insurance will not pay for apap

Wulfman · Post by **Wulfman** » Sat Mar 17, 2007 1:08 pm

Slinky,

Actually, I thought I was being quite nice to our uninformed and rude "guest".

I just thought it was very ironic that our guest questioned MY knowledge when in fact he/she (I'm betting HE) didn't have it right.

I have NO problem apologizing when I get something wrong.....but anonymous posters can get all their facts wrong and don't have to worry about being accountable or apologetic. And, they can be as rude as they wanna be.

Den

Slinky · Post by **Slinky** » Sat Mar 17, 2007 1:18 pm

Hey, Den, I did NOT ask you to apologize! It just surprised me to see you "lose" it like that. I've seen you disagree w/someone before but I haven't seen you get into a "pissing" match w/someone so I had a pretty good idea just how PO'd you were. Not a problem on my part. I just hate to see things escalate. I can't say about our "guest" but I have a pretty good idea from your previous posts that you aren't a trouble maker or pot stirrer AT ALL. And you've always been civil. I have a darn good idea of WHO the BIGGER person is!

Catnapper · Post by **Catnapper** » Sat Mar 17, 2007 1:29 pm

I agree, Slinky. I tried to get the insurance to make a ruling but got no place with them. You would thing they care about contracts and surcharges - otherwise why bother?

The sleep doctor warned me it might happen, too. He said that the DME would very likely charge extra for the autopap. They must be in cahoots!

In the end, it was worth the $150 to get it done.

Catnapper - Joanie

Wulfman · Post by **Wulfman** » Sat Mar 17, 2007 1:31 pm

Slinky wrote:Hey, Den, I did NOT ask you to apologize! It just surprised me to see you "lose" it like that. I've seen you disagree w/someone before but I haven't seen you get into a "pissing" match w/someone so I had a pretty good idea just how PO'd you were. Not a problem on my part. I just hate to see things escalate. I can't say about our "guest" but I have a pretty good idea from your previous posts that you aren't a trouble maker or pot stirrer AT ALL. And you've always been civil. I have a darn good idea of WHO the BIGGER person is!

I know. It's just that our "guest" got on my "bad side" right off the bat.....and stayed there.

I've been in a few "pissing matches" before.....usually with rude guests or some of our "multiple personality" users (people purporting to be sombody or something they're not).

Like anybody, I have a limit to how much "abuse" I can tolerate.....either to me or to others.

Den

Slinky · Post by **Slinky** » Sat Mar 17, 2007 2:01 pm

Yeah, CatNapper, if I didn't dislike and resent my local DME supplier so much it would be worth it to me too. But I've grown to dislike them so much I resent every penny them make off me via my insurance!!! I know I'm cutting my nose off to spite my face by not approaching them about the possibility but they just torque my jaws so badly ....... If I had a decent DME supplier, I'd do just as you did, jump at the chance for $150 extra!!!

Don't sweat the small stuff, Den. We know YOU. You're A-OK and a keeper.

Ric · Post by **Ric** » Sat Mar 17, 2007 11:10 pm

Like catnapper, I too bought my first APAP from a local DME with a CPAP prescription, and paid $150 "surcharge" to Sleepmed to cover the difference. We were both happy, I got the machine same day, they got $150 on top of the OUTRAGEOUS sum the insurance (UHC) allowed for a CPAP. (They got $1300 for something I could have bought for $600 online and which probably cost them half that).

I also bought my "spare" Remstar AUTO from cpap.com using my original CPAP prescription. What the anonymous DME fails to grasp or doesn't want you to know is that an APAP IS a CPAP with an advanced firmware that allows it to adjust automatically for the variations in pressure requirements that we all experience from time to time. It's a CPAP with an automatic transmission. It also does some other cool things that a bottom-of-the-line-CPAP-that-DMEs-push-vigorously can't do, like it gives you a sleep study and a titration EVERY night, and records the data, and lets you download it to your computer and analyze it. Not a surprise that some DMEs HATE that, it could seriously damage their margin of profit. Also not a surprise that many sleep labs actually use the same Remstar AUTO to perform the titration phase of a sleep study. As harikarishimari once pointed out, competition sux! (giving credit where credit is due, thx HKS).

I also agree that Wyoming owns some of the most beautiful land in the whole USA. Anyone who has driven through the Tetons or rafted down the Snake river would agree. I landed the Mooney a few of Aprils ago at Jackson Hole to run an "unofficial" marathon with some friends; We were greeted at sunrise by a herd of Moose, a few antelope that scattered across the road, and a family of racoons that allowed us to share the trail. Not much else. In all it was an exhilarating experience, and we plan to do that again. The people there are wonderful. I would trade my steel-and-concrete jungle for your wilderness almost any day. DEN, you have nothing for which to apologize thereat. Truth is, we're jealous!

The anonymous coward owes you and the whole board and apology, for slandering your state, and for attempting to foist blatantly false and self-serving information to this forum and to those who come here for support and advice. Hopefully that will backfire, people need to know that you CAN get an APAP with a CPAP prescription, although some third-party payors will balk at paying the DIFFERENCE in price. The other take-home advice is that you are entitled to a copy of your prescription and it is good for a lifetime. Keep it in a safe deposit box or make multiple copies of it, or whatever. It can save you another sleep study or multiple trips to the doctor and possibly many long hours of BEGGING!

Thanks BILL for pointing out that really old post by RIC, that was spot on. Couldn't've said it better myself! .

-Ric

Wulfman · Post by **Wulfman** » Sun Mar 18, 2007 9:47 am

Hey, Ric......your posts on this forum have become too few and far between.
Do you suppose you could improve on that a little bit?
AND, if HKS is perchance reading, I always enjoy reading her wit and wisdom, too.

Anonymous wrote:Nice talk. Typical person from Hickland (AKA Wyoming).

I actually had to laugh at this post yesterday......because our guest also insulted MANY, MANY wealthy, prominent, corporate and famous people with this post. There are an awful lot of those folks who have been building homes and living in this area since the 1800's.....but that number has been growing significantly in the last 50 years.
When you look back into the history of Wyoming, the early cattle barons were mainly wealthy aristocrats from the eastern U.S. or from Europe.

"Hickland"??? HA!.....hardly. Or, if it is, I've got good company and neighbors.
I wish I could tell you who all lives just right up the road from here and within about a 100 mile radius....but I wouldn't want to disclose their whereabouts and that they're actually "hicks", too.

Best wishes from "vacationland".....aka. "Hickland".

Den

TGregg · Post by **TGregg** » Sun Mar 18, 2007 10:05 am

KALDEX wrote:I work for a DME company and i can tell you first hand that we know more about the equiptment than any of your DOCTORS, so please consult us on which machine is best for you

LOL. My DME rep didn't believe me when I told her that the ResMed S8 Elite had an Advanced/Detailed patient menu that included an option to enable or disable the leak alarm. Even when I showed it to her in the manual. 20 minutes of somewhat heated discussion ensued with no results. So I went home, looked up how to get into the clinical menu here, and within three minutes had the advanced menu set.

And she's a hosehead! Obviously oblivious to this forum, though.

Sorry KLADEX, but I knew more about my machine within an hour of getting it (after having read the manual) than my DME rep still does today. YOU may know more about your machines than some doctors, but I bet most readers of these forums know more about their machines than their local DME reps.

TGregg · Post by **TGregg** » Sun Mar 18, 2007 10:25 am

Wulfman wrote:Actually, I thought I was being quite nice to our uninformed and rude "guest".

I suspect most of us agree that being arrogantly wrong as an anonymous poster is one of the problems of the net. The smaller the mind, the bigger the mouth sometimes.

Some of these DME supporters show up and only make DMEs look worse.

.

Guest · Post by **Guest** » Sun Mar 18, 2007 12:49 pm

And sometimes BECAUSE these DME RTs are NOT ALLOWED to set access to the Advanced Patient Menu w/o a doctor's order they feel it is safest and/or easiest to just play "dumb" about them.

neversleeps · Post by **neversleeps** » Sun Mar 18, 2007 1:43 pm

Den and Ric, it's great to read your posts. Wish there were more of them!!!

TGregg wrote:I suspect most of us agree that being arrogantly wrong as an anonymous poster is one of the problems of the net.

Good point. Then again, arrogantly wrong registered posters can be an even bigger problem.

"Arrogantly wrong" is annoying no matter where it comes from. (She said, arrogantly.)

TGregg · Post by **TGregg** » Sun Mar 18, 2007 5:03 pm

Anonymous wrote:And sometimes BECAUSE these DME RTs are NOT ALLOWED to set access to the Advanced Patient Menu w/o a doctor's order they feel it is safest and/or easiest to just play "dumb" about them.

It's even easier to say "I can't set it without a doctor's order."

But it's interesting to see you admit they lie like rugs whenever they think it makes life easier for them. I wouldn't come out and call them a bunch of sleazy liars like you are.

Guest · Post by **Guest** » Sun Mar 18, 2007 6:00 pm

"I suspect most of us agree that being arrogantly wrong as an anonymous poster is one of the problems of the net"

So if I register I'm not anonymous. Yeah right.

rested gal · Post by **rested gal** » Sun Mar 18, 2007 8:34 pm

Guest wrote:DME RTs are NOT ALLOWED to set access to the Advanced Patient Menu w/o a doctor's order

Really? I never had thought about that one way or another, but that sounds kind of odd. I can understand that DME RTs are not supposed to change pressure settings without a doctor's order, but.... they are not allowed to turn on the Patient Menu feature without a doctor's order?

Not arguing. Just sincerely curious about what the rationale would be for that. Why would setting access to the patient menu require a doctor's order?

NightHawkeye · Post by **NightHawkeye** » Mon Mar 19, 2007 4:06 am

rested gal wrote: .... they are not allowed to turn on the Patient Menu feature without a doctor's order?

Not arguing. Just sincerely curious about what the rationale would be for that. Why would setting access to the patient menu require a doctor's order?

LOL. I'd like to see the answer to that one too, RG.

Regards,
Bill ( . . . wondering whether anyone can come up with more than a lame rationalization along the lines of "Doctor knows best . . .")

insurance will not pay for apap

extra charge

Re: DME companies and your DR.