new machine, first night

[vicchap1]

ok, here goes my first post.

I did my two night sleep study a few weeks ago. Today they brought me my cpap machine. Why do I feel like I was sold a vw for the price of a caddy.

Although insurance is paying 80 % of 800 dollars., which is what they say they will charge them. Seem high for no more features in machine. For now, i am renting the machine. This is what the insurance wanted to do for a short time.

They sent me a REMstar Basic M Series with Heated Humidifier. WIth the setting at 6 ramping to 8, I guess sleep problem is not too bad.

My question is , who determines how feature rich a machine i get?

The medical supply company said that this is what the doctor ordered. is this true.

Any extra info would be great.

Thanks in advance for the help.

[bluegrassfan]

They all do that....doesn't mean it's right...big business. You probably need to post some of your findings from the final sleep study. What your AHE is , how many CA's, how many Ob's etc. Someone will get on here who is better than me and give you some direction. The basic machine may do the job for you...then again it might not. Depends on your problems or lack of problems. I've tried the basic machine, same as yours, I'm having problems still after 2 months, so I'm right now back to the doctor asking for an updated machine that will tell me what kind of therapy I'm getting. Read the old posts...world of knowledge in them. Saved my sanity! bob

[snoregirl]

The basic machine you have is fine if you want to go only by how you feel as opposed to looking at numbers.

I personally like to know what the numbers say to make sure I am getting the best possible treatement.

You should have your prescription. That is the only way to know "what the doctor ordered" If he just put CPAP and pressure, than they can give you the cheapest machine they can. If he specifies a certain machine, or feature that only comes on a certain machine then they can't palm off the cheapest on you.

Not only should you get your prescription, but get copies of your sleep studies too. While $160 out of your pocket isn't bad for even the basic machine, you would most likely be paying the same for a machine with more features.

[Slinky]

For insurance purposes there are ONLY two types of xPAP machines: CPAPs and Bi-Levels (BIPAP is a proprietry brand name). The reimbursement for ALL CPAPS is the same whether for a bare bones model or a fully data capapble AutoPAP. The reimbursement for all bi-levels is at a higher rate but the same for all bi-levels.

So, REFUSE or return ANY CPAP the DME tries to pawn off on you that is NOT FULLY DATA CAPABLE. Contact your sleep lab/doctor IMMEDIATELY and tell them that the CPAP the DME has provided you with is NOT fully data capable and question the sleep lab/doctor HOW on earth they intend to monitor your CPAP therapy and response to CPAP therapy WITHOUT the full data being available to them - or aren't they interested in your health care beyond whether you are compliant or not?

[Wulfman]

ok, here goes my first post.

I did my two night sleep study a few weeks ago. Today they brought me my cpap machine. Why do I feel like I was sold a vw for the price of a caddy.

Although insurance is paying 80 % of 800 dollars., which is what they say they will charge them. Seem high for no more features in machine. For now, i am renting the machine. This is what the insurance wanted to do for a short time.

They sent me a REMstar Basic M Series with Heated Humidifier. WIth the setting at 6 ramping to 8, I guess sleep problem is not too bad.

My question is , who determines how feature rich a machine i get?

The medical supply company said that this is what the doctor ordered. is this true.

Any extra info would be great.

Thanks in advance for the help.

Your pressure has nothing to do with your apnea severity. The pressure is supposed to be determined to be what it takes to keep your airway open to eliminate your events.

Who determines what machine you get? Ultimately YOU do/can. In these times with all the information on the Internet, people need to do their homework BEFORE the get their equipment and into their therapy.

Unless your doctor owns or is fully involved with the sleep lab and DME supplier, the doctor usually doesn't determine which make/model of machine you get.....UNLESS you need a BiPAP/VPAP type of machine (which are required for pressures over 20 or special breathing issues.

The DME charges insurance providers the same amount of money whether you get the cheapest machine of the high-end Auto-titrating machine.
Consequently, if you want to drive a Caddy for the price of a Caddy.....ask for the Caddy. If you WERE buying a car, you wouldn't lay down the price of a Cadillac and take whatever they gave you.....would you? Same difference here.....except for the amount of dollars we're talking about. In some way or other, it's YOUR money that you and your insurance provider are spending. Don't accept the cheapest thing they give you.

Good luck,

Den

[bp4Christ]

i got machine yesterday afternoon, and last night was my first night. the dme, as everybody seems to be calling them, brought me a REMstar Pro m series, with cflex and ramp. i looked at the paperwork and that is what my sleep study doctor specifically order it looks like, and he told them to set the pressure on it to 14 and the cflex to 3, i guess based off of my study results. i am starting to become concerned though, is the machine i got crap? at my second study, the started me off i guess on the basic air pressure, and when i finally got to sleep, which took forever becuase i am normally still at work at 10pm, it was 1am, and they woke me up at 5am, i guess they just monitored my incidents and kept turning up the pressure until they found that pressure that stopped my incidnets. they said i went from twenty something an hour, to the norm of like 4 or 5 is what i think they said, which is normal. what i don't get is that my insurance paid 100% of the sleep study costs, all i had to do was go, but they are only paying 80% of the machine, and i am having to rent it for a year, and then at the end of like 12 or 13 months, according to the dme, the insurance company will offer me the option of justing making it a purchase instead of a rental, because the cost would have been met at that point. the total cost on the sheet was like $939, and i had to pay a $67 dollar copay, and it said something about that being an estimate, so i am still not totally sure or understand that, i told the guy that i could not affor $67 dollars a month for that machine, i just am not able right now to really fit that in a budget it would seem like, but i guess you find a way for things you need. does anybody have any advice? sorry topic creator, i don't mean to ask a question and steal your topic from you.

[bp4Christ]

i also didn't even get one of those cards that records your data. but the dme said he was going to look into getting one of those for me, try to find one i guess.

[Slinky]

Did you check out the price of the Respironics Pro M series at cpap.com?? Its a good machine. But check out the price. Can you handle the one time cost of purchasing it outright?

Check w/your insurance company if they will reimburse you directly if you purchase the equipment from a reputable online DME supplier out of your own pocket and then submit the statement of proof of purchase and proof of payment to them for 80% reimbursement? Point out the savings in cost to them if they would allow you to do so. Also point out that since you are the insured w/them that you are "contracted" with them.

And that $939 a month doesn't work out to a $67 a month copay for you. $67 a month for 13 months comes to $871. Something isn't kosher here. To the best of my knowledge the CPAP is the ONLY piece of equipment that is subject to the capped rental. The humidifier, whether integrated or not, the mask, hoses, etc. are all immediate purchases.

[Wulfman]

i got machine yesterday afternoon, and last night was my first night. the dme, as everybody seems to be calling them, brought me a REMstar Pro m series, with cflex and ramp. i looked at the paperwork and that is what my sleep study doctor specifically order it looks like, and he told them to set the pressure on it to 14 and the cflex to 3, i guess based off of my study results. i am starting to become concerned though, is the machine i got crap? at my second study, the started me off i guess on the basic air pressure, and when i finally got to sleep, which took forever becuase i am normally still at work at 10pm, it was 1am, and they woke me up at 5am, i guess they just monitored my incidents and kept turning up the pressure until they found that pressure that stopped my incidnets. they said i went from twenty something an hour, to the norm of like 4 or 5 is what i think they said, which is normal. what i don't get is that my insurance paid 100% of the sleep study costs, all i had to do was go, but they are only paying 80% of the machine, and i am having to rent it for a year, and then at the end of like 12 or 13 months, according to the dme, the insurance company will offer me the option of justing making it a purchase instead of a rental, because the cost would have been met at that point. the total cost on the sheet was like $939, and i had to pay a $67 dollar copay, and it said something about that being an estimate, so i am still not totally sure or understand that, i told the guy that i could not affor $67 dollars a month for that machine, i just am not able right now to really fit that in a budget it would seem like, but i guess you find a way for things you need. does anybody have any advice? sorry topic creator, i don't mean to ask a question and steal your topic from you.

i also didn't even get one of those cards that records your data. but the dme said he was going to look into getting one of those for me, try to find one i guess.

bp,

Make sure you read all the documents and understane everything before you accept anything or agree to the terms.

DO THE MATH.

If your co-pay is $67 per month for 12 of 13 months, that's $804 or $871 for your share. Then they're going to bill your insurance another $939 for a machine that out-of-pocket would cost you $596.00 from CPAP.COM.

https://www.cpap.com/productpage-bundle ... undle.html

That's roughly $1800 or more that they're going to charge. You could buy 3 machines for that amount.

As far as the Smartcard that SHOULD have been in your machine......it's SUPPOSED to be in the machine (and come with the package). It is what stores the nightly detailed data from your sleep time, including your compliance information. The machine you were given (M Series Pro) is essentially a good machine as it DOES record the detailed information. BUT, they're charging 3 times the price for it.

Den