Persistence Pays-Got a new machine coming my way!

atruvirgo · Post by **atruvirgo** » Thu Jul 12, 2007 8:22 am

I wrote my doctor a letter last friday stating that is was absolutely necessary that I be provided with a machine that gives me data. He had argued the point at my last visit until I either wore him down or helped him see the light! I said if I was a diabetic and you told me to take insulin and never checked my progress how would you know that my treatment was effective?? I told him in order for me to be compliant and to do the best job I can at managing my health I had to have that kind of feedback. At the end of the appointment he told me to decide what kind of machine and mask I want and let the nurse know so she could order it. So I sent a fax'd letter on friday and APria called Tuesday to say they had my order ready and did i want the machne with the smartcard..I said Hell Ya!...billed to the insurance and all done. So in a few days I will go get it. Yeah!!!

TXKajun · Post by **TXKajun** » Thu Jul 12, 2007 8:23 am

Awright!! It sometimes pays to be a persistent squeaky wheel!

Kajun

tangents · Post by **tangents** » Thu Jul 12, 2007 8:25 am

Way to Go!!

You're an inspiration to us all.

Let us know when you get it, and how it goes.

Cathy

Slinky · Post by **Slinky** » Thu Jul 12, 2007 9:22 am

Good on you! Way to go! CONGRATULATIONS! Enjoy!

ozij · Post by **ozij** » Thu Jul 12, 2007 9:31 am

Bravo!!! (and I don't mean the mask...)
Guess it should be "Brava!!!"

O.

Coastal_ZZs · Post by **Coastal_ZZs** » Thu Jul 12, 2007 9:37 am

I spent a lot of time researching and preparing my speech for my doctor. Called to see when I could see him. They asked why, I told them I needed a different machine. They asked which one. I told them. They said come by and pic up the prescrip! DANG! Well, I think I am going to do the same for the software and see what happens!

atruvirgo · Post by **atruvirgo** » Thu Jul 12, 2007 8:28 pm

Yes it is nice to win a debate now and then!!!! I mean really....I work at a school...what if students took tests but never got a grade to show how well they did???? What's the payoff???

jennmary · Post by **jennmary** » Thu Jul 12, 2007 9:22 pm

I have an odd question....I am sorry if it seems dumb.

I have had my machine just over a month. My insurance purchased after 30 days....so it is now mine, no rental.

If my doc decides I need an apap or bipap and prescribes a new machine do I give them back the other one? And would the insurance cover another machine so soon just because it is a different one? Just curious.

Coastal_ZZs · Post by **Coastal_ZZs** » Fri Jul 13, 2007 5:07 am

jennmary wrote:I have an odd question....I am sorry if it seems dumb.

I have had my machine just over a month. My insurance purchased after 30 days....so it is now mine, no rental.

If my doc decides I need an apap or bipap and prescribes a new machine do I give them back the other one? And would the insurance cover another machine so soon just because it is a different one? Just curious.

I don't consider that a dumb question at all! Just prepare for yourself for the prior helpful, friendly, courteous and kind people of your DME changing up a little bit as they try and tell you why you DON"T need another machine...

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CPAPopedia Keywords Contained In This Post (Click For Definition): bipap, DME, APAP

Guest · Post by **Guest** » Fri Jul 13, 2007 8:49 am

jennmary wrote:I have an odd question....I am sorry if it seems dumb.

I have had my machine just over a month. My insurance purchased after 30 days....so it is now mine, no rental.

If my doc decides I need an apap or bipap and prescribes a new machine do I give them back the other one? And would the insurance cover another machine so soon just because it is a different one? Just curious.

It depends on your insurance really, some of them will purchase a new machine only every 5 years if the old machine is broke, some will purchase even if it isn't. I haven't ran into a situation where insurance hasn't purchased a machine if it is a different HCPC code, but since a CPAP and an APAP are the same HCPC code, that doesn't really apply in your case. Last but not least, I have had 5 patients in the last month that have tried to get insurance to purchase an APAP after they had purchased a CPAP. We tried every angle under the sun, but none of them got approved. However that's not to say yours won't, there's no harm in trying.

TXKajun · Post by **TXKajun** » Fri Jul 13, 2007 9:19 am

On a kinda/sorta related thought, what happens if your employer changes insurance carriers? We seem to get a new insurance plan every year. I haven't tried getting a new mask or APAP since my original insurance plan about 2.5 years ago.

Kajun

darthlucy · Post by **darthlucy** » Fri Jul 13, 2007 11:06 am

Anonymous wrote:
jennmary wrote:If my doc decides I need an apap or bipap and prescribes a new machine do I give them back the other one? And would the insurance cover another machine so soon just because it is a different one? Just curious.
It depends on your insurance really, some of them will purchase a new machine only every 5 years if the old machine is broke, some will purchase even if it isn't.

Don't ya just hate it when those darned CPAPs go jumping off of 10-story buildings? Oops! It broke! Imagine that!

jennmary · Post by **jennmary** » Fri Jul 13, 2007 11:53 pm

That sounds a WHOLE lot more fun that my idea of oops....got water in it. darn. lol

I have VERY good insurance. But I dont think they would cover an auto after just buying a CPAP. Not saying I even want one. I was just curious. Thanks. I guess I could go with an auto bipap. lol kidding kidding. I love my elite.

geoDoug · Post by **geoDoug** » Sat Jul 14, 2007 12:44 am

atruvirgo wrote:I wrote my doctor a letter last friday stating that is was absolutely necessary that I be provided with a machine that gives me data....So in a few days I will go get it. Yeah!!!

Woohooo!!! Congratulations! I use the diabetic analogy all the time. It sounds like we've got very similar situations--both dealing with Apria and both attempting to upgrade to real data-collection machines. I've got my followup to upgrade scheduled for the 23rd.

jennmary wrote:I have an odd question....I am sorry if it seems dumb.

FAAAAAR from a dumb question. Knowing how insurance companies operate this is my guess: if the machine is rent-to-own, then essentially what's happening is you are renting up to the value of the machine then you own it outright. During that period they will exchange it. If they outright bought it at the time, they won't exchange it. That's just my guess, though. I'd love to know the answer. What's your insurance company?

Doug.

jennmary · Post by **jennmary** » Sat Jul 14, 2007 12:58 am

I have blue shield. It is throught the county and we pay big bucks for it. They cover 100% with zero copay and zero deductable. They paid for the machine outright after the first 30 days. I guess the 30 days was just to make sure I was using it. I really do get good benefits from them. From what I have read I realize that I get a whole lot more covered than most people. I am thankfull for this. I actually really dont think I need an auto. The air swallowing has gone down (though not completely gone). I am not uncomfortable with the 14 pressure, and dont even really notice it anymore. Even with a few glasses of wine in me my AHI stays around 3...without the wine its at about 2.6.
I can see how an auto would help a lot of people. But I am not having adjustment problems and am very happy with the machine I have. I am always just curious about just about everything. lol I am still new to the insurance end of this whole business. I have never had to deal with my insurance company really. They have always just paid for everything with no questions asked.

Mask

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Persistence Pays-Got a new machine coming my way!

Persistence Pays-Got a new machine coming my way!

Re: Persistence Pays-Got a new machine coming my way!