Hello world

jhallas · Post by **jhallas** » Wed Apr 28, 2010 9:38 pm

Hi Everyone,

First real post here. I completed my initial sleep study showing an AHI of 28 slightly more than 2 months ago and the CPAP titration yesterday; they kind of dropped the ball. They said they should have a prescription for me within 5 days.

I'm currently trying to decide whether I should go to a DME provider like Apria or just order my parts on cpap.com. My insurance stated that I could get reimbursed and their coverage of durable medical equipment is 80% up to $1000 paid out ($1250 total price). I've heard that DME providers normally require you to rent the cpap for a range of months before allowing you to purchase them and they can be finicky about what particular machine you get. As far as I can tell my insurance doesn't care if I rent or buy any particular unit. Are there any benefits with going through a DME provider besides switching out masks if I don't like one? Would the price be lower or higher with cpap.com or Apria?

I'm interested in the S9 Autoset after reading the forums quite a bit and the maybe Swift FX depending on what pressure they state I should be running at. Any input on that?

Let me know what you think
J

Julie · Post by **Julie** » Thu Apr 29, 2010 1:02 am

If your insurance co. will fund Cpap.com without going through a DME (most seem to have no problem) then you'll be much happier, and Apria seems to have a particularly bad rep. to begin with, though I suppose individual dealers might not be terrible.

Redeye · Post by **Redeye** » Thu Apr 29, 2010 7:47 am

I'm not sure where you are, but the way things work vary widely depending on what kind of insurance plan you have. That's why it will be important to get your working parameters from the insurance company. The rental vs buy is insurance-driven, not driven by DME policies (typically). Most policies will have a concept of providers (including DMEs) being in-network or out-of-network. In-network is almost always better pricing and reimbursement. As far as where to buy your stuff, the questions are: Is your DME in-network? If so, do they have negotiated rates/pricing with your insurance provider? That negotiated rate is likely to beat out normal pricing. E.g. Outpatient, same-day Angioplasty (thigh) w/o complications ran $19,500 on the first bill, i.e. what someone would pay if they didn't have insurance. Negotiated rate (the place was an in-network provider) was $9,200. Granted, this wasn't CPAP but things work similarly. For your mask, what did you use during your titration study? Most DMEs will have a change-out policy of some kind, so ask about it. Also, find out from your insurer how often they will replace the mask (e.g. 3 months). It's not lifetime commitment! The very best of luck!

Redeye

jhallas · Post by **jhallas** » Thu Apr 29, 2010 10:28 am

I think I'll check out Apria, which is who the doctor's office recommended and see what kind of pricing they have available. If it's more expensive, less options, etc., I'll call my insurance company and confirm that I can buy and not rent the CPAP machine myself. I previously talked to them but the girl I talked to didn't seem to understand that well, asked someone else, and said sure as long as I provide a detailed invoice with the insurance specific codes and a copy of the credit card transaction from the bank.

During the sleep study I used a nasal pillow mask, not sure which one. I'm not really sure how it went except that I think I felt more rested yesterday. If the pressure they titrated me at is high I'm assuming I'll get another type of mask as from what I've read those type of masks leak at high pressures.

As far as changing out the mask etc., I'm not entirely sure. I have a student health plan at the university I attend and from what the lady at the insurance company told me it's just 80% coverage up to a maximum of $1000 benefit per year. She didn't tell me of any specific rules or regulations particular to CPAP.

Thanks for the input,
J

jhallas · Post by **jhallas** » Thu Apr 29, 2010 1:47 pm

I called the sleep clinic today and they said that the study showed a titration of 10. Is this high? Are there restrictions on the mask I can use with 10 cm of h2o?

They also said that the doctor has to score the study before I get a prescription, and they don't work on Fridays. I'll get it next week but I feel rather impatient. I think I've had this for years but I'll be damned if I have to wait any longer than I have to.

Redeye · Post by **Redeye** » Thu Apr 29, 2010 2:46 pm

I don't think 10 is that high. That's my pressure too. There should be no restrictions on the type of mask you can use with that pressure. The selection has more to do with whether or not you mouth breathe. If you do, you'll need either a full-face mask, hybrid mask, or a nasal mask/pillows w/a chin strap or other way (duct tape!) to hold your mouth closed. Duct tape may be a stretch! Maybe super-glue would be better!

Redeye

Gerald · Post by **Gerald** » Thu Apr 29, 2010 3:07 pm

J.....

With all due respect to Redeye, the mention of super-glue is a bit of humor. Many of us use nasal masks and tape our mouths shut...so as to eleminate leaks while enjoying the comfort of a nasal mask. No one uses super glue except to repair mask parts.

As for going with a DME or buying your own, you've had your warning. You've been jerked around...they've dropped the ball.....and there's no reason to expect things to get better. if you can possibly do it, your smartest.....and least expensive way forward....is to purchase your own equipment from cpap.com and get reimbursed by your insurance company.

The choice of the S9 is good......and you might want to consider the Philips Respironics PR-1 (newest model) automatic with integral humidifier. You also want software to go with whatever machine you purchase....so that you can tweak and tune your therapy over the months and years ahead.

The whole idea is to learn how to operate at the lowest pressures...with the best results...and the most comfort. It's extremely doubtful that your doctor and DME combination can do that for you. You have to do it yourself....because you can do it far, far better than they can....PROVIDED you have the software so that you can check your progress.

LSAT · Post by **LSAT** » Thu Apr 29, 2010 3:30 pm

If you purchase the CPAP machine directly from cpap.com, it might be a good idea to purchase the mask from the DME. In that way,you have a 30 day return available so you can actually try different masks to find the perfict fit.

jhallas · Post by **jhallas** » Thu Apr 29, 2010 3:34 pm

Hi all,

Thanks for the replies. I got the joke . I think I'll check out whatever DME's are available and see what they offer me in terms of price etc., and if they can't help me I'll just buy it online. Benefit of DME is that I can exchange masks easier and I don't have to wait on shipping. If the DME won't give me the machine I want then I just walk out the door.

Edit: Thanks for the idea LSAT. If the price is comparable I'll definitely take that into consideration.

J

jhallas · Post by **jhallas** » Fri Apr 30, 2010 2:29 pm

Hi Everyone,

So I'm trying to figure out what I want to order for when I get my prescription next week. I put together a shopping cart on cpap.com. I'm not worried about how much it costs as I figure it's a good investment and I'll be getting 1k back from insurance anyway. I'm not sure about what I should get for cleaning products, the chin strap, the pap pillow, and the hose management. I just added what seemed popular on the site. Any recommendations? Let me know if there's anything I'm missing or if there's a better product to replace one of the items below. The total is currently at ~$1550. Anyone have a promo code?

Thanks,
J

S9 AutoSet™ CPAP Machine
Size: N/a Quantity: 1
Edit
$853.00

S9™ Series Humidaire H5i™ Heated Humidifier with Climate Control
Size: N/a Quantity: 1
Edit
$219.00
List Price: $244.00
Savings: $25.00 (10%)

ClimateLine Tubing for S9 and H5i Climate Control System
Size: N/a Quantity: 1
Edit
$51.00

Disposable Standard Filters for S9 Series CPAP Machines (6 pack)
Size: N/a Quantity: 1
Edit
$12.95

Disposable HypoAllergenic Filters for S9 Series CPAP Machines (6 pack)
Size: N/a Quantity: 1
Edit
$15.95

In-line Outlet Bacteria Filter for CPAP/BiPAP (5 Pack)
Size: N/a Quantity: 1
Edit
$22.90

Citrus II CPAP Mask Wipes
Size: N/a Quantity: 1
Edit
$15.95

Control III Disinfectant CPAP Cleaning Solution - 16 oz Concentrate
Size: N/a Quantity: 1
Edit
$16.00

Swift FX™ Nasal Pillow CPAP Mask with Headgear-Sizes (S, M, L) Included
Size: Sizes (S, M, L) Included Quantity: 1
Edit
$127.00

HoseBuddy Tangle Free CPAP Hose Suspension System
Size: N/a Quantity: 2
Edit
$99.90

Double Edge PAPillow
Size: N/a Quantity: 1
Edit
$63.95

Premium Chinstrap
Size: N/a Quantity: 1
Edit
$24.70

Uncle_Bob · Post by **Uncle_Bob** » Fri Apr 30, 2010 2:35 pm

Hi J and welcome. Thats a fantastic shopping cart to be starting off with.

Personally I'd ditch the chin strap and get a PapCap chin-strap from pur-sleep.

http://www.pur-sleep.com/products/produ ... category=6

Good luck

jmelby · Post by **jmelby** » Fri Apr 30, 2010 2:51 pm

The HypoAllergenic and Standard filters are redundant--you need one or the other, not both. The machine will come with a standard filter. I don't know how others feel about this, but I think the mask wipes and cleaning solution are a waste of money when you can use a regular mild soap (except Dawn) and vinegar/water solutions for cleaning.

echo · Post by **echo** » Fri Apr 30, 2010 5:48 pm

Ditto to the papcap, nix the chinstrap. (Well we are an opinionated bunch, and probably chinstraps work for some, but not all. I've got the receding jaw issue, and the chinstrap just makes it worse by pulling my jaw back, but the papcap doesn't seem to do that)

As for hygiene, that's different for everyone. When I first started out I was crazy about cleaning everything diligently. Now I use Dr Bronner's soap to clean the mask (daily) and the humidifer tank (weekly or so), and I haven't rinsed out my hose in 3 months or more. This is a very controversial topic so do what works for you... just sayin' that you don't need to over-clean everything. It does help to have that stuff laying around (in my opinion) for cold/flu season, but even then I just use vinegar.

Happy shopping

park_ridge_dave · Post by **park_ridge_dave** » Fri Apr 30, 2010 5:56 pm

Papcap, definitely, and welcome to the forum!

Cheers,

Dave

KatieW · Post by **KatieW** » Fri Apr 30, 2010 6:02 pm

It all looks good, except I don't know about this:

In-line Outlet Bacteria Filter for CPAP/BiPAP (5 Pack)
Size: N/a Quantity: 1
Edit
$22.90

Find out if it's compatible with your S9, before ordering.

And I agree with others about the papcap, rather than a chinstrap.

I would also suggest a hose cover, unless you intend to make your own. It's nicer to feel soft fabric against your skin, than a plastic hose. They have generic ones at cpap.com, but in my opinion, these are better made, and more choice of colors:

http://www.padacheek.com/PAC_Hosecover.html

cpap.com will price match, for items that are listed on the internet for less. You just need to give them the URL and price over the phone. They will verify, then give you the same price.

Hello world

Hello world

Re: Hello world

Re: Hello world

Re: Hello world

Re: Hello world

Re: Hello world

Re: Hello world

Re: Hello world

Re: Hello world

Re: Hello world

Re: Hello world

Re: Hello world

Re: Hello world

Re: Hello world

Re: Hello world