Advice needed for struggling CPAP user

[Fubblin]

Thanks for the encouragement. I have heard of the SleepWeaver, I was looking into the Elan and Advance 3 masks ago but have not gone any further. The design looks pretty interesting but I didn't try it at first because I was told it has issues with leaking. At this point though I think that is going to be the next mask I try.

Unfortunately I found out today from the DME I have 2 weeks to bring up my compliance or I have to give back my Dreamstation, they also informed me I cannot get any supplies until I prove that I am using it. I am hoping I can get my doctor to advocate on my behalf that I am trying. Does anyone have experience dealing with insurance/DME when it comes to compliance and working with the insurance company? I really want to use the therapy but I am afraid 2 weeks is not enough time, especially since I currently have no mask that works for me.

[Pugsy]

Use the machine while awake watching TV or reading a book or something.
That time will count towards the compliance usage hours needed.
You can't just turn the machine on and let it blow without being attached (it knows if breathing is going on or not) but it doesn't know if you are asleep or not and will simply record the usage.

[Fubblin]

That is what I was doing to get acclimated to the PAP, the main problem I have now is wearing any of the masks available to me for 4 hours straight. I suppose I could just try and tough threw it a few nights or take a pain pill clock some hours. I was under the assumption I had to have 4 consecutive hours per night in order to comply, is this correct? The rough outline I was told today was they would like to see at least 4 hours consecutively for 22 days out of the month with a review happening after the first 60 days of receiving my machine and a return on no compliance within 90 days, but my DME has lied to me before so I may just have to verify it directly with my insurance company.

[Pugsy]

It doesn't have to be 4 hours straight. It's cumulative hours within a 24 period.
An hour here and an hour there will add up. It doesn't have to be 4 hours all in one session. You can have multiple sessions.

In most cases it's at least 4 hours of use for 70% of 30 nights and only the 30 has to be consecutive.
You can't take 3 months to come up with 22 nights of at least 4 hours of usage.
Most insurance companies will mimic Medicare's requirement and that's what Medicare wants.
Now sometimes DMEs will make out like it is more than that like 4 hours consecutive or 22 nights consecutive but that's more to light a fire under someone.
When in doubt check directly with your insurance company as to what their requirements are. Some insurance plans don't require any proof of compliance but DMEs tell everyone the same thing.

[Fubblin]

Thank you for the clarification on the 4 hours of compliance per 24 hour period, the DME is not very clear about it. I meant to say they told me 22 days per 1 month period they want to see 4 hours of use, having 60 days initially from when I received the machine to have free usage with the device being taken away 90 days from receipt of machine if compliance is not met. I will check directly with my insurance company, but they also told me I could try as many masks as I wanted to in the first 30 days as long as I returned them and my DME would not comply. My respiratory therapist told me anything more than 8 or 9 returns in a short period of time would count as "abuse" and the manufacturer would not honor the return, but the other staff at the DME did not want to refit me after my 2nd mask. After arguing with them they offered me one final "courtesy refit" and said the only way they could do it is if the mask was left up front for me without actually seeing anyone (that is when I got my P-10). This all sounds like some incredibly shady business practices to me. My insurance tells me one thing and the DME tells me something completely different.