Titration results and my doctor

Pilot_Ron · Post by **Pilot_Ron** » Thu Jan 17, 2008 2:48 pm

Well, I was armed with knowledge, and prepaired for battle!!

Thanks to the information received from this forum, I was able to make a stand against a doctor, who I thought was supposed to be this great physician. It turned out to be less than pleasant as it pertains to the equipment he wanted to supply me.

My visit felt more like them getting my order wrong at the drive through at McDonalds than a follow up with a sleep specialist. He wanted to give me a straight CPAP with no data capabilities and when confronted with a reason for my request for Auto w/ A-flex, he wanted to know why I would need such a thing.

He then tried to tell me that an M-series Plus would give me data...yeah ok...I can tell him just as easy as the machine can that I am in compliance! And according to him C-flex is the same thing as A-flex.

I did not tell him that I already own a Plus machine, and am well aware of the capabilities, or lack thereof with that machine. I love the C-Flex that my machine provides, and I sure as hell don't want to go through the misery of trying to get used to constant blowing. My argument was simple for wanting flex. I need to have the option of going to full face masks when I get a cold, and without flex, it just isn't going to happen.

As far as Auto vs. CPAP, I had to explain that I wanted to keep an eye on the progress of my therapy. It's not exact science, but it will show me when there are problems.

To make a long story short, his final response was "you have obviously done a lot of research, you know what you are doing, see you in a month, and bring the little card with you." He wrote out the script and handed it to the nurse to order the equipment. I will have to wait and see if the insurance company will cover it. I did tell him that I would rather have nothing but a copy of the prescription if they refuse. I will buy the damn thing myself.

Just venting, but when you add this to the list of disgruntled patients on this board, it seems to be happening all to often! Here's your machine, here's your pressure, have a nice life!!

Wulfman · Post by **Wulfman** » Thu Jan 17, 2008 3:11 pm

Way to go, Ron!

Feels good to be in the "driver's seat", doesn't it?

Best wishes,

Den

RipVW · Post by **RipVW** » Thu Jan 17, 2008 3:16 pm

Good for you, Ron! Knowledge IS Power!!

Slinky · Post by **Slinky** » Thu Jan 17, 2008 4:50 pm

GOOD GOING! Now don't let the local DME supplier BS you that insurance won't pay for that auto w/A-Flex. Just remind them that auto w/A-Flex is an HCPCS Code E0601, same code as the Plus, insurance is paying for an E0601 and they, the DME supplier CONTRACTED w/your insurance to provide an E0601, not any particular brand or model.

And before buying out of pocket, if you end up going that route, try billmyinsurance.com to see if they accept and work w/your insurance.

Pilot_Ron · Post by **Pilot_Ron** » Thu Jan 17, 2008 6:05 pm

Slinky wrote:GOOD GOING! Now don't let the local DME supplier BS you that insurance won't pay for that auto w/A-Flex. Just remind them that auto w/A-Flex is an HCPCS Code E0601, same code as the Plus, insurance is paying for an E0601 and they, the DME supplier CONTRACTED w/your insurance to provide an E0601, not any particular brand or model.

And before buying out of pocket, if you end up going that route, try billmyinsurance.com to see if they accept and work w/your insurance.

_________________

I had read your prior posts very carfuly, and actually made notes, which I took to the doctors office. I even mentioned that to him, and he agreed that it was the same code, and I think that was the final straw for him when he gave in. So thank you!

sleepycarol · Post by **sleepycarol** » Thu Jan 17, 2008 6:18 pm

Good going Ron!!!

Isn't it great to have knowledge!!!!

Without this informative board I would still be using an M series Plus and frustrated with my therapy as it was NOT working the way it should have been!!!! By now it would have probably been in the closet gathering dust. Instead I am 100% compliant and feel that I am taking an active role in my therapy!!

mindy · Post by **mindy** » Thu Jan 17, 2008 6:24 pm

Way to go, Ron!

Always good to hear the results of folks getting the information they need and taking back their power

Mindy

GrizzlyBear · Post by **GrizzlyBear** » Thu Jan 17, 2008 6:45 pm

Hiya, Folks.

I'm new to this cpap stuff, but it seems from my distance (Australia) that there are a lot of people in the US with our condition, many of whom are being serially and seriously ripped off by elements of the sleep 'industry'.

Like pilot_ron, I have benefited enormously from my short access to this forum and all you wonderful people. Unlike many of you, I didn't do enough research before I was ripped off by an Australian version of your DMEs. A spot of caveat emptor, I guess, but I am much better prepared for the future.

I was wondering, however, that there is so much brilliant advice on this forum, is it possible to try and get it out 'there', for access before people succumb to the sleep industry's blandishments? Is there an association of sleep apnea sufferers that could supply information brochures to family doctors (GPs, in my country), perhaps set up a website with information pages, and so on.

I would like to discuss this a little further, but I'm under instructions to take my kids for a yum cha, and then shopping - better go, or I'll get my bum kicked.

Regards,

Thoughtful GrizzlyBear

mindy · Post by **mindy** » Fri Jan 18, 2008 6:33 am

Hi GrizzlyBear,

What's a "yum cha"?

We do have a sleep apnea organization here and it does have some good info but in order for an organization like that to survive, they need the support of the medical establishment. That limits the amount of certain types of useful information they can supply (see http://www.sleepapnea.org). They do have some info articles about sleep apnea and they also have a forum. I've heard (but can't verify) that their moderators do a bit of censoring. IMHO, this forum is better and more open about all of the issues. If others have different perspectives, I hope they'll chime in!

Mindy

bdp522 · Post by **bdp522** » Fri Jan 18, 2008 7:53 am

I have spent time on some of the other forums. They DO censor posts. They also tell you that you need a MD or RT to change settings. They will remove posts with instructions for changing settings. They do not allow links for products of any kind. This forum is much more open and more likely to get you the info you need to make this treatment work for you.

Brenda

GrizzlyBear · Post by **GrizzlyBear** » Fri Jan 18, 2008 5:00 pm

Hiya.

Mindy, a yum cha is a Chinese thing where the restaurant brings around a whole swag of little bits and pieces to eat. I pigged out as usual in the first 15 minutes (as did my partner). Even my sons lasted longer than me, and normally they won't eat anything but chicken nuggets and chips!!!!

By the way, I wasn't talking down this forum, very far from it. My concern is that so many of us don't find the forum until long after we've been diagnosed, we've been ripped off (or suspect that we have), then we start searching for more information, and then discover the forum. Yes, of course, we should start searching earlier, but many of us foolishly trust in our medical specialists - I always have. This is the first time I've been burnt by a medical specialist who obviously regards himself as a businessman before he regards himself as a service deliverer.

However, if my GP (family doctor) had access to good information, I'm sure he would have passed it on, even if its only a webpage or address. The only issue I have with this forum is that it can sometimes be hard to find the information we want without searching through great swags of material, or having just the right search term (and I just don't have the time!!). We're EXTREMELY dependent on the oldtimers like Rested Gal and Wulfman (and you others) noticing our messages and passing on the information. The Collective Wisdom site is great, but it doesn't contain anywhere near all of the wisdom on this forum. That's why I suggested a website with referenced webpages for collective information.

Regards,

GrizzlyBear

mindy · Post by **mindy** » Fri Jan 18, 2008 5:20 pm

Hi GrizzlyBear,

Aha --- I think what you call "yum cha" we call "dim sum".

I agree about searching and finding info .... here's a little tip I picked up on this forum. Instead of using the search facility on this site, use google as follows:

Let's say you want to search on quattro leaks. You would type (in google):

quattro leaks site:cpaptalk.com

You'll probably need better search terms than that but it does help.

Mindy

Pilot_Ron · Post by **Pilot_Ron** » Fri Jan 18, 2008 7:45 pm

Personally I think that every patient at their first sleep sstudy should get 1 copy of each. "Sound Sleep, Sound Mind" by Dr. Barry Krakow, and"This Book Blows" by Mike Moran, both members of this forum.

I would also like to take this oportunity to thank everybody for the positive words...Thanks!!

Pilot_Ron · Post by **Pilot_Ron** » Thu Jan 24, 2008 6:06 pm

just an update...If anybody cares?

I arrived home tonight, and to my surprise, was a box filled with my new goodies.

I have Cigna, and knew that it was going to be a fight to get what I wanted, but through perseverance, and calling Apria to make sure they were going to send what I wanted, the delivery was exactly what I requested from my doctor.

M-Series Auto W/ A-Flex
Swift II Nasal mask
F&P HC-150 Humdifier

Thanks guys!!

Slinky · Post by **Slinky** » Thu Jan 24, 2008 7:56 pm

Whoooo hoooo, Ron! Atta boy! Sleep will tonite.

Humidifier

Additional Comments: Remstar Auto A-Flex Aussie Heated Hose Auto 8-15 cm H2O pressure A-Flex 2 Backup Remstar Plus w/C-Flex