E0471 - are my eyes deceiving me? $$$

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
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Denise_in_MI
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E0471 - are my eyes deceiving me? $$$

Post by Denise_in_MI » Fri Nov 21, 2014 4:28 pm

...after 3 sleep studies...

The DME place calls me and says that I need an appointment for E0471 and E0562. So, I google E0471 machines and my jaw drops... My insurance pays 50% after I reach my deductible. Should I go to my appointment, then check with my insurance company to see if it is less expensive for me to buy elsewhere (online with approval)?

If my eyes are not deceiving me, this thing should come with 4 tires and a steering wheel!

Denise
Throwing a few Centrals, this way and that....

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Pugsy
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Re: E0471 - are my eyes deceiving me? $$$

Post by Pugsy » Fri Nov 21, 2014 5:00 pm

Those machines are indeed pricey.
Find out what your out of pocket costs would be if using a DME and your insurance with the 50% copay...and any deductible you may not have met yet.

This machine would get the job done. PR S1 model 960
https://www.cpap.com/productpage/pr-60- ... anced.html
Do call for the discounted price...it is much less than the advertised price.
Compare the cost of this supplier against your out of pocket costs using insurance and what a DME will want to charge.

This website has some new open box specials
http://www.secondwindcpap.com/Open_Box.html
for both the 950 ($1329) and the 960 ($1429) models....down near the bottom of the page.
The 960 is the newest model and is heated hose capable...plus it has a variable EPAP setting that the 950 doesn't.
The 950 is not heated hose capable.
Prices include humidifier but not the heated hose on the 960 but that's an easy upgrade if you want a heated hose.

Do the math and compare out of pocket costs using insurance vs just buying online.

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Denise_in_MI
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Re: E0471 - are my eyes deceiving me? $$$

Post by Denise_in_MI » Fri Nov 21, 2014 5:06 pm

SUPER! Thanks for the tips! So glad I found this website. LOVE you all!

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cnaumann
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Re: E0471 - are my eyes deceiving me? $$$

Post by cnaumann » Fri Nov 21, 2014 5:19 pm

I am afraid your eyes are not deceiving you. You will not get tires and a steering wheel, but the good news is that machine doubles as an emergency air mattress inflator.

E0471 is a BiPAP with back up rate. It is a type of non-invasive ventilator used to treat certain types of central sleep apnea, periodic breathing, and certain other breathing disorders.

There are about 4 machines currently on the market. Two are made by Philips Respironics, two are made by ResMed. The two different machines that each company makes are used to treat different conditions. The ASV class machine are used to treat central apnea and periodic breathing, the S/T class machines are used to treat conditions like COPD and Obesity Related Hypoventilation syndrome. The ASV class machines seem to be a lot more common here and since your tagline mentions centrals, I am assuming you will be looking at an ASV class machine.

All four machines cost about the same.

My DME charges $5200 retail for these machines.
Blue Cross of Alabama has an allowable rate of about $4400 for these machines.

If you have 50% coverage, even with no deductible you may be looking at $2200 out-of-pocket just for the machine if you go through a local DME.

I will also mention that insurance companies HATE paying for these machines and will (likely) give your DME the run around and your DME will keep pestering your doctor for more justification.

There are a few other options, but they come without any type of local support. Specifically, my machine, the Philips Respironic Model DS960 which is an ASV machine can be purchase new online for about $3200. See our sponsor page (https://www.cpap.com).

There is a yet another option. You can buy an 'open box' machine on the gray market for about $1400 from a company call http://www.secondwindcpap.com. You will have to pay cash, and you really need to know exactly what you need and be comfortable setting up the machine yourself to take this route. The company is reputable and friendly, but being an online company, support will be limited to email and phone. This is the route I took. I am in the process of finding out if my insurance will reimburse me for this purchase.
Last edited by cnaumann on Fri Nov 21, 2014 7:20 pm, edited 2 times in total.

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Denise_in_MI
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Re: E0471 - are my eyes deceiving me? $$$

Post by Denise_in_MI » Fri Nov 21, 2014 6:24 pm

LOL I saw the emergency mattress inflator thread!

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Re: E0471 - are my eyes deceiving me? $$$

Post by palerider » Fri Nov 21, 2014 7:54 pm

cnaumann wrote:two are made by ResMed.
*cough*three*cough*

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Re: E0471 - are my eyes deceiving me? $$$

Post by Tatooed Lady » Sat Nov 22, 2014 8:21 am

Gray market? Secondwind? You make it sound so...seedy. Like it's a guy with a laptop and trench coat selling them from an old phone booth.

I'm pretty sure it's a reputable site...many here have recommended it.

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cnaumann
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Re: E0471 - are my eyes deceiving me? $$$

Post by cnaumann » Sat Nov 22, 2014 8:49 am

Gray market? Secondwind? You make it sound so...seedy. Like it's a guy with a laptop and trench coat selling them from an old phone booth.
That was not intended to sound seedy at all. Gray market is anything that is being sold through an unoffical chanel. It is quite common. There is nothing remotely illegal or seedy about it. But is it not a 'factory authorized dealer' either.

For a while, Costco was selling re-imported Omega watches and they were not an offical dealer recognized by said watch manufacturer. That is selling on the gray market. There is nothing seedy or nothing illegal about it, but it did piss Omega off and they managed to force Costco to stop though some odd legal action that I still do not fully understand. (I think it was we are going to keep sueing you untill you get tied of paying for lawyers to defend your perfectly legal operation.)

I buy re-imported camera lenses from very reputable dealers all the time. Again, gray market.

Sorry for the confusion. I have nothing but good things to say about secondwind CPAP. I don't know that it is much more than a guy with a laptop selling out of an old phone booth, but it is a really nice guy and his merchandice is exactly what he claims it to be.

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palerider
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Re: E0471 - are my eyes deceiving me? $$$

Post by palerider » Sat Nov 22, 2014 12:14 pm

Tatooed Lady wrote:Gray market? Secondwind? You make it sound so...seedy. Like it's a guy with a laptop and trench coat selling them from an old phone booth.
well, I tend to refer to my in person trades as "drug deals at the local coffee joint" *giggle*

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Re: E0471 - are my eyes deceiving me? $$$

Post by Paul B » Sun Nov 23, 2014 8:22 am

Craigs List also has some great deals. I just picked up a Respironics DS760 bipap with 200 hours on it, which is almost new, with humidifier for $300. Just be careful where you go and take someone along with you.

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Re: E0471 - are my eyes deceiving me? $$$

Post by palerider » Sun Nov 23, 2014 2:08 pm

Paul B wrote:Craigs List ... Just be careful where you go and take someone along with you.
so far all my drug deals, er, cpap buys, have been conducted at starbucks... they're ubuquitous, there are usually plenty of people around, and they almost always have power outlets handy to allow plugging in the machine and testing it. I just suggest it as protection for both of us when arranging a meet, and so far, everybody's been thrilled at the idea.

plus you can get some usually decent coffee

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DeadlySleep
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Re: E0471 - are my eyes deceiving me? $$$

Post by DeadlySleep » Sun Nov 23, 2014 4:39 pm

cnaumann wrote:Gray market is anything that is being sold through an unoffical chanel.
I never buy from this type of market because I don't like the smell of perfume.

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Tatooed Lady
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Re: E0471 - are my eyes deceiving me? $$$

Post by Tatooed Lady » Sun Nov 23, 2014 5:12 pm

palerider wrote:
Paul B wrote:Craigs List ... Just be careful where you go and take someone along with you.
so far all my drug deals, er, cpap buys, have been conducted at starbucks... they're ubuquitous, there are usually plenty of people around, and they almost always have power outlets handy to allow plugging in the machine and testing it. I just suggest it as protection for both of us when arranging a meet, and so far, everybody's been thrilled at the idea.

plus you can get some usually decent coffee

Crap...I got screwed outta coffee???

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Re: E0471 - are my eyes deceiving me? $$$

Post by palerider » Sun Nov 23, 2014 5:26 pm

Tatooed Lady wrote:
palerider wrote:plus you can get some usually decent coffee
Crap...I got screwed outta coffee???
I can send you a gift card, if you like

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Re: E0471 - are my eyes deceiving me? $$$

Post by Midnight Strangler » Sun Nov 23, 2014 7:04 pm

DeadlySleep wrote:
cnaumann wrote:Gray market is anything that is being sold through an unoffical chanel.
I never buy from this type of market because I don't like the smell of perfume.
bwaaahahahaaahahahaaaa!!!