Justification for a data capable machine

brothertony · Post by **brothertony** » Mon May 12, 2008 12:57 pm

Alright this was a suggestion. I am lookin for some experts to help me out . I am being told I should get a data capable machine. and seeing that I have only had my machine a week and am very new to this what Justification do I use to the DME to get a data capable machine. I am not able to purchase one at the prices I see for them so if I can justify it and return the one I have that will be great.

GumbyCT · Post by **GumbyCT** » Mon May 12, 2008 1:04 pm

I don't see why YOU have to justify it - Have your doctor order it.

Else, I say just find another DME.

yardbird · Post by **yardbird** » Mon May 12, 2008 1:31 pm

The DME is getting paid the same if it's a low end machine or a higher end machine. Of COURSE tehy want to give you as low a machine as you will accept because then THEY get more money in their pocket.

Tell your doctor you want to be actively involved in your treatment and the way for you to do that is through your ability to see what is happening. A data-capable machine can let you see what is happening so that you can understand and take part in your therapy.

and remember.... "data-capable" means full data reporting... NOT just compliance monitoring.

tangents · Post by **tangents** » Mon May 12, 2008 1:56 pm

Reasons for needing a data capable machine:
1. Not sure if your mask is leaking, or if you are breathing through your mouth during the night. The data records your leak rate.
2. Not sure if all of your apneas/hypopneas are being eliminated. The data gives your AHI
3. Insurance only covers a machine every 5 years or so. During that time, many things can change (like your weight) that would affect your pressure requirements. The data will track your progress, so that changes can be made WITHOUT doing another sleep study.

I'm sure others will chime in with more reasons to give your DME.

Good Luck,
Cathy

Guest · Post by **Guest** » Mon May 12, 2008 1:59 pm

In addition to what the others said......

It's your life, your health and your money that's paying for it. And, since your insurance is paying the same amount for whichever CPAP (including Auto) you get......you might as well get the best.

Having a machine with which you can monitor your therapy will also make you a more "compliant" user, too.

Diabetics (Types 1 & 2) HAVE to monitor their therapy......it should be the same for XPAP users.

Or, the converse of this is to have them justify to you why you should NOT be able to monitor it. (if they give you a hard time)

Den

cflame1 · Post by **cflame1** » Mon May 12, 2008 5:44 pm

As folks have said... if you have any kind of a problem... without a data capable machine, you, your doctor and/or your DME are just guessing.

bap40 · Post by **bap40** » Mon May 12, 2008 6:06 pm

It makes a huge difference in one's therapy when you can literally see where problems may lay and can work to fix those problems by knowing what they are. Everyone of us has or has had problems problems during the course of treatment. It's the nature of the beast. I fired my first DME because they would have nothing to do with giving out Data Capable machines. You are entitled to have the machine YOU want. They aren't the ones using it so although supposedly trained, it is not the same thing as having apnea.

Slinky · Post by **Slinky** » Tue May 13, 2008 1:44 am

1] Because YOU are paying for it (thru your insurance)
2] Because you WANT a fully data capable CPAP
3] *Because you CAN and WILL go elsewhere if necessary to get what you are paying for and want
4] Because your doctor has no way of knowing what is going on w/your therapy w/o the full data
5] Because you aren't interested in multiple titration studies to determine any problems you may have w/CPAP therapy
6] Because you are NOT interested in your doctor adjusting your therapy by guess and by gosh because he doesn't have the data
7] Because YOU are paying for it (thru your insurance)
8] Because you WANT a fully data capable CPAP
9] *Because you CAN and WILL go elsewhere if necessary to get what you are paying for and want
10] Because YOU are paying for it (thru your insurance)
11] Because you WANT a fully data capable CPAP
12] *Because you CAN and WILL go elsewhere if necessary to get what you are paying for and want
13] Because YOU are paying for it (thru your insurance)
14] Because you WANT a fully data capable CPAP
15] *Because you CAN and WILL go elsewhere if necessary to get what you are paying for and want

*Call your insurance company and ask them what local DME CPAP suppliers they are contracted with. HOPEFULLY you have the option of more than just this one!!!!

NightHawkeye · Post by **NightHawkeye** » Tue May 13, 2008 7:05 am

Ditto to what Slinky said, but would add the following reasons:

16] Because YOU are paying for it (thru your insurance)
17] Because you WANT a fully data capable CPAP
18] *Because you CAN and WILL go elsewhere if necessary to get what you are paying for and want
19] Because your doctor has no way of knowing what is going on w/your therapy w/o the full data
20] Because you aren't interested in multiple titration studies to determine any problems you may have w/CPAP therapy
21] Because you are NOT interested in your doctor adjusting your therapy by guess and by gosh because he doesn't have the data

Blatant deliberate plagiarism employed. Emphasis mine.

Regards,
Bill

brothertony · Post by **brothertony** » Tue May 13, 2008 7:29 am

Thanks everyone I spoke with my equipment provider and they told me to get in contact with my doctor and have him order the equipment. I am waiting on a call back from them.

GumbyCT · Post by **GumbyCT** » Tue May 13, 2008 7:46 am

brothertony wrote:Thanks everyone I spoke with my equipment provider and they told me to get in contact with my doctor and have him order the equipment. I am waiting on a call back from them.

You can list 200 items - the ONLY one that matters to the DME (or Ins. - or License Auth.) is the "Prescription" ordered by the doc.
Good Luck,
GumbyCT

Beulah · Post by **Beulah** » Tue May 13, 2008 9:04 am

Hopefully it won't be as hard as you anticipate. After almost two months of cpap therapy on a regular M series, armed with knowledge from this place, I told my DME that I just wanted to know "if it was working" and "how I was doing". She had thought that the machine I had would give me that info, and as soon as she did some research (like within hours), she traded out my machine for an M series that was data capable. She was lovely and gracious about the whole thing. Apparently to them there was only a $75 difference between the two machines and it was fine with them. As far as the insurance company goes, they're still paying for a cpap machine rental and couldn't care less what kind it is.

So, as far as justification, I think that "I want to know that it's working" is more than enough. Remember, it's not - or shouldn't be - any skin off the DME's nose which machine you have.

Good luck

Paula

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