My DME Experience Today

LavenderMist · Post by **LavenderMist** » Wed Oct 17, 2007 11:21 am

My auto got approved. I had requested REMstar Auto with cflex. The guy calls yesterday to set a time to setup my cpap (his words) I'm thinking cpap???. I asked him what machine I was getting. He said a M-series auto w/ cflex. He told me they don't make the REMstar autos any more. He shows up this morning with the machine. I ask him if it shows AHI data on the LED screen. He didn't know and started flipping through the book. He then tells me they have also ordered a mask. I told him that it hasn't been three months since my last mask. He says I'm getting one with the order. I told him I'd heard good things about the Quattro. He looked at me like I was from Mars. He says he has never heard of it. He ended up giving me the only thing he had which is an Ultra Mirage ffm. I told him I was interested in trying the nasal pillows and he says, but "Oh, but you mouth breathe." I proceeded to tell him that I knew of some very creative folks who were able to use nasal masks and pillows by taping or using poligrip strips. He says that some people make to big of a deal of mouthbreathing. It really doesn't affect your treatment, something about the pharnyx, blah blah. He just contradicted what he said earlier and what I know to be truth. He leaves and of course, I get right into the clinician's menu to make sure it is set up to show me ahi data and see there are numbers on blower hours. So, I think they are selling me a used machine and charging me for a new one. Grrr.

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CPAPopedia Keywords Contained In This Post (Click For Definition): mirage, cflex, CPAP, AHI, Nasal Pillows, auto

Wulfman · Post by **Wulfman** » Wed Oct 17, 2007 11:27 am

How many hours?
There are separate numbers for therapy hours and blower hours. The therapy hours can be cleared but the blower hours cannot be.

There is supposedly a limited number of hours that it can still be considered "new"......I'm told. SOME of those blower hours could be for factory testing/burn-in, too.

Den

LavenderMist · Post by **LavenderMist** » Wed Oct 17, 2007 11:37 am

Oops, I rechecked it and blower hours show 0. What I was seeing was a screen that said Compliance 65450. Any idea what that means?

I was just bumfuzzled because the guy didn't seem to know what he was talking about from what I've read here. Also, the fact he was pushing a mask on me when it hasn't been three months since I got my last one. If the insurance doesn't pay for this mask, I'm going to be hopping mad.

I guess I'll just have to go by screen data until I receive a smart card reader. I guess some data is better than what I've had for two years, no data.

Wulfman · Post by **Wulfman** » Wed Oct 17, 2007 11:43 am

LavenderMist wrote:Oops, I rechecked it and blower hours show 0. What I was seeing was a screen that said Compliance 65450. Any idea what that means?

I was just bumfuzzled because the guy didn't seem to know what he was talking about from what I've read here. Also, the fact he was pushing a mask on me when it hasn't been three months since I got my last one. If the insurance doesn't pay for this mask, I'm going to be hopping mad.

I guess I'll just have to go by screen data until I receive a smart card reader. I guess some data is better than what I've had for two years, no data.

I've seen folks report numbers like that and in all honesty, I don't have a clue how to interpret that number. On the pre-M machines, it's much clearer than that.....they give the exact number of hours.
If it was total therapy hours, putting 65,000+ hours on a machine would take years and years. These machines are only a little over a year old.

Den

LavenderMist · Post by **LavenderMist** » Wed Oct 17, 2007 11:52 am

Thanks Den. I guess I can calm down now. After all I've read, I'm a little paranoid about DME providers.

TXKajun · Post by **TXKajun** » Wed Oct 17, 2007 11:59 am

Congrats, LavenderMist on managing to get an excellent XPAP from your DME!! Like you said, some data is better than no data. In the case of your APAP, I bet you're gonna find bunches of data!!

Again, congrats!

Kajun

msheda · Post by **msheda** » Wed Oct 17, 2007 12:20 pm

The compliance number is a checksum hash. It assures the program reading it that the data was really generated by a Respironics machine and not hand entered.

This is also used by Credit Card authentication programs. (there is a formula that you apply to the number on the card, and it has to equal a certain number based on the type of card it is so that they are assured that it is a real number and not something someone made up)

LavenderMist · Post by **LavenderMist** » Wed Oct 17, 2007 12:44 pm

Thank you for the congrats TXKajun. It should be interesting to see the results. I've been on a straight 10 pressure for a year now and original titration was 9.

msheda, thank you for solving the mystery.

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CPAPopedia Keywords Contained In This Post (Click For Definition): Titration

GumbyCT · Post by **GumbyCT** » Wed Oct 17, 2007 1:23 pm

I recently ordered a reader from here-
Desktop USB Smart Card Reader
Price: US $24.00
shipping cost: USD 7.80
Total: USD 31.80
http://www.two-factor.com/shop/index.php?productID=115

The drivers are also at the above link for anyone who needs them.

I used Paypal. It took 2 days to get an email confirmation - 7 days after that I was using it.

I think you want the USB Reader?

Good Luck,
GumbyCT

lilsheba · Post by **lilsheba** » Wed Oct 17, 2007 2:03 pm

I'm having issues with Two Factors delivering my card reader. Right now I think it's at the post office but I"m not sure, I ordered it a month ago and the tracking shows it's delivered but I don't have it. Usually at my complex if they deliver something and I"m not there they take it to the front office and so far the front office hasn't seen it. I don't know why this can't be more straight forward!

papdaddy · Post by **papdaddy** » Wed Oct 17, 2007 2:14 pm

lilsheba wrote:I'm having issues with Two Factors delivering my card reader. Right now I think it's at the post office but I"m not sure, I ordered it a month ago and the tracking shows it's delivered but I don't have it. Usually at my complex if they deliver something and I"m not there they take it to the front office and so far the front office hasn't seen it. I don't know why this can't be more straight forward!

Lilsheba I recently received a reader from two-factor and it only took 10 days. The post lady brought it to our door and scaned it for proof of delivery. Maybe some one else picked it up. They should of scanned it when delivered.

Rich

Robbie · Post by **Robbie** » Wed Oct 17, 2007 2:22 pm

He shows up this morning with the machine. I ask him if it shows AHI data on the LED screen. He didn't know and started flipping through the book.

<Warning - Rant Zone. Fines Doubled When Workers Present>
I'm trying to tone down my 'demonizing' of DME reps, (although the one's I've dealt with keep "loading my gun" for me) but you'd think they'd read the manual BEFORE they arrive. I wouldn't expect anyone to know all the specific details of every piece of equipment they handle, but since they're all probably similar (when you boil it all down) a few minutes prep work would be nice and perhaps even .. dare I say it .. (dare! .. dare!) professional ?

I was thinking when I bought my "second/back up/heck I just want a new one" mask I'd go through a DME the first time so I could borrow of their fitting advice and expertise. NOT ANYMORE !!!

I finally got around to swapping out my F&P 407 yesterday - for an Activa. The DME rep knew why I was coming in. He had no idea how to adjust the thing - didn't EVEN read the directions. He fiddled with the forehead piece a bit (miraculously without breaking it) straps this rubber Eiffel Tower on my face really tight and walks out to give me time on the hose to see how I liked it. Fortunately I read the online instructions the night before - a little loosening and adjusting - the mask was great (albeit it seemed a bit large at first) - I couldn't shake it loose enough to noticeably leak. Had I been totally new and not read a bunch of great advice on CPAPTALK.com, I would have thought the mask was adjusted properly (and consequently the mask sucked because it was soooo uncomfortable when "properly adjusted").

Point is - there was no value add going through the DME in my experience. Sounds like LavenderMist didn't see any value add going through the DME. I can understand paying a little extra for local service and someone's expertise/hand holding. I can't see paying the extra when I would more than likely get much better service on CPAP.com as well as a much better price.

As someone who works in healthcare billing/reimbursement, I'm more than willing to bet that we'll either see local DME's extending substantial discounts to healthcare payers in the future - or internet based xPAP equipment distribution by insurance companies. I rarely go to the local pharmacy anymore to have a prescription filled. My maintenance prescriptions go electronically to a fulfillment center who ships me a 90 day supply. Can xPAP be far behind? xPAP and supplies for the moment appears to be a "cash cow" with many insurers still paying under the old 80/20 model.

<End Rant Zone - Assume Normal Speed>

Have a nice day

papdaddy · Post by **papdaddy** » Wed Oct 17, 2007 2:37 pm

[quote="Robbie"][quote]

As someone who works in healthcare billing/reimbursement, I'm more than willing to bet that we'll either see local DME's extending substantial discounts to healthcare payers in the future - or internet based xPAP equipment distribution by insurance companies. I rarely go to the local pharmacy anymore to have a prescription filled. My maintenance prescriptions go electronically to a fulfillment center who ships me a 90 day supply. Can xPAP be far behind? xPAP and supplies for the moment appears to be a "cash cow" with many insurers still paying under the old 80/20 model.

<End Rant Zone - Assume Normal Speed>

Have a nice day

Guest · Post by **Guest** » Wed Oct 17, 2007 2:37 pm

um, DMEs are BUSINESSPEOPLE, not medical professionals.... That's it. They're just a place to go to pick up your machine.

Guest · Post by **Guest** » Wed Oct 17, 2007 3:34 pm

Thanks for the link GumbyCT. I have it bookmarked. As soon as I get some $ I'll order it.

Umm, guest, this was supposedly a licensed respiratory therapist or so he says. So he isn't just a business person, but a medical professional. He brings out the equipment to you. He also delivers and sets up oxygen and supplies to patients on oxygen etc. You'd think since he does it every day that he would know more. The problem is, that most patients he encounters haven't been reading this forum and don't ask the kinds of questions I did. I thank all the wonderfully informative people here for that. Most probably just take what he hands them and signs the dotted line no questions asked.

The trouble with having an hmo is that you don't get to choose which dme you want. That decision is made for you by the insurance company. Unfortunately, billmyinsurance doesn't take my insurance or I would go that route.

Mask

Additional Comments: Also using: 1. Pad A Cheek head gear covers. 2. Respironics comfort select nasal mask. 3. Pur-Sleep aromatherapy. Pressure 16 straight CPAP.

Machine	Mask	Humidifier

Machine	Mask	Humidifier