New and Excited -- My Solipsistic Update Thread

Called Anthem today and verified that they pay by HCPCS/CPT code and therefore make no distinction for payment purposes between machines. As long as I use an in-network DME, I have 50% coverage, no deductible, and balance billing is prohibited by their contracts with suppliers.

I also spoke to the insurance company about DMEs. They helped me locate several in the area. There's a relatively local chain with three outlets that carries Phillips products. Unfortunately the only DME I've been able to find locally that carries ResMed is LinCare. That alone might decide me in favor of the Series 60 Auto if all else is equal.

Called my pulmonologist this afternoon to ask about results. Not sure how to feel that when I told her who I was she went from sounding like this was the 10,000th time someone had called to ask about results to saying, "Oh, yes! Just a minute!" I guess maybe my results were memorable?

Anyway, the doctor read the results today and dictated his report. The diagnosis is, as suspected, OSA. When they get his report back from transcription they're going to fax it, along with his order for an APAP to the DME. They strongly recommended a DME I had forgotten about. It's a little farther away, but it gets great reviews and I even have experience with them -- they delivered a nebulizer to my daughter in the hospital when she had RSV. Very professional, from what I remember. For what it's worth, they won an award from HME News (a trade magazine) for Best Home Respiratory Provider in the nation. But the best part is that they carry the full line of both ResMed and Phillips Respironics machines.

Oh, and the nurse volunteered that he had ordered an APAP, so there will be no struggle to get a machine I can accept. And since the DME carries both I'll get to look at both before deciding. I'm still not certain which to choose, so any further advice would be appreciated.

I'm psyched. I just wish the paperwork didn't take so long. On the other hand, the delay has given me time to find this place and do some research so I'm not going into it blind. Thanks again, everyone!

So now you only have to make sure of 2 things:

That they do not try to give you a USED APAP.

The APAP they give you has the LATEST internal software version .

Also remember that ResMed makes an Escape Auto, don't get talked into that!

Bama Rambler wrote:Also remember that ResMed makes an Escape Auto, don't get talked into that!

Thanks for the warning!

Hmmm. I'm a relatively newer person, been PAPing since November.

I found doing allll of it the first night for the whole night was a little much. But I was all the way there leaks aside by day 2 once I hit on the exposure acclimation idea with something boring on Netflix to distract my brain from "omg there's a thing. it's stuck to my face. omg."

I saw you have BCBS, BCBS at least in Michigan doesn't count your first 30 days towards the 70% compliance at all...so if you need to take a few days or weeks to get used to this thing all night, that is ok to adjust at your own speed. Just make sure days 31-60 you have 70% of your days with 4 hours a night used. It's cumulative too over a 24 hour period. So if you have say 2 hours, then you're up for an hour wandering/watching infomercials to make the bad dreams go away, then back to at least 2 more hours of sleep by wakeup time, you're good!

And if the DME tries to tell you a leak in the mask is so big you can stick your finger in the gap is ok and normal, RUN AWAY and pick someone else. That bozo doesn't know what they're doing! (I had that guy. It was bad. Much happier now with the new DME.)

Doublecheck that the machine has the correct settings before you go out the door. Including your timezone. That particular menu's a bit hidden on S9's...

And you may find the nice aromatherapy things from our hosts are helpful with the adjustment. They mask the plasticky smell pretty well. You still need to clean your stuff though! But hey, I'd rather smell candy or strawberries or that nice clear-sinus-y peppermint/menthol-y thing smell instead of plastic. The Clear one helps my sinuses this time of year open up enough I can get the mask working well, too.

And if you want to know my favorite thing besides physically feeling better, it's that I can go snorkeling under all my covers when it's cold. And still get nice cool air in Blanket fort made one step better!

I thought of one other question: I've read about "patient" and "clinical" menus. If one buys through a DME, is it possible for them to restrict access to the clinical menu so that the patient cannot adjust settings? It seems like that would be unfortunate...

To enter the Clinicians menu, you have to press specific key strokes. While the DME will tell you (or not tell you) to stay out, in the end it is your body, your health and your machine

Once you get your machine, someone will let you know how to get into the clinicians menu.
-tino

http://www.cpaplibrary.com/machines.html

Above link has some videos on how to use the secret handshake to get into the clinical setup menu area...it's not difficult.
Also offers some of the other features.
S9 is there...scroll down a bit for System One Respironics.

The Latinist wrote:I thought of one other question: I've read about "patient" and "clinical" menus. If one buys through a DME, is it possible for them to restrict access to the clinical menu so that the patient cannot adjust settings? It seems like that would be unfortunate...

In theory you aren't supposed to mess with the clinical menu unless you are a clinical person.

My sleep doc told me to do an internet search to find out how to change my settings. That way I wouldn't have to wait for the DME to come out and change them for me. Thus, how I ended up here.

Tino2You wrote:To enter the Clinicians menu, you have to press specific key strokes.

Ah, so it's like in the old days with cell phones. Gotcha.

DISCLAIMER: I haven't felt a need to know anything more than the little I know about my XPAP machine ...

A word of caution I have seen elsewhere on this group: be careful not to go overboard fiddling with your behind-the-curtain controls (aka clinical menus). Seems to me you may want to make very little adjustments, give them time for your brain to adjust, then try a bit more or less, etc. As I have pointed out elsewhere, I feel truly blessed to have a very helpful DME and a very helpful sleep doc who has done the micro-tuning. She did tell me to go to the internet to back-up what she had just showed me to do to fiddle with settings, underscoring the importance of the consumer becoming their own best advocate (and machine technician).

Good luck!

Don

I was actually able to access my Clinician's menu recently - the DME exchanged the brick they gave me with a PR System One - DS460 - but neglected to set the machine up. When I emailed my RRT about this her reply was "whoops - call me." I called and she talked me through how to get into that menu - on the Respironics machine it's very simple - at least the one I have. I was afraid I would mess something up just by being in there, but you have to actually toggle through things and physically change them by pressing buttons. I think it's a good thing to know how to do, but it's not something you need to know right away and everyone is right - the directions are easily found on the internet. I wrote down the directions when she talked me through it as well and they are in my nightstand, just in case. I've taken the stance that knowing how to operate my equipment gives ME the control over my therapy. That doesn't mean I'm going to willy nilly go change my pressure. It just means I have a working knowledge of the equipment I'm using - which I think is important. Good luck!

Thanks OboeVet and Scootergirl. I certainly don't intend to mess regularly with my settings; but I'd like to have the option. So far I've been very satisfied with my pulmonologist and DME, but things can change...

Long ago, I set my ramp for 5 minutes.
I hardly notice it.