Question for people being monitored by insurance

[Sasquatchswapgator]

I have not looked at Oscar but will do so later. Having issues with a dry throat because of my mouth being open. Any way to solve this? The dreamwear full face mask I thought was working and now I’m constantly fiddling with it during the night. The mask makes my face hot and I’ll wake up to it “pooting”. I’m using the humidifier. I know I can probably take the mask back to the DME but I’m not sure yet. The dry throat is what is mainly bothering me.

The Dreamwear FFM gets very high ratings. Find it on youtube and watch three or four videos on fitting and adjusting.

You might have your humidifier set too warm.

I’ll be watching the video. I set the tube temp to 65 that’s probably not doing anything. Was on 81. I put the climate control on auto. When it was on manual it was on 4. It’s already humid here. Last night was 80%. I’ll be doing more research before I fiddle with anything again.

[Sasquatchswapgator]

I’m still having problems with my mask leaking. I sleep through it so I don’t know until I log into Oscar. It was over 22% at one point. I’m sure that’s why I’m not getting the sleep I need. I noticed when trying to mess with it on being awake when I open my mouth just a little one corner will leak. Not sure that can be fixed. It was fine when I first started therapy. I’ve watched videos and everything else. Is there a way to fix it without forcefully keeping my mouth shut? I can not do that. I have a dreamwear full face mask.

[Julie]

There are so many masks, of diff. types shown on e.g. Cpap.com with lots of info and pix you should have no trouble finding others that will work for you... but 22% is not actually terrible - some leak is compensated for by the machines and won't wreck your AHI or sleep.

[plakky]

I'll just throw this out there: I too would have small leaks from a corner of the Dreamwear Full Face Mask when I would relax and my mouth would slightly open. Tightening the straps helped, although sometimes to a slightly uncomfortable point. Other people swear by mask liners. I ended up trying the Airfit F30i - very similar (practically identical) mask style - and had fewer leaks. As a 100% side sleeper, it seems like the F30i mask is slightly narrower and doesn't get shifted around by movement/the pillow as much as the Dreamwear FFM, and in general the F30i is just a sturdier mask with the same top-of-the-head hose, etc. features.

[ChicagoGranny]

I’m still having problems with my mask leaking. I sleep through it so I don’t know until I log into Oscar. It was over 22% at one point.

That's 22 liters per minute (lpm). Your machine (ResMed) can easily compensate for that much leak. Since it is not waking you, that shouldn't be causing your problems.

I’m sure that’s why I’m not getting the sleep I need.

What are your symptoms?

[4betterO2]

Back to original topic,...
My DME says they receive the data my modem sends, and they keep it in case the insurance asks for compliance. I'd not want to send my data to any other entity (software servers etc.). I'm glad my machine has the modem option, so it can send on its own power, independently from any of the other connectivity technologies and accounts I have. If there is any problem with my data, I can deal with that with my RT directly, in person.

On another note, like the OP I have an oppressive DME, I get the impression that they are under pressure to find reasons to make the patient have to see the sleep doctor, while I prefer to only get an annual visit for the prescription renewal... Since the DME interacts very well with the insurance to get CPAP bills paid, I think it's best to please them and not make changes until the rental period is over.
And btw, Medicare and Medicare advantage companies can ask to see compliance at any time!
Their requirement is that patients use their machine for 4 hours or more per day at least 70% of the time in ANY 90 DAY PERIOD while they are receiving coverage for not just the machine, but also the supplies! Keep that in mind: it means as long as you are getting CPAP care, lifelong, they have the right to ask for compliance data, though they do it rarely past the rental period.

[Pugsy]

And btw, Medicare and Medicare advantage companies can ask to see compliance at any time!
Their requirement is that patients use their machine for 4 hours or more per day at least 70% of the time in ANY 90 DAY PERIOD while they are receiving coverage for not just the machine, but also the supplies!

Who told you that?
Have you seen actual documentation as to that statement from Medicare at Medicare's website?

Proof please in the form of documentation from Medicare and not just "my DME told me or my doctor told me".

I have scoured Medicare's website for such documentation in the past...can't find it. Doesn't mean it isn't there but I sure can't find it.

Plus I have a Medicare Advantage plan and nowhere in the documents does it state that sort of requirement. They do generally follow Medicare's guidelines though....but at Medicare.gov website...the only thing I ever found for requirement pertained to new cpap users within the first 90 days of getting the machine and it was the 4 hour thing for 70% of a 30 consecutive period within that 90 days and then a face to face with the doctor before the 91st day. That's all I have ever found.

Anyone can prove me wrong but I want links to actual documentation and not "so and so told me" because I have realized a long time ago that so and so often doesn't know what they are talking about or just wants to flat out lie.

[chunkyfrog]

Another DME told a lie . . .
We need barrels of truth serum!
Aerosolize it, and pipe it in the window.