A Conflict of Interest???

blarg · Post by **blarg** » Sat Jan 06, 2007 1:10 am

Rabid1 wrote:Gracias my friend! Basement eh? Did my wife tell you I snored THAT loud??

De nada. I haven't talked to your wife yet, but the only available sleeping areas are the basement or my bed, so I guess you get to pick if you wanna take me up on the offer. lol

milkman · Post by **milkman** » Sat Jan 06, 2007 3:10 am

I have a combo sleep doc/sleep lab/DME here in Portland and have had a great experience from day one with quality service and a lot of convenience.
Had my split night study a couple of days after my initial appointment with the doc. Walked out of the study at 8:30 am with a remstar pro2 under my arm. Turns out the minimum machine they provide has full recording capabilities. This was before I knew any better and before I found this forum. The doc made it clear when he reviewed my study with me that morning that I could get the equipment anywhere I wanted, but they would be happy to set me up right there if I wanted. Knowing nothing about cpap, I let them set me up. I have severe OSA and my insurance bought my machine outright the first month without any rental period. After about 6 months, I went in for a follow up and told the doc I was still tired much of the time. The encore pro report showed my AHI running between 4 and 7. My titrated pressure was 9, he said they would up the pressure to 10. Told me to try that for 4 weeks and if the pressure change didn't help, we would look at an auto. I came back and while my AHI improved, it as still over 5 many nights. He looked at the reports and said OK, I'm going to have our DME coordinator give you an auto. I told him my pro2 had already been purchased 8 months ago. He said "oh, our dme coordinator is easy to work with, lets go talk to him." The DME coordinator said "we will just swap out the cpap you have now with an auto at no cost to you. You can just take the auto now and drop off your old cpap when ever it is convenient for you. My pro2 was 8 months old and had 1400 hours on it, but I walked out with a brand new M-series auto. The m-series was not yet available when I first had my study, and I've been quite happy with it, but frankly, the auto hasn't made that much difference. MY AHI still varies about the same as it did before. But after 6 weeks on the auto, the AHI vs. pressure chart shows my ideal pressure to be 9, my titrated pressure from my split night study. Maybe I'll be one of those who just will not get the AHI as low as some of you do. My sleep study noted "the AHI is elevated by the score set, however these were mostly REM related variables and rarely associated with arousals." When I have time, I'll post the data to get some of your opinions on it. Thanks for all the great posts.

milkman · Post by **milkman** » Sat Jan 06, 2007 3:12 am

I have a combo sleep doc/sleep lab/DME here in Portland and have had a great experience from day one with quality service and a lot of convenience. Had my split night study a couple of days after my initial appointment with the doc. Walked out of the study at 8:30 am with a remstar pro2 under my arm. Turns out the minimum machine they provide has full recording capabilities. This was before I knew any better and before I found this forum. The doc made it clear when he reviewed my study with me that morning that I could get the equipment anywhere I wanted, but they would be happy to set me up right there if I wanted. Knowing nothing about cpap, I let them set me up. I have severe OSA and my insurance bought my machine outright the first month without any rental period. After about 6 months, I went in for a follow up and told the doc I was still tired much of the time. The encore pro report showed my AHI running between 4 and 7. My titrated pressure was 9, he said they would up the pressure to 10. Told me to try that for 4 weeks and if the pressure change didn't help, we would look at an auto. I came back and while my AHI improved, it as still over 5 many nights. He looked at the reports and said OK, I'm going to have our DME coordinator give you an auto. I told him my pro2 had already been purchased 8 months ago. He said "oh, our dme coordinator is easy to work with, lets go talk to him." The DME coordinator said "we will just swap out the cpap you have now with an auto at no cost to you. You can just take the auto now and drop off your old cpap when ever it is convenient for you. My pro2 was 8 months old and had 1400 hours on it, but I walked out with a brand new M-series auto. The m-series was not yet available when I first had my study, and I've been quite happy with it, but frankly, the auto hasn't made that much difference. MY AHI still varies about the same as it did before. But after 6 weeks on the auto, the AHI vs. pressure chart shows my ideal pressure to be 9, my titrated pressure from my split night study. Maybe I'll be one of those who just will not get the AHI as low as some of you do. My sleep study noted "the AHI is elevated by the score set, however these were mostly REM related variables and rarely associated with arousals." When I have time, I'll post the data to get some of your opinions on it. Thanks for all the great posts.

Linda3032 · Post by **Linda3032** » Sat Jan 06, 2007 1:47 pm

Milkman, sounds like an absolutely great clinic. Please be sure to post your numbers - including leaks. You might be having HIs due to leaks. Also, what do you have your auto set on? If it's wide open, and bumps up to a pressure of 13 or so, that could cause apneas.

HRhuffANDpuff · Post by **HRhuffANDpuff** » Sun Jan 07, 2007 4:14 pm

Rabid1, you need to Chill out Beavis!

How can anyone take this guy seriously? He buys an illegal device over Yahoo and at the same time wants to make a federal case over a lab maximizing their profit. IMO Its not a conflict of interest as long as the patients are being served. Do you have any idea how many lab owners have set up a nephew as a DME?

If you really cared about you're health I'd suggest you forget about finding a lab/DME that meets your business standards and focus on getting an accurate titration and a valid script.

Did anyone else breathe on that Yahoo box? Gross.

Rabid1 · Post by **Rabid1** » Sun Jan 07, 2007 4:35 pm

HRhuffANDpuff,

Thank you for your post. Your contributions to this forum are legendary!

I guess I can understand why someone that uses a male porn star as their avatar would not take me seriously.

What DME do you work for slick?

BTW, the machine I purchased was factory sealed in the box.

pstuck · Post by **pstuck** » Fri Jan 12, 2007 4:22 pm

Aetna or any insurance company for that matter is not going to shell out for the cost of a Bipap without a very sound medical reason for needing one. Bipaps are harder to get covered by insurance companies and strict guidelines must be met. Patient comfort is not one of those guidelines.