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General Discussion on any topic relating to CPAP and/or Sleep Apnea.
alexsmom
 
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Re: Surviving DME with Medicare

Postby alexsmom on Sat Apr 15, 2017 8:23 pm

I had the favorable Medicare experience with American Home Patient. My last sleep study was in 2012. My current Resmed S9 Auto was starting to be loud and had humidifier problems and I was concerned it was at the end of its useful life. I had purchased that machine myself and now needed Medicare to replace it. During the replacement process, AHP only required me to have a face to face with my primary doc and they needed an updated prescription. I picked up the new Airsense 10 Autoset yesterday, had a thorough and friendly visit with their respiratory therapist who went over how to work the machine. She stated I needed to have another visit with my doc sometime in the next several months (had to be at least 30 days after receiving the machine). She had no issues with me adjusting the settings on the machine. When she found out I was using Sleepyhead, she threw in an SD card for the Airsense. She also gave me a chin strap to try. I have used AHP for the past 3 years and have been very happy with them. My experience may not be the norm but I am pleased with their service.

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Comfortably Numb
 
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Re: Surviving DME with Medicare

Postby Comfortably Numb on Sun Apr 16, 2017 2:25 pm

alexsmom wrote:I had the favorable Medicare experience with American Home Patient. My last sleep study was in 2012. My current Resmed S9 Auto was starting to be loud and had humidifier problems and I was concerned it was at the end of its useful life. I had purchased that machine myself and now needed Medicare to replace it. During the replacement process, AHP only required me to have a face to face with my primary doc and they needed an updated prescription. I picked up the new Airsense 10 Autoset yesterday, had a thorough and friendly visit with their respiratory therapist who went over how to work the machine. She stated I needed to have another visit with my doc sometime in the next several months (had to be at least 30 days after receiving the machine). She had no issues with me adjusting the settings on the machine. When she found out I was using Sleepyhead, she threw in an SD card for the Airsense. She also gave me a chin strap to try. I have used AHP for the past 3 years and have been very happy with them. My experience may not be the norm but I am pleased with their service.


Thank you for your alternate opinion. I'm going to call them tomorrow morning to see how hungry they are for my business. If they can beat a three week delay and promise me Airsense 10 Autoset Tri-Pack heated tubing (unfortunately they only list CO-Pack, which is slimline tubing), then I'll probably go there.

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klm49
 
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Location: Texas
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Re: Surviving DME with Medicare

Postby klm49 on Tue Apr 18, 2017 4:12 pm

LSAT wrote:
Why do you need a sleep clinic/sleep doctor? Any of your doctors can write a prescription.....Primary Care, specialist, Physicians Assistant, Nurse Practitioner, Dentist..etc


My PCP is unwilling to write s prescrip. for the DME, claims he doesn't know anything about it (supplies etc.) and says he doesn't need any more medicare paper work. I didn't push the issue, but the DME said he could give the PCP an example of what to write. I don't want to pi** off my PCP, Dr.'s that take Medicare are getting scarcer all the time.

_________________
Machine: DreamStation Auto CPAP Machine
Mask: Amara View Full Face CPAP Mask with Headgear
Humidifier: DreamStation Heated Humidifier
Additional Comments: Setting: APAP, 17 - 20 CFLEX=2, Humidifer & Heated Hose

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chunkyfrog
 
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Location: The middle--yet nowhere.
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Re: Surviving DME with Medicare

Postby chunkyfrog on Wed Apr 19, 2017 7:46 pm

My PCP is the same way, but Medicare and my supplement pays for my pneumo, once a year.
I looked at the Medicare allowable, and-just-smiled. 8)
Nobody is getting rich, I guarantee.

_________________
Machine: AirSense™ 10 AutoSet™ For Her CPAP Machine with HumidAir™ Heated Humidifier
Mask: AirFit™ P10 For Her Nasal Pillow CPAP Mask with Headgear
Additional Comments: Backup: Devillbiss Intellipap Autoadjust
I once was lost in apnea; but now I'm found--breathing easily all night long.

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Comfortably Numb
 
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Re: Surviving DME with Medicare

Postby Comfortably Numb on Wed May 03, 2017 2:27 pm

Any Last Minute Recommendations?

After waiting for exactly three weeks to get an appointment with my DME (Aerocare), I'm going in tomorrow morning to pick up the equipment. They called today to confirm that between Medicare and my secondary insurance, I won't have to pay anything. I went over my preferred equipment list again with the scheduler, and she confirmed that I would be getting exactly what I asked for. The following is what I expect to get: Airsense 10 Autoset with Humidair Heated Humidifier and Heated Tubing (Tri-Pack); and, Amara View mask. She said the cpap unit sends data in wirelessly to confirm that I'm using the machine. When I mentioned the "Sleepy Head" program, SD card, etc., I immediately lost her. I assume that's something I can take up with the therapist and, of course, this forum.

I'm wondering if there is anything else I should be aware of that Medicare might provide (if only I ask). For example, if I need something like a hose extension, hose hanger, or a Pad A Cheek liner for the mask http://www.1800cpap.com/pad-a-cheek-ama ... liner.aspx will I be expected to purchase these items out of pocket from cpap.com or another vendor? I have no problem with that. Just wanted to know what to expect (once I confirm face-to-face that I'm getting the specified equipment with 0 miles). thanks

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chunkyfrog
 
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Re: Surviving DME with Medicare

Postby chunkyfrog on Wed May 03, 2017 2:37 pm

Medicare pays for a NEW machine, and probably ASSumes that is what you get.
You should INSIST on seeing the RUN hours--not usage hours--before going out the door.
---Especially if your DME is one of the big chains.

_________________
Machine: AirSense™ 10 AutoSet™ For Her CPAP Machine with HumidAir™ Heated Humidifier
Mask: AirFit™ P10 For Her Nasal Pillow CPAP Mask with Headgear
Additional Comments: Backup: Devillbiss Intellipap Autoadjust
I once was lost in apnea; but now I'm found--breathing easily all night long.

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LSAT
 
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Re: Surviving DME with Medicare

Postby LSAT on Wed May 03, 2017 2:43 pm

The extra items you mentioned will not be covered by medicare. These items can be bought on line. For padacheek liners, go directly to padacheek.com/

_________________
Machine: S9 AutoSet™ CPAP Machine
Mask: Mirage Quattro™ Full Face CPAP Mask with Headgear
Humidifier: S9™ Series H5i™ Heated Humidifier with Climate Control
Additional Comments: S9 Autoset...APAP Settings 11-15

Back up mask is another Quattro FF and an F20
Buckwheat Hull Pillow (CPAPfit) from http://www.pur-sleep.com/

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klm49
 
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Location: Texas
Gender: Male

Re: Surviving DME with Medicare

Postby klm49 on Wed May 03, 2017 3:36 pm

Comfortably Numb wrote:Any Last Minute Recommendations?

After waiting for exactly three weeks to get an appointment with my DME (Aerocare), I'm going in tomorrow morning to pick up the equipment. They called today to confirm that between Medicare and my secondary insurance, I won't have to pay anything. I went over my preferred equipment list again with the scheduler, and she confirmed that I would be getting exactly what I asked for. The following is what I expect to get: Airsense 10 Autoset with Humidair Heated Humidifier and Heated Tubing (Tri-Pack); and, Amara View mask. She said the cpap unit sends data in wirelessly to confirm that I'm using the machine. When I mentioned the "Sleepy Head" program, SD card, etc., I immediately lost her. I assume that's something I can take up with the therapist and, of course, this forum.

I'm wondering if there is anything else I should be aware of that Medicare might provide (if only I ask). For example, if I need something like a hose extension, hose hanger, or a Pad A Cheek liner for the mask http://www.1800cpap.com/pad-a-cheek-ama ... liner.aspx will I be expected to purchase these items out of pocket from cpap.com or another vendor? I have no problem with that. Just wanted to know what to expect (once I confirm face-to-face that I'm getting the specified equipment with 0 miles). thanks


I would ask about spare filters / mask cushions?

_________________
Machine: DreamStation Auto CPAP Machine
Mask: Amara View Full Face CPAP Mask with Headgear
Humidifier: DreamStation Heated Humidifier
Additional Comments: Setting: APAP, 17 - 20 CFLEX=2, Humidifer & Heated Hose

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ChicagoGranny
 
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Re: Surviving DME with Medicare

Postby ChicagoGranny on Wed May 03, 2017 3:47 pm

Comfortably Numb wrote:"Sleepy Head" program, SD card, etc., I immediately lost her. I assume that's something I can take up with the therapist


Extremely unlikely.

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Comfortably Numb
 
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Re: Surviving DME with Medicare

Postby Comfortably Numb on Thu May 04, 2017 2:28 pm

Iv'e Got to Give Credit Where Credit is Due

Granted this is only my first day with this company (Beacon Respiratory Services of Georgia, AKA "Aerocare"), but I received all specified equipment and instructions without a single hitch. I was fortunate to get paired with a respiratory therapist who has had 15 years experience with the company. He explained that about two years ago, Medicare changed something about the program (possibly more competitive bidding) and this has had the effect of reducing the number of approved contract suppliers in my area from over 20 to just 3. Thus my 3 week wait for an appointment. I would assume that similar problems exist throughout the country.

He set the unit up as follows: Ramp = Auto; Auto Range = 5-9 per my physician; Tube Temperature = 73 degrees (my bedroom temp.); and, Humidity Level = 1. I've read on this forum that some have the heated hose set to Auto and the Humidity Level set to 5-6. I'm not sure why he wants me to start at 1 but I sure don't want to encounter another sinus issue like I got from my overnight study where there was no humidity at all. 1 is pretty close to 0. He said something about avoiding "blowback," but I don't see that as a problem in my Columbia, SC summers when I keep the inside humidity below 50%. May be an issue in the winter when I keep my bedroom temperature in the high 50's. I also told him that I intended to use the Sleepy Head program. He pointed to the sticker on my Aerosense 10 that says "My Air" from resmed. com. Since most on this forum use Sleepy Head, I think that's the way I'll go. But I am curious as to how the two programs compare if anyone knows.

I was exhausted after two nights in a row with very little sleep and decided to try out the unit and mask with a nap after returning home. I passed out immediately and slept for 2 hours with no problem. The mask right out of the box (size medium; no Pad A Cheek yet) felt great. I was surprised at how light and unobtrusive the mask is and how little I was aware of the 6 ft. heated hose. The nap served to give me confidence in the face of dread. Maybe this won't be as bad as I thought if I can get the humidity issue settled. I guess that will be a trial an error thing, but 1 seems too low if not useless.

Thanks to everyone for all the support I've received so far. I could tell that the therapist was a little taken aback at how prepared I was--all a direct result of my time here.

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ChicagoGranny
 
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Re: Surviving DME with Medicare

Postby ChicagoGranny on Thu May 04, 2017 4:35 pm

Comfortably Numb wrote:He said something about avoiding "blowback,"
Maybe he meant rainout.


Comfortably Numb wrote:I guess that will be a trial an error thing
Yes. It's very specific to the individual.


Comfortably Numb wrote:I'm not sure why he wants me to start at 1
Isn't it humid where you live? 1 is a good place to start. Too much humidity can cause problems. Some of us don't use a humidifier.


Comfortably Numb wrote: But I am curious as to how the two programs compare if anyone knows.

MyAir is close to nothing compared to Sleepyhead. You can get all the info off your machine display that is available in MyAir.

However, if your machine settings are optimal as prescribed, and your mask leak is low (see machine display), you may not need the advanced data that Sleepyhead provides.

Comfortably Numb wrote:I passed out immediately and slept for 2 hours with no problem. The mask right out of the box (size medium; no Pad A Cheek yet) felt great. I was surprised at how light and unobtrusive the mask is and how little I was aware of the 6 ft. heated hose. The nap served to give me confidence in the face of dread. Maybe this won't be as bad as I thought

The nature of a forum like this is seeing mostly people who have problems. It's good to hear you are off to such a good start.

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