How to have the prescription written?

[Catalytic]

I go tomorrow to get my results/prescription. Assuming I only need CPAP, I am going to ask for the S9 AutoSet. I plan to use Optigen as my DME. What, exactly, should the prescription say? Does it have to list the mask I want (undecided on that atm) or just APAP and humidifier, or what? How long is the prescription good for? Sorry, thought I had this all together in my mind, but then somewhere I read about "dispense as written" so I want to be sure what I need it to say. Already having insurance issues because my PCM referred me to the same pulmonologist that owns the sleep center for my asthma, and it was mis-coded in the authorization as being for apnea, so now my insurance is denying everything (including the authorization to purchase, not rent, my machine) as being duplicate requests :banghead:

[Pugsy]

Go with "mask of patient's choice" that way you get to choose and change around if you want to.

If you want the S9 Autoset...have it listed as exactly that...full name and make sure Autoset is clearly written.
If you say "APAP" that leaves the door open for the S9 Escape Auto...which is an APAP machine but only gathers AHI and average pressure.

Dispense as written box...that means the DME can't substitute.

Length of time the RX is good for...that depends on maybe your insurance but generally they are considered lifetime.

So something like this.

ResMed S9 AutoSet...heated hose and humidifier...mask of patient's choice
....dispense as written box checked.

[Catalytic]

Will having dispense as written on an S9 AutoSet hinder getting say an S10 AutoSet in 10 years when I need a replacement? Or should I just get my PCM at that time to rewrite the script for whatever machine I want then? Thanks for all the help!

[Pugsy]

When it comes time to get a new machine....just get a new script for the machine.
Oh, I forgot to mention pressure...do you know your pressure recommendations?
Mention the pressure in a range.. like 6 cm / 15 cm (or whatever).

[Catalytic]

When it comes time to get a new machine....just get a new script for the machine.
Oh, I forgot to mention pressure...do you know your pressure recommendations?
Mention the pressure in a range.. like 6 cm / 15 cm (or whatever).

I don't know pressure yet, I assume they will tell me tomorrow? I had my titration Sunday night, and this is to get the results from that.

[jdm2857]

There are different prescription strategies for different situation.

Pugsy's advice for as specific perscription as possible is perfect when one is trying to ensure that and insurance company or DME will supply the desired machine.

But, if you are paying for the machine yourself, you want as generic a prescription as possible to give yourself as many options as possible.

For example, a script for an APAP cannot be used to buy a straight CPAP, because a CPAP cannot provide the auto functionality specified in the prescription. But, a prescription for a CPAP can be used to buy an APAP, because the APAP can provide straight CPAP functionality.

[Catalytic]

There are different prescription strategies for different situation.

Pugsy's advice for as specific perscription as possible is perfect when one is trying to ensure that and insurance company or DME will supply the desired machine.

But, if you are paying for the machine yourself, you want as generic a prescription as possible to give yourself as many options as possible.

For example, a script for an APAP cannot be used to buy a straight CPAP, because a CPAP cannot provide the auto functionality specified in the prescription. But, a prescription for a CPAP can be used to buy an APAP, because the APAP can provide straight CPAP functionality.

Insurance will be paying for the machine, and I intend to buy a backup machine from mcdover on this forum if I do indeed just need CPAP/APAP. (I'm planning on the Icon auto.) I *should* be covered for insurance for life, unless Tricare goes ont he chopping block at some point, which wouldn't surprise me in the least.

[jdm2857]

I understand your situation and Pugsy gave you great advice.

My comments were aimed to others whom are no doubt reading this thread.

Good luck.

[LinkC]

Mine says "APAP of patient's choice". But then I went to the DME's office with a barely used CPAP and asked what it needed to say to get what I wanted. Then called the Doc and dictated it to the receptionist as she typed it. A PA signed it and faxed it. Took about 10 mins. I even had the DME make me a copy of the new one "for travel". Still use it...

[edm_msu]

Also add things like: tubing or heated tubing, disposable filters, washable filters, heated humidifier, chinstrap, and headgear. My DME required these specifics so they would get paid. My other prescription said "and related supplies" and that was not good enough.

[Catalytic]

OK, well I'm back. I goofed and forgot (not really forgot, there's a huge language barrier between the doc and I) to have the ClimateLine tubing put down, but I DID get a script for ResMed S9 AutoSet with humidifier. I am supposed to see the doc again on April 22, and I will ask for a script for the heated tubing then. Sent my script off to Optigen, and am very hopeful I will have a machine ...soon? *Maybe* Friday, if I'm really lucky, more likely in a week-ish. Thank you all for the help with this!

[Pugsy]

Not a big deal about the ClimateLine hose....they might even include it but if they don't and you end up needing it they are pretty easy to get on your own or you can request it as part of your replacement schedule allowance for a new hose (whatever that might be). If it is similar to Medicare's schedule...at 3 months.
It might not even be needed...wintertime is usually when it really comes in handy.

[fredr500]

My DME automatically threw in the ClimateLine hose. I had to ask if that worked without the humidifier to get the other one included. Just ask when you get the machine, shouldn't be an issue.

[Catalytic]

Optigen.net is who I am using for my DME, since we move a lot. They said the prescription had to say the heated tubing to get it, BUT...when they called back to let me know they had arranged for the tech to call and set up delivery (already!!! I am ecstatic, I really thought it would take a while since my insurance likes to take forever to approve things sometimes), they said they were contacting my doc to get a prescription for the ClimateLine, so....as long as doc approves it, I should get it. If not, I will ask for a script for it when I go for follow-up in April...hmmm...or get my PCM to write it? Hmmm, hadn't thought about that, my PCM is fantastic! I'm not overly concerned about it here in Texas, but we're moving to upstate(? Watertown, I have no idea what is considered upstate LOL) NY in August, so I am thinking it would be handy there.

[jdm2857]

In NY, upstate is anything north of Central Park.