DMEs

nlt6mor · Post by **nlt6mor** » Wed Dec 23, 2015 1:45 pm

I just talked to my DME first time in months. I have been hosing for 4 1/2 months now and getting curious about a new mask to help with some small irritating leaks. Wanted to know when I was allowed a new mask purchase on insurance. She said 6 months, so I will wait to have for a back up and to try a different mask for leaks.
I let her know how I was doing. Pretty well I must say, considering all the other stories told on this site. I told her my AHI was between 2 and 5 for the first three months. This was at the prescribed CPAP pressure of 8. I told her for the past month I changed the machine to APAP and pressure range of 8 to 12 and now my AHI was between 1 and 2. I naïvely thought this would be good news to her. But alas, she read me the riot act starting with "You can't do that!" It illegal to mess with the prescription. I told yes I can, it was easy! Anyway so in your opinion, is the 6 month rule normal to get a new mask. How long will I go to the pokey for changing my prescription? lol Merry Christmas

Julie · Post by **Julie** » Wed Dec 23, 2015 1:49 pm

You must call your insurance co. for that info and never depend on DME's to tell you that.

And go right ahead and change your pressure (we all do) ... it's your therapy, not theirs!

Cardsfan · Post by **Cardsfan** » Wed Dec 23, 2015 1:55 pm

You should be out on good behavior by Valenttines Day.
Call your ins. Co and ask them how often your plan covers mask replacements.

nlt6mor · Post by **nlt6mor** » Wed Dec 23, 2015 1:58 pm

Thanks! DMEs are just much easier to reach than calling into my insurance companies help line. Takes forever. By the way just curious. Any one know if they allow you to bring CPAP machines, while in prison?

BlackSpinner · Post by **BlackSpinner** » Wed Dec 23, 2015 2:01 pm

nlt6mor wrote:Thanks! DMEs are just much easier to reach than calling into my insurance companies help line. Takes forever. By the way just curious. Any one know if they allow you to bring CPAP machines, while in prison?

They will even provide one for you!

bwexler · Post by **bwexler** » Wed Dec 23, 2015 2:08 pm

I heard it is one year minimum sentences.
6 months seems common, but only your insurance company can tell you for sure.
Yes they will provide you with one.

grayghost4 · Post by **grayghost4** » Wed Dec 23, 2015 2:16 pm

I will probably go away for the rest of my life ( if they catch me)... I have sold many cpap's and masks without a script and I experiment with pressure changes and machine changes for my self often.
Because I want to know how they all work

Janknitz · Post by **Janknitz** » Wed Dec 23, 2015 2:35 pm

I don't know if I'd trust those prison DME's. On Orange is the New Black one inmate supposedly had a CPAP--but it was actually an oxygen concentrator.

When you get to CPAP prison, write and tell us all about it. I think every single person here belongs there, according to the law your DME made up.

chunkyfrog · Post by **chunkyfrog** » Wed Dec 23, 2015 4:09 pm

THEY WILL NEVER TAKE ME ALIVE!

LSAT · Post by **LSAT** » Wed Dec 23, 2015 6:08 pm

grayghost4 wrote:I will probably go away for the rest of my life ( if they catch me)... I have sold many cpap's and masks without a script and I experiment with pressure changes and machine changes for my self often.
Because I want to know how they all work

Now you did it.....I think I hear Sheriff coming....

chunkyfrog · Post by **chunkyfrog** » Wed Dec 23, 2015 6:26 pm

Sheriff is on our side; like Robin Hood.

flightco · Post by **flightco** » Wed Dec 23, 2015 6:49 pm

nlt6mor wrote:I just talked to my DME first time in months. I have been hosing for 4 1/2 months now and getting curious about a new mask to help with some small irritating leaks. Wanted to know when I was allowed a new mask purchase on insurance. She said 6 months, so I will wait to have for a back up and to try a different mask for leaks.
I let her know how I was doing. Pretty well I must say, considering all the other stories told on this site. I told her my AHI was between 2 and 5 for the first three months. This was at the prescribed CPAP pressure of 8. I told her for the past month I changed the machine to APAP and pressure range of 8 to 12 and now my AHI was between 1 and 2. I naïvely thought this would be good news to her. But alas, she read me the riot act starting with "You can't do that!" It illegal to mess with the prescription. I told yes I can, it was easy! Anyway so in your opinion, is the 6 month rule normal to get a new mask. How long will I go to the pokey for changing my prescription? lol Merry Christmas

It seems a lot of DME's are weird or on a power trip. I got the same treatment from mine, but thanks to this site I knew what to say. I told her to show me the law in writing and she could not do it or tell me where to find it. I said I am sure if it is OK for me to adjust my own insulin (which can kill you if you use too much) I am sure it is ok to adjust air pressure. My sleep doc, on the other hand, told me he was proud of me for figuring out what was needed and lowering my AHI.

Sheriff Buford · Post by **Sheriff Buford** » Wed Dec 23, 2015 7:48 pm

Oh Yea??? Everybody up against the wall! You got anything that'll poke or cut me? I've never frisked a frog... this will be fun!!

I only use the DME to order stuff. I get supplies every 3 months, but every time I call my DME (Crapria) they tell me I'm only eligible every 6 months. We always get a good laugh about it.

Sheriff

Wulfman... · Post by **Wulfman...** » Wed Dec 23, 2015 8:36 pm

nlt6mor wrote:I just talked to my DME first time in months. I have been hosing for 4 1/2 months now and getting curious about a new mask to help with some small irritating leaks. Wanted to know when I was allowed a new mask purchase on insurance. She said 6 months, so I will wait to have for a back up and to try a different mask for leaks.
I let her know how I was doing. Pretty well I must say, considering all the other stories told on this site. I told her my AHI was between 2 and 5 for the first three months. This was at the prescribed CPAP pressure of 8. I told her for the past month I changed the machine to APAP and pressure range of 8 to 12 and now my AHI was between 1 and 2. I naïvely thought this would be good news to her. But alas, she read me the riot act starting with "You can't do that!" It illegal to mess with the prescription. I told yes I can, it was easy! Anyway so in your opinion, is the 6 month rule normal to get a new mask. How long will I go to the pokey for changing my prescription? lol Merry Christmas

In those cases, demand ( I repeat.... DEMAND ) that they show you the statutes that prohibit the owner of the machines from changing their own settings. They won't be able to provide them......they don't exist. The laws only apply to DMEs and their employees (non-owners). They're not supposed to change settings without an "order" from a doctor.

As an example, just because a pharmacy gives you a prescription for a medication that a doctor has prescribed, doesn't mean they can force you take your prescribed dosage or even make you take it at all.

But, another CYA method is to use software and monitor your therapy and save your reports. Then, you could show them that your therapy is actually better with the settings you picked.

Den

.

archangle · Post by **archangle** » Thu Dec 24, 2015 12:44 am

The worst thing is that the CPOPE will excommunicate you and your CPAP will stop working.

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