s9 escape

[sleepyspinner]

Realized that my machine that is still currently in the rental phase (that's the way my ins. does it) is a ResMed S9 Escape. I have seen a few posts on here that tell people to RUN from the escape. Could someone please elaborate as to WHY RUN, for me? I am going to my DME tomorrow and I want to discuss a permanent machine because my rental period is almost up and I want to talk intelligently.'
Thanks for any help.

[cflame1]

It doesn't give enough data... for an example leak data. The straight Escape in the pre S9 models didn't even offer AHI data. An Elite and an Autoset (not the Escape Autoset) offer both the leak data and the AHI data. The Escape Autoset only offers the AHI data... not the leak data.

That's why it's not considered a fully data capable machine.

[Janknitz]

If your rental period is almost up, you are probably out of luck There's no profit to be made by anyone to switch you to a better machine.

The reason we advise people to run from the Escape is that the Escape has no efficacy data. If you are having a problem with your therapy--not feeling well, not sleeping well, very tired during the day, there's NO way to tell what might be going on with the Escape.

The other ResMed models have "efficacy data"--data that tells you if the machine is working for you like AHI (apnea-hypoopnea Index), whether you might be having central apnea (apnea not caused by an obstruction of the airway) or possibly unmanageable leaks from your mask or hose. An autopap can also tell you if you are getting enough or too much pressure from your machine. NONE of this is available on the Escape.

When you go talk to your DME, they are likely to try to put this all back on you, that you accepted the Escape in the first place (because you didn't know any better) and that you have been doing fine without the data (perhaps, but even they have no way of knowing that, because without efficacy data neither the DME nor your doctor know if it's really controlling your apneas or not). They may also lie and tell you your machine DOES have data (the only data it has is compliance data--the number of hours of use, which is not very helpful to anybody except your insurance company to help them determine if it's worth paying for your machine or not).

Or they may tell you there is no such thing as patient accessible data—that’s a lie too, as you can see from this board, patients CAN get the software and CAN access their own data if they want to. They may even tell you it’s illegal to access your own data (it’s not).

Other common DME lies:
1. You need to have a prescription for a data capable machine. No, you don’t.

2. Your insurance wouldn’t cover a data capable machine. In most cases, this is not true either. If you have traditional Medicare (Parts A and B, NOT part C Medicare Advantage, though), it’s definitely not true. For other insurers, you’ll have to call and ask how they pay for CPAP machines. If they pay by billing codes (HCPC’s codes), the HCPC code for the Escape is EXACTLY the same as for the Elite or Autoset, so your insurance would have paid for ANY of those machines. They would have paid the same for any machine, so the DME gave you the Escape because it’s cheaper, and thus the DME makes a better profit on the Escape than the others. But unless you have an HMO type insurance, in most cases, the insurance company doesn’t care WHICH of the three machines you get, only the DME does.


If you were early in your rental period, you might be successful in persuading this DME to swap out the Escape for a data capable machine, or you might get another DME to provide a data capable machine and accept a month or two less in rental fees toward the ultimate purchase. But if you are at the end of your rental period, it’s a lose-lose situation for your DME to swap out a machine used for more than a year to give you a brand new data capable machine now, and no other DME will want to give you a data capable machine when all they are ever going to get paid is 1 or 2 months of rental. So I’m afraid you’re too late to get a data capable machine if you want insurance to cover it.

That doesn’t mean you can’t have a data capable machine, but you will have to pay for it yourself. DON’T buy it from your DME—they will charge you way too much. Look at online suppliers like our hosts at Cpap.com, or used machines from a place like Secondwind.com and Craig’s list. They are not supposed to be able to sell them on Craigslist or eBay because you need a prescription, but you can find them there sometimes anyway. If you’re willing to switch brands (which means you need a new humidifier, too), you can also look on cpapauction.com (you’ll need a copy of your prescription). And some other manufacturers make very reasonably priced data capable machines you can purchase brand new from online suppliers.

[sleepyspinner]

I've had my machine since Dec. 23, 2010. I think the rental is 3 months.

How do I leave one DME and go to another? I mean, how do I find out what another DME will do for me?

Thanks for all your help and info. It is all so new and still confusing to me. It seems crazy that the Dr. would be satisfied with only comliance data, how awful is that?!

[Pugsy]

It seems crazy that the Dr. would be satisfied with only comliance data, how awful is that?!

It's actually the insurance company who wants the compliance data. DME might also send the doctor a copy but main object of compliance data is to satisfy insurance requirement.

It is not uncommon for a doctor to go entirely on "how you feel" and if you don't feel so great the usual response is give it time but they don't have a clue if something is going wrong. Leak or inadequate pressure.

When I was to go for my 2 month follow up I was initially told to "bring my machine" so they could see how longed I used it. I explained I had bought my machine out of pocket, so no insurance involved. "Oh, in that case, we don't need to see the machine"..

[Janknitz]

Hmmm, Medicare requires a 13 month rental, so assuming you have only private insurance and NOT Medicare you should call your insurance company up to see how they will reimburse for the purchase.

Take a look at my blog post on what you need to know before you meet your DME (link in my signature below). You may be OK, if:
1. The insurance company pays by HCPC's codes
2. If you have a choice of DME's (some insurers dictate what DME's you can use)
3. If the insurer pays a decent amount for the purchase even at the expiration of the rental period (note, the allowable amount is typically much LESS than the DME would charge for the machine).

If your insurer pays by HCPC's codes, your DME wasn't going to get any more money to give you the Elite or Auto in the first place, so if you approach them politely but firmly and insist you want one of those machines (it helps if your doctor will give you the specific RX), the DME MAY be willing to switch it out for you, or you may be able to have another DME give you the desired machine.

It will take a little finesse here to deal with the DME without blowing your stack. Good luck!