New Member - Looking for the TRUTH!

[archangle]

If at all possible, try to avoid getting an S8 anything or a REMstar Series M anything. Get a ResMed S9 machine or a Philips Respironics REMstar Series One (PRS1) machine.

The newer machines use SD memory cards and are much easier to get the data off of. If you get an S8 machine, you can no longer find the card reader to read the data yourself. If you get the REMstar M series, you can get the card reader, but it's a pain in the backside. Most computers will read the SD memory card easily, and you can easily look at the data yourself with a free program written by a member here.

You may not want to mention wanting to look at the data yourself. This tends to make the members of the medical mafia pull back into their shells to protect themselves.

If you have an S9 or PRS1 machine, it's much easier to monitor your data yourself. You want at least an S9 Elite or a PRS1 Pro (NOT a PRS1 PLUS). S9 Autoset or PRS1 Auto is better because they will do auto pressure. You can turn off auto pressure if you don't want it.

Let me simplify the machine data collection questions. If you have a fully data capable machine, your doctor can look at the data and see that you're having apnea problems. It's even possible that he could see breathing problems and treat them before they cause further heart problems. If you had had a doctor monitoring your S8 Elite data after you moved, you might (MAYBE) have avoided the AF (Atrial Fibrillation) . Not all AFs come from apnea, and it's not always possible to avoid all apnea problems even with CPAP.

Call your insurance and find out what other DMEs you can use. Even if you stay with the same DME, knowing you have a choice helps you lean on him. By the way, CPAP machines usually start off as a rental, not a purchase, so you should not be stuck with the brick they gave you.

The DME is wrong about the new sleep study. It's very common for the doctor to adjust pressure settings solely based on the data collected by a data capable CPAP machine. There is even software for the doctors that allows you to mail them the card, have him check it, and mail the card back to you with a new pressure setting. This can even be done via modem or wireless on some models. If your DME doesn't know this, he's really, REALLY incompetent.

However, you may need or benefit from a new sleep study. A competent sleep study will catch a lot of things even the best CPAP machine will not see because the sleep study has EEG leads, cameras, and a real live human monitoring it. The DME is NOT! the person who should be deciding if you need a new sleep study.

The PRS1 machines are very much better than others at keeping water out of the machine from the humidifier. You still want to take the tank out before moving it, but it's much less likely do damage your machine this way.

If you can't force the DME into giving you a useful machine, you can buy a brand new PRS1 Auto machine with humidifier for under $700 from cpap.com, the sponsor of this site, or from other reputable online sellers if you get a copy of your prescription. ResMed machines are a little more expensive online. It's easy to set your pressure yourself to what the doctor prescribed. See if you can get your old doctor to send you a copy of your original prescription on paper so that you can order online if you need to. Given that you've already had one hospital visit, the cost of a good CPAP is probably not a big deal, even if you have to pay for it out of pocket, vs. the out of pocket costs of ending up in the hospital again.

[archangle]

Did the doctor ever actually adjust your settings based on looking at that data?

Cheers,

Bill

Actually he never did make any adjustments to them. Is that normal? Do they ever make adjustments based on that information?

It's possible that your CPAP treatment was working well back in 2009.

By the way, the PRS1 and S9 data capable machines collect a lot more data than the previous generation machines as well. They both collect waveforms that show your actual inhalation and exhalation waveforms.

The older machines would say "you had an apnea at 2:15 AM." The newer machines see more kinds of breathing problems and record an actual waveform of your breathing. You can look at the waveform and see how low your breathing went, how long the event lasted, what the breathing looked like before and after the event, etc.

[Ladelnutts]

I spoke with my insurance company this morning. They will pay for any CPAP provided it falls under the E0601 code as many people have stated. Called the DME and asked them what their billing/procedure code was for CPAPs and it is the E0601. I specifically asked her if that covered all CPAPs and she said yes. I called my primary doc this morning and have an appointment to get in with him on Wednesday morning. I will (hopefully) get a new script from him for a specific machine. I am going to stick with the Resmed S8 series since I have an H3i humidifier from the old machine and got a new H4i with the Escape II. I am going to have the Rx written for the S8 Autoset II. The other good thing I found out is that my insurance company will pay for a new machine every 3 years instead of 5. I'll let you know how it goes on Wednesday.

[tbone421998]

When I was in Charlotte the doctor would use this information to monitor how things were going and assess if my settings needed adjusted.

I know that i started with my pressure range at 10 cmh2o to 20 cmh20. After three weeks of data, my doctor's nurse called me and said that they were going to have the DME put me on striaght CPAP at 16 cmh2o. Lucky for my that my DME called my wife to set up an appointment for me to bring in my S9 Autoset to have it switched. She told them that she thought I already knew how to do that. Which I did from this forum. Thanks for that.

When they called me, I confirmed that I did know how to do it and she said that would be fine. If my DME would have made that change, would they have charged something to my insurance company? I'm lucky to have a really good DME. I knew that I wanted a S9 Autoset but they already had one ready for me. I am blessed.

[archangle]

I spoke with my insurance company this morning. They will pay for any CPAP provided it falls under the E0601 code as many people have stated. Called the DME and asked them what their billing/procedure code was for CPAPs and it is the E0601. I specifically asked her if that covered all CPAPs and she said yes. I called my primary doc this morning and have an appointment to get in with him on Wednesday morning. I will (hopefully) get a new script from him for a specific machine. I am going to stick with the Resmed S8 series since I have an H3i humidifier from the old machine and got a new H4i with the Escape II. I am going to have the Rx written for the S8 Autoset II. The other good thing I found out is that my insurance company will pay for a new machine every 3 years instead of 5. I'll let you know how it goes on Wednesday.

Get an S9 Autoset machine or a Philips Respironics Series One Auto. Seriously. Even if you have to buy a new humidifier.

These machines record waveforms, which are enormously better than simply recording "you had an apnea at x:xx AM". You can see how long, how severe, look at breathing patterns, etc. You don't need a proprietary card reader. In the S8 case, you can't even buy the card reader any more. You won't have to worry about device drivers to drive your card reader when you upgrade your PC.

An S9 or PRS1 will also work with open source software to read your data, although the software is in development mode at the moment.

Be careful the DME doesn't trick you with an "escape auto" instead of an "autoset" if you're getting ResMed.

[Dojers]

Boy do I feel your pain - I JUST went through this with MY DME as well - they tried to give me a "brick" which was the exact type of CPAP machine I had given to me by a friend! I had TOLD them when I went to buy this one that I wanted a machine that would read ALL the data I needed not just compliance - I'm ALWAYS compliant - I don't even lay down if I have a headache without wearing the machine just in case I fall asleep while waiting for the headache to go away. So When I told them I wanted a machine that would read my AHI and any breathing irregularities that I may have they sold me the PR System One which THEY told me was data capable. What they DIDN'T tell me was it was only compliant capable. I just spent over a week AFTER my doctor wrote a different script with my machine specified fighting to get my new machine. I finally got it today but it was an eye opening experience. They charge you (at least here) $2135 for a $549 machine. And that's the same price they get for the "brick" and for the best of the best. And since that $549 is the price I can buy it online - that means they have to get it a lot cheaper than that. So they are making at least $1500 profit! So don't let them get away with it. Don't know how much they charge for yours but you gotta know that they are making a TON of $$ off your machine - get what you want. If you have to, call your physician and ask him/her to write a script for whatever machine you want. What ever you do, don't give up!!

Just saw all that I said has already been said - we'll just consider this a booster for that

[Ladelnutts]

I appreciate the suggestion archangle but I am going to stick with the s8 series. I don't want to have to buy another humidifier - that's why I pay for health insurance. If the DME would've given me the elite ii in lieu of the escape ii I wouldn't have complained a bit. I just want to get a machine that will work with what I have, record data, and take the $250 that an h5i would cost and buy something fun. I think the s8 autoset ii will do me fine plus the h4i was a purchase not a rental. In three years when I can get another cpap I will know the ropes and not fall prey to the DME tricks!!

[idamtnboy]

I appreciate the suggestion archangle but I am going to stick with the s8 series. I don't want to have to buy another humidifier - that's why I pay for health insurance. If the DME would've given me the elite ii in lieu of the escape ii I wouldn't have complained a bit. I just want to get a machine that will work with what I have, record data, and take the $250 that an h5i would cost and buy something fun. I think the s8 autoset ii will do me fine plus the h4i was a purchase not a rental. In three years when I can get another cpap I will know the ropes and not fall prey to the DME tricks!!

Let me chime in. I can understand your reluctance to pay for another humidifier, but if the insurance is willing to pay for a replacement machine they'll pay for the humidifier also. Push for it, hard. The S8 is an out of date machine. It's history. Do not buy it. You'll kick yourself to kingdom come if you get an S8 because even if you get the fully data capable one you aren't going to get the data out it unless you already have the Resmed proprietary card reader. As others have said, you'll play hell getting a card reader for the S8. I can't say for certain, but if you are running Windows 7, or plan to in the future, you very well may have zero luck installing the card reader drivers you need for the S8 card reader.

Have your doctor write the script specifically for the S9 w/ humidifier. That way the DME has to give you the humidifier.

If nothing else you can buy an H5i humidifier on eBay, craigslist, or CPAP auction.

So once again, for your own future peace of mind get the S9, not the S8. The improved data presentation will be well worth it.

[JoeFromSC]

Hey. I am real new to this, but followed this board and others for a couple of weeks before I had my Dr. (ENT) write the script. I told him I wanted a Data Capable machine that him and I could properly monitor my progress with. I told him I had researched it and this is the script he needed to write. RESMED S9 AUTO kinda made it difficult for the DME to dance, but believe it or not, they did. I went to three DME's and only one was smart enough to step up to the plate and do it write. (right!)

If I were your I would have my Cardiologist (if a reasonable guy) write you a script that say you need a data capable machine to record AHI and leakage. Then have him write RESMED S9 Auto (or the machine you feel most comfortable with). Then get a couple DME's in play by making copies of the script and faxing it to them.

Just a thought.

[Pugsy]

I just want to get a machine that will work with what I have, record data, and take the $250 that an h5i would cost and buy something fun

Do you already have the ResMed Smart Card reader? If so then you are set to use the software if you wish.
If not and you want more data than the S8 Elite offers on the LED screen then purchase of the card reader (if you can find one) will eat up at least $100 of that $250. Last I saw available from someone in Israel or China only and S & H on top of that $100. The Smart cards are also next to impossible to find and very pricey also.

[Slinky]

Rather than be locked into a specific brand and model PAP by your script, yet ensure that you get a fully data capable PAP, ask your prescribing doctor to include the phrase: "access to Leak, AHI and AI" on the script. The local DME providers can't legally get around providing anything but a fully data capable PAP. This does allow them the leeway of providing you w/their choice of Resmed, PR or DeVilbiss, Fisher & Paykel, PAPs, but they HAVE to provide a fully data capable PAP to be in compliance w/your script. Your being flexible about which of the fully data capable PAPs you will accept can make the process a whole lot easier for all concerned. Most local DME providers get the majority of the PAPs in bulk from Resmed or PR and thus get the best cost to them making it more palatable to them to provide you w/whichever brand they get the bulk price on.

[archangle]

Then have him write RESMED S9 Auto

Not "S9 Auto," "S9 AutoSET". Otherwise, you may get a junk "S9 Escape Auto" machine instead of the "S9 Autoset" you really want.

[Ladelnutts]

Got my revised Rx this morning from my PCP. He wrote the script that the machine is to have access to leak, ahi, ai, and pressure data. I called the DME but the CPAP guy wasn't there I went ahead and faxed the Rx over to them. So I'm just playing the waiting game at this point. I'll keep you posted.

[Ladelnutts]

Made the swap out for the machine this morning. It was actually relatively painless. The DME really didn't have any leeway to argue anything since the script quoted the specific machine and that it was to have access to leak, pressure, ahi, & ai data. Thanks to everyone who responded with advice. I am scheduled for a new sleep study scheduled at the end of August so it will be interesting to see what that finds.

[Slinky]

Congratulations, LadelNutts. What are the pressure settings?