Hi All. I had my first sleep study on 7/6 and was diagnosed with mild sleep apnea. I sent back for my CPAP study on 7/13 and am now I'm waiting for a call from my doctor on what's the next step. Any recommendations on machines, masks and anything else would be greatly appreciated.
New and looking for any advice
6 posts
• Page 1 of 1
1] Call your insurance company.
a] Ask them what local DME CPAP suppliers they are contracted with
b] Ask them what your DME CPAP benefits are: copays? deductibles?
2] Since you found this forum I can guarantee you that you are NOT going to be satisfied w/anything LESS than a FULLY DATA CAPABLE CPAP.
a] Start checking out CPAPs at cpap.com. Never mind price at this point. Just check out the features. You can choose those CPAPs that interest you and cpap.com offers the opportunity to run a comparison of features of those that interest you.
b] Check out autoPAPs separate from "just" CPAPs. You might well get "auto fever" before you are done reading here.
3] Prepare a WRITTEN request for:
a] The doctor's dictated results of BOTH your sleep evaluation AND your titration studies
b] The full scored data summary report w/condensed graphs for BOTH your evaluation AND your titration studies
c] The script (equipment order) so that you may "shop" your local DME options
d]If you will not be seeing the sleep doctor for a consultation again FAX this above request to him and keep the proof of FAX. If you will be seeing him BEFORE you receive your equipment then you can just GIVE the request to him TO BE PUT IN YOUR RECORDS as well as discuss the results w/him.
Fully data capable CPAPs I am aware of:
a] Resmed S8 II Elite w/EPR
b] Resmed S8 Elite w/EPR
c] Respironics M Series Pro w/C-Flex
Fully data capable autoPAPs I am aware of:
a] Resmed S8 II AutoSet
b] Resmed S8 AutoSet Vantage
c] Respironics M Series Auto w/A-Flex
d] Respironics M Series Auto w/C-Flex
e] Puritan Bennett GoodKnight 420E
You will get just as good therapy w/the CPAPs as you will w/the autoPAPs - but the autoPAPs are like two in one as they can be used in CPAP mode as well as auto mode. The DATA CAPABILITY is THE important issue, moreso than auto or not.
When shopping the local DME suppliers they most likely are going to whip out a bare bone, compliance data capable only device. You can counter by asking for one of the autos. Most likely they aren't gonna wanna provide one. But if you mention the importance of the data capabilities to you that gives them the negotiating room to offer you a fully data capable CPAP. Voila! You should both be happy!
Understand that most all insurances pay by HCPCS code, NOT by brand or model. And when insurances contract w/local DME suppliers they agree on one set reimbursement fee for that HCPCS code E0601 CPAP. AND autoPAPs are coded as HCPCS E0601 (as well as the CPAPs). The catch is that, of course, the bare bone, compliance data only CPAP "costs" the DME supplier less to buy than the fully data capable autoPAPs. So most protect their profit margin by foisting off as many bare bones, compliance data only CPAPs as they can on unsuspecting new CPAP clients.
When shopping the local DME suppliers be sure to inquire about their mask exchange policy. You will want one that has a lenient mask exchange policy.
And another little secret most local DME suppliers would prefer you not know: Resmed, Respironics and Fisher & Paykel all provide FREE mask exchanges to the local DME suppliers most all of their masks that a client has tried and not been successful w/IF the DME fills out a form and returns that mask W/IN 30 DAYS.
Now, just because so many of us in the forums have encountered lousy local DME suppliers (the reason many of us are here), there ARE GOOD local DME suppliers out there. DON'T go in w/a chip on your shoulder EXPECTING them to try to take advantage of you. Keep an open mind, but be prepared.
Be FIRM, be DIPLOMATIC, be TACTFUL, but be FIRM. YOU are the one paying for this equipment, whether thru insurance OR out of pocket. No difference. W/o YOU they miss out on a lucrative sale. YOU are going to be sleeping w/this device for the next 5 years.
a] Ask them what local DME CPAP suppliers they are contracted with
b] Ask them what your DME CPAP benefits are: copays? deductibles?
2] Since you found this forum I can guarantee you that you are NOT going to be satisfied w/anything LESS than a FULLY DATA CAPABLE CPAP.
a] Start checking out CPAPs at cpap.com. Never mind price at this point. Just check out the features. You can choose those CPAPs that interest you and cpap.com offers the opportunity to run a comparison of features of those that interest you.
b] Check out autoPAPs separate from "just" CPAPs. You might well get "auto fever" before you are done reading here.
3] Prepare a WRITTEN request for:
a] The doctor's dictated results of BOTH your sleep evaluation AND your titration studies
b] The full scored data summary report w/condensed graphs for BOTH your evaluation AND your titration studies
c] The script (equipment order) so that you may "shop" your local DME options
d]If you will not be seeing the sleep doctor for a consultation again FAX this above request to him and keep the proof of FAX. If you will be seeing him BEFORE you receive your equipment then you can just GIVE the request to him TO BE PUT IN YOUR RECORDS as well as discuss the results w/him.
Fully data capable CPAPs I am aware of:
a] Resmed S8 II Elite w/EPR
b] Resmed S8 Elite w/EPR
c] Respironics M Series Pro w/C-Flex
Fully data capable autoPAPs I am aware of:
a] Resmed S8 II AutoSet
b] Resmed S8 AutoSet Vantage
c] Respironics M Series Auto w/A-Flex
d] Respironics M Series Auto w/C-Flex
e] Puritan Bennett GoodKnight 420E
You will get just as good therapy w/the CPAPs as you will w/the autoPAPs - but the autoPAPs are like two in one as they can be used in CPAP mode as well as auto mode. The DATA CAPABILITY is THE important issue, moreso than auto or not.
When shopping the local DME suppliers they most likely are going to whip out a bare bone, compliance data capable only device. You can counter by asking for one of the autos. Most likely they aren't gonna wanna provide one. But if you mention the importance of the data capabilities to you that gives them the negotiating room to offer you a fully data capable CPAP. Voila! You should both be happy!
Understand that most all insurances pay by HCPCS code, NOT by brand or model. And when insurances contract w/local DME suppliers they agree on one set reimbursement fee for that HCPCS code E0601 CPAP. AND autoPAPs are coded as HCPCS E0601 (as well as the CPAPs). The catch is that, of course, the bare bone, compliance data only CPAP "costs" the DME supplier less to buy than the fully data capable autoPAPs. So most protect their profit margin by foisting off as many bare bones, compliance data only CPAPs as they can on unsuspecting new CPAP clients.
When shopping the local DME suppliers be sure to inquire about their mask exchange policy. You will want one that has a lenient mask exchange policy.
And another little secret most local DME suppliers would prefer you not know: Resmed, Respironics and Fisher & Paykel all provide FREE mask exchanges to the local DME suppliers most all of their masks that a client has tried and not been successful w/IF the DME fills out a form and returns that mask W/IN 30 DAYS.
Now, just because so many of us in the forums have encountered lousy local DME suppliers (the reason many of us are here), there ARE GOOD local DME suppliers out there. DON'T go in w/a chip on your shoulder EXPECTING them to try to take advantage of you. Keep an open mind, but be prepared.
Be FIRM, be DIPLOMATIC, be TACTFUL, but be FIRM. YOU are the one paying for this equipment, whether thru insurance OR out of pocket. No difference. W/o YOU they miss out on a lucrative sale. YOU are going to be sleeping w/this device for the next 5 years.
_________________
| Mask: Quattro™ FX Full Face CPAP Mask with Headgear |
| Additional Comments: PR SystemOne BPAP Auto w/Bi-Flex & Humidifier - EncorePro 2.2 Software - Contec CMS-50D+ Oximeter - Respironics EverFlo Q Concentrator |
Last edited by Slinky on Thu Jul 17, 2008 3:13 pm, edited 1 time in total.
Women are Angels. And when someone breaks our wings, we simply continue to fly.....on a broomstick. We are flexible like that.
My computer says I need to upgrade my brain to be compatible with its new software.
My computer says I need to upgrade my brain to be compatible with its new software.
THANKS!
Slinky - THANKS for the post with so much great information. This website and people like you are going to help this process so much easier by helping me be informed. Thanks again.
Thanks, Echo. I don't know how to do it either.
_________________
| Mask: Quattro™ FX Full Face CPAP Mask with Headgear |
| Additional Comments: PR SystemOne BPAP Auto w/Bi-Flex & Humidifier - EncorePro 2.2 Software - Contec CMS-50D+ Oximeter - Respironics EverFlo Q Concentrator |
Women are Angels. And when someone breaks our wings, we simply continue to fly.....on a broomstick. We are flexible like that.
My computer says I need to upgrade my brain to be compatible with its new software.
My computer says I need to upgrade my brain to be compatible with its new software.
a hah, i found it! Go to Collective Wisdom -> then go to whichever category it belongs to, then click "Add Article" at the bottom.
I think this is more than a purchasing primer.. more like, what you should do before or just after your sleep study, or something like that!
anyhoo i have to go to bed now so i'm not going to post the article in the collective wisdom... maybe over the weekend unless you do it first
I think this is more than a purchasing primer.. more like, what you should do before or just after your sleep study, or something like that!
anyhoo i have to go to bed now so i'm not going to post the article in the collective wisdom... maybe over the weekend unless you do it first
PR System One APAP, 10cm
Activa nasal mask + mouth taping w/ 3M micropore tape + Pap-cap + PADACHEEK + Pur-sleep
Hosehead since 31 July 2007, yippie!
Activa nasal mask + mouth taping w/ 3M micropore tape + Pap-cap + PADACHEEK + Pur-sleep
Hosehead since 31 July 2007, yippie!
6 posts
• Page 1 of 1