to have my sleep doctor. He is up to date on machines and actually cares that his patients get the proper care in the easiest way possible. The RN in his office also wrote down the website name here, cpaptalk.com, to give to their patients after I raved about you guys here \o/.

I know alot of people do not get great sleep doctors, but I felt compelled to mention that sometimes, our sleep doctors are awesome.

[LSAT]

How old is the Resmed you are trading in?

[packitin]

deleted

[Zzz_Jim]

Good for you! Glad to see the DME system still works for someone!

{Thread Hijack mode ON?}

The jury is still out on my Doc, the DME I'm already irritated at 1-1/2 months into CPAP therapy.

My DME stuck me with a non-data capable Respironics PR System One "Plus" rather than the "Pro" or "Auto" models. I forgot the Respironics model numbers at the time, so I asked the RT when I was picking it up and he incorrectly told me the "Plus" did AHI and Leak data, only to find out later he was wrong (only compliance hours, mistake #1).

DME did a 1-day follow up call and missed me, so I called back - talked for a minute, then "I'm with a patient right now, I'll have to call you back (click!)". No return call (mistake #2). I had told him I had to turn off C-flex as I found it too irritating to sleep with, and he said "Thats OK", not realizing that I had to get into the clinical menu to do it. (Patient menu on plus only lets you change back-off pressure setting to "1,2,or 3", but not off.)

DME did 1 week follow-up call so I bitched about not having data capability. "It doesn't do that? I'll have to talk to our download tech and call you back", which they never did (mistake #3). They also claimed if I wanted to change out the machine there would be a "$350 charge" - I'm on a month-to-month rent to own, so I can't figure out why I can't screw them and just return it. The fine print on the back of my contract says I'm only on the hook if my insurance doesn't pay. But I figured it might be easier if I work it from the Doc end, so...

I mentioned it to my Doc at my one month follow up and both his nurse and he had the attitude "Why do you want data anyway??? You don't know what to look for. You need a RT at the DME to interpret the data for you - we don't download. And besides - data from the machines is no good - you should only trust a sleep study (at multi-$K bucks of insurance money a pop, at our next-door sleep lab)! Let's talk more at you next follow-up and see how you're doing."

It ain't like its Rocket Science. If diabetes was treated this way the streets would be full of dead people from Insulin induced comas...

Personally I'm more inclined to trust the data capable machine than a one or two time sleep study, where you never sleep normally to begin with.

Now my DME billed me for my co-pay, which I had already paid them when I originally picked up the (wrong to me) machine. Is that mistake #4 or #5 for them?

So it looks like I have to get an attitude with both my DME and my Doc. The only good news is I'm tolerating CPAP pretty well - I'm just waiting for that magic rested feeling to kick in, so I wanted to see my data to see if something bad is going on. I'm tempted to return the blower, buy my own (Pro or Auto, or S9), and file a claim on my insurance - cutting the useless DME out of the loop. I just thought I might wait a month in case my doc wants to switch me to bi-pap instead of straight CPAP, even if my initial split-study didn't show the need (only 9 cm/h2o fixed me up nicely that night).

There. I feel better now!

{Thread Hijack mode OFF}

[TheTwinsMom1]

I am not sure of the age of the machine. I have only been on CPAP since March 29, 2010. I am still with in the grace period where I can switch things out if something is not working. My doctor also called and said, he wanted me on this particular machine and it should have been this machine since day 1. Basically he called them, and then faxed in a new script asking for this machine by name this time.

My DME is Walgreens Homecare and so far they have been awesome. We have a RT in our local walgreens 3 days a week, so she just brings the equipment from the big office. So far I have nothing to say about them but good things. I already knew that DME's tend to try and give you the basic things so I knew exactly what to talk to my sleep doctor about thanks to these forums. Plus I am happy to say his staff and him are all very knowledgeable about OSA and what supplies are out there. His first question for me was how was my mask fitting and if I had any concerns about my machine \o/

[GumbyCT]

Hmmm...Why when I call do they not carry it, yet when my doctor requests the machine by name, they suddenly have one.

It's a prescription - a "machine (make/model) specific" prescription - instead of cpap prescription.

I think some Ins. Co. have it written in the contract that should the prescription change in 2 yrs. the DME will replace it at no charge to the Ins. Co.

The reason they didn't have it the 1st time is you didn't have a prescription. A prescription is like having a "Work Order", if you are familiar with Work Orders, if it doesn't say it - you don't get "it".

Zzz_Jim - IF your doc won't write a new script (a "machine (make/model) specific" prescription) to deal with the DME then it is time to find another doc who will. Which is the whole reason to get a copy of your sleep study AND your script from the beginning.

[TheTwinsMom1]

Yeah I figured that was the reason. I just thought it was funny.

[GumbyCT]

Yeah I figured that was the reason. I just thought it was funny.

Yes and No... as you can see most DME's don't have a sense of humor. I will say you have a good doc who knows how things work.

[Zzz_Jim]

Zzz_Jim - IF your doc won't write a new script (a "machine (make/model) specific" prescription) to deal with the DME then it is time to find another doc who will. Which is the whole reason to get a copy of your sleep study AND your script from the beginning.

Actually, the first office visit after the spit-study, I got a copy. Shows all the data, and charts of the de-sats (down to 84%), sleep stages, events, etc. AHI=104! It all pretty much cleared up with CPAP at a straight 9cm, which I seem to tolerate well. Cycled through REM. So the split study showed pretty straightforward results. There maybe a couple of events yet at 9cm (copy a little hard to read)

I could have sworn I didn't sleep during the first part of the study though!

I also left with a generic CPAP script, pressure 9cm. When I went though one of the DME's the Doc's office suggested, apparently it was handled via fax, as I didn't have to show them my prescription. I imagine the script is still good (but didn't see expiration date or longevity info), but the Doc may wonder if anyone calls them...

So I figure I can still pretty much cut-and-run any time I want, I'm just waiting to see if I can get anything more useful out of this Doc, before starting 1/2 over again with someone else. I don't think it's appropriate to do it completely alone, especially if I'm expecting insurance to pick up the tab.

I also don't really think its too appropriate to be obsessing over getting my AHI to zero, from say 1. Things will change that much every night, like if I roll onto the Swift LT headgear and loosen it. But then that's why I want to see leak data - and I don't know I'm at low AHI's! I just know I don't have to get up in the middle of the night anymore. But I felt more rested the first month when I saw the doc last, and now seem to be falling back.

It's kind of a better the devil you know (PR One) than to switch to an S9 at this point. No data, but I could maybe change to a PR One Pro or an Auto, and use non-bootlegged viewer software. Respironics = crummy display, I hate c-flex, and some people claim they don't like the puffs the auto uses to detect CA's. Have to cover up the stupid humidifier LED's that never seem to go off (even messing with the setup menu). It will run on 12V if I have to. I like the humidifier box. What's rain-out?

Vs. S9 with supposedly nicer display, more expensive, needs 12V to 24V adapter or inverter to run portable. Delicate slim-line hose (could use respironics performance hose if I don't get heated Resmed). Need to bootleg software to plot data. Unknown whether I will like a-flex, or will like their auto algorithm, or will be helped more with their heated hose. So-Cal isn't really humid anyway, and don't let the house get that cold, so perhaps rain-out is a non-issue here? Don't know, never experienced it yet...

I was kind of looking at insurance to buy my primary (fancy) machine, then maybe get an Everest with the built-in battery for travel and camping, out of pocket.

So I'm bitching, but I'm not in a non-recoverable bad spot yet. It's more that I'm just envious of all you people with data.