Getting a machine from DME, please advise

[snyderm]

I just found out that the Sleepstyle 254 is just a temporary machine to measure what pressure I need. They will probably get me a cheaper machine, that is the only reason I can think of as to why they would give me an Apap machine temporarily.

My Sleep company that I deal with (is this called a DME? What does it stand for?) says that they carry fisher and paykel, and resmed machines. Apparently, I will get no say in the matter of what machine I get.

I really don't trust the people who work with me, I am not confident that they are looking out for my interests at all. This machine is something that I am going to spend an incredible amount of time with, what should I do to ensure that I get what I want?

Is it possible to just get my doctors prescription and ignore the sleep care people? What can I do?

[jerseygirl]

You need a prescription from you sleep doctor for the machine.
Be sure your Doc writes the prescription for Resmed Auto 25. and mask of choice.

The Resmed units are very quite.

The Auto 25 is the newest and you have to insist the DME sets it so you can see the daily readouts for AHI and HI.

We have to be proactive and specify what the Doc writes, because they don't seem to. Mine will write what I want , i just have to ask for it. They dont' really want to be too much involved once they writh the script!

Best therapy! After a few months adjustment you will wonder why you waited so long to get the needed rest you need!

[snyderm]

The only doctor I have is my GP. He ordered the sleep study. Is he the one with the power? Or is it the doctor that interpreted my sleep study?

[jules]

Do you want to use insurance or are you willing to pay for the machine out of pocket?

If you want to use insurance, check who are in network providers with them and start the phone calls to all of them.

Be sure to get a copy of the script anyhow and a copy of the sleep study.

If you are willing to pay out of pocket for the machine such as buy from cpap.com, your GP can write the script - any doctor you see can. You need to get that script anyhow.

[timbalionguy]

Another way is to get a prescription that describes generically the machine you need. For instance, 'Autoadjusting CPAP with efficacy data reporting, heated humidifier, mask of patients choice and related supplies' would be one appropriate wording. (The pressure(s) have to be specified as well.) Then, go to an online provider and buy what you want. Sure, you will have to pay out of your pocket. But you will get exactly what you want. The satisfaction you will get will be worth having to pay down your credit card for a few months.

Any MD can write your prescription. If they need a guide to language, there is one on cpap.com

[snyderm]

Thanks everyone. I guess the best thing to do right now is to wait and see which machine they try to give me.

[don331]

Don't wait... I just went through the same thing.

Your regular Dr can write you a script for a xPAP machine, hose, and mask. All he needs to note is the type (CPap, etc) - NOT THE BRAND.

Then you can get whatever you want - if you have insurance, (like my Blue Cross) - I just have to pay the 20% of whatever the tab came to.

Or you can send in the prescription to one of the online folks and submit the receipt to insurance for reimbursement! My regular Dr summed it up as "this machine is going to save your life. It's very important. Get the best machine you can afford"

[Pugsy]

Thanks everyone. I guess the best thing to do right now is to wait and see which machine they try to give me.

They will try to give you the most basic of models. Whichever is cheapest for them.
No data except hours of usage to satisfy insurance requirements.

Start doing your homework. Check with other DME's (durable medical equipment providers).

If you go with ResMed product or Respironics, there are many more of us here to help you with it. Not many F & P users here on this forum.

Check with your insurance company to see if they will reimburse (whatever they pay) if you buy online. Some will, some won't. Do the math, sometimes the total out of pocket is less when you buy online.

[mattman]

Okay, first off as most people here know I am a former DME employee. I believe firmly that most DME companies can help and provide a good service to most patients.

Now, with that disclaimer out of the way...

Here's my feeling on your current situation and my advice.

First off - relax. Seriously. The more worked up you get, the more distrustful you become, the more on edge you become the worse things are going to work out for you. I am a VERY strong believer in the notion that we all will generally find exactly what we go looking for. If you think this company coming to set you up is going to screw you over then I pretty much assure you that is what you are going to find and that this whole thing is going to be a waste of time for you.

If you look to a DME provider as a partner in your care then you may well find that is exactly what they will be.

NOW - again - all that being said...

If you do not feel you need anyone local to help you out or assist you with your treatment then by all means - cancel the appointment and buy your CPAP online from somewhere. You may well save yourself some money and some hassles.

DME companies are best suited for patients who need a local partner in their care regardless of if it's oxygen, CPAP, nebulizers, support surfaces etc.

Online companies are best suited for patients who know what they want, when they want it and don't want anyone elses hands in their treatment.

Only you can effectively decide where you are on that scale right now and where you will be 6 months from now, a year from now etc.

Insurance companies are still behind the times. 99% of the time they will not reimburse you for CPAP equipment you buy online. There is currently just still too much liability and documentation required for them to do so and they haven't spent a lot of time figuring out how to make it work.

So if you go online don't expect to be paid for it. Talk to your insurance company and find out how much they pay for a CPAP machine (Code E0601 if I remember it right) and then figure out based on your deductible if it will be worth it for you to buy out of pocket.

Good luck and I hope that helps you decide!

mattman

[cinco777]

Snyderm, 9 times out of ten, the DME will give you the cheapest machine that they can - one with only compliance reporting (blower hours). If you are going to be successful with your CPAP sleep therapy, you will need a machine that reports efficacy data (AHI, leak, etc.). If you take Mattman's advice (previous post)

If you look to a DME provider as a partner in your care then you may well find that is exactly what they will be.

then you will have a 1 in 10 chance in getting a fully data capable machine. If your DME is Apria, you will have less than a 1 in 10 chance in getting a machine that reports efficacy data. Read this forum for all the "horror" stories of folks who have been sold down the river by their DMEs. Learn from our experience. Don't add your name to the list of "I wish I had known".

Get your doctor to write a prescription for a CPAP machine that reports efficacy data. You will be spending 1/3 of your life with this machine so get one that will help you succeed with your sleep therapy right from the beginning.