CPAP vs APAP - Choice?

eugene · Post by **eugene** » Thu Apr 14, 2005 5:18 pm

I know this has been covered in this forum and I did do a search and found some posts.

I picked up a RESmed CPAP machine with Swift interface today. My sleep doc's office had told me that I was going to get an APAP, but the DME told me that I didn't need the APAP (my setting is 9). Again, I have read the posts on this forum and there seems to be a consensus that the APAP is the preferable machine due to its ability to adjust to ones needs. The cost of either machine is covered by insurance or, if not, I would be happy to pay the extra cost.

Help or suggestions would really be appreciated.

Bill

Mikesus · Post by **Mikesus** » Thu Apr 14, 2005 5:21 pm

Couple of suggestions, insist on an Apap, or get your RX and purchase online. I did and got reimbursed. Actually paid less with my copay buy purchasing online than if I had gone with the DME...

wading thru the muck! · Post by **wading thru the muck!** » Thu Apr 14, 2005 5:36 pm

Bill,

Your Doc told you you were getting an APAP, but did the prescription say APAP? If not you may have gotten STUCK. Call the DME and tell them you did not get what your Doc told you that you were going to get. Tell them there may have been a problem with the prescription. Find out from the Docs office if the prescription said APAP specifically, tell them the Doc told you your were going to get an APAP. I would consider not using the machine until you get things straightened out. Otherwise the DME may tell you that you used it so your stuck with it. Hope you can get this resolved without any problems.

coffee · Post by **coffee** » Fri Apr 15, 2005 7:58 am

the DME told me that I didn't need the APAP

The DME may be reimbursed the same set amount for a CPAP or APAP by your insurance. The billing code is apparently the same for both. The APAP will cost them more and give them a smaller profit on the deal. This may be a factor why they are not offering you the best care available. CPAPs work for some but are primitive devices compared to APAPs.
Get the APAP!

Mikesus · Post by **Mikesus** » Sat Apr 16, 2005 5:28 am

coffee wrote:
the DME told me that I didn't need the APAP
The DME may be reimbursed the same set amount for a CPAP or APAP by your insurance. The billing code is apparently the same for both. The APAP will cost them more and give them a smaller profit on the deal. This may be a factor why they are not offering you the best care available. CPAPs work for some but are primitive devices compared to APAPs.
Get the APAP!

Isn't it great when the DME decides what the Doctor Wants? G's. If your doc said yes to an AUTO, then fire the DME and get a new one.

The DME is like a pharmacist in a way, they are giving you what the Doctor ordered. If the doc said give patient X an antibiotic, you sure wouldn't go home with a coulple of aspirin cuz they were cheaper. Would you?

DME's HAVE NO PLACE DECIDING WHAT THE PATIENT NEEDS WHEN THE DOCTOR HAS SPECIFIED OTHERWISE!!

If they are not helpful, you can try to find another DME, or resort to purchasing online, (which more than likely will get you a better machine, and you STILL can get reimbursed) good luck either way!

wading thru the muck! · Post by **wading thru the muck!** » Sat Apr 16, 2005 5:40 am

mikesus wrote:DME's HAVE NO PLACE DECIDING WHAT THE PATIENT NEEDS WHEN THE DOCTOR HAS SPECIFIED OTHERWISE!!

My guess is the doc said an APAP to the patient but didn't specify on the prescription. Remember the prescription also called for a fixed 9cm.

This is why we have to be proactive and sometimes maybe a pain-in-the-ass about making sure we don't get STUCK with some equipment we don't want.

This is a good less for the rest of us to stay on our toes!

Mikesus · Post by **Mikesus** » Sat Apr 16, 2005 6:09 am

wading thru the muck! wrote:
mikesus wrote:DME's HAVE NO PLACE DECIDING WHAT THE PATIENT NEEDS WHEN THE DOCTOR HAS SPECIFIED OTHERWISE!!
My guess is the doc said an APAP to the patient but didn't specify on the prescription. Remember the prescription also called for a fixed 9cm.

This is why we have to be proactive and sometimes maybe a pain-in-the-ass about making sure we don't get STUCK with some equipment we don't want.

This is a good less for the rest of us to stay on our toes!

I was going by the statement of

but the DME told me that I didn't need the APAP (my setting is 9)

Implying that they knew about it, but decided against it because his pressure is only 9.

Either way, I would set them straight and insist that you get what your doc ordered.

wading thru the muck! · Post by **wading thru the muck!** » Sat Apr 16, 2005 6:21 am

Mike,

My guess is taht the Doc did not specifically say APAP on the prescription. I think the DME only commented about the APAP because santacruz mentioned it. I think this probably happens fairly often. I do agree that the DME should not have been so quick to disregard what the patient is telling them. I just hope that Bill (santacruz) does not get STUCK with this machine. I can see a senario where the Doc didn't specify and the DME hangs his hat on that fact. We all know that "once the plastic has been opened, you bought it" line form the DMEs.