Study results, my doc, and the DME

[txtornado]

So, I met with my doctor today to get my official sleep study results. The most notable thing about my results was that I had a total absence of REM sleep. Not even one measley minute of it! Anyway, the results show an AHI of 40. They tested me on pressures of 4-15cm and found that I responded best at 11. But the lab states that since REM sleep was never achieved, this titration is not considered optimal. Which supports my original belief that I'd need an AutoPap.

Onto my doctor - who is not a sleep doc, by the way. I really like her. After discussing the results I told her I'd like an Rx for an Auto so I could work to find the right pressure setting myself, and she was in complete agreement. She was thrilled that I've been reading up on my treatment options and encouraged me to keep it up. She also thought it was a great idea to get the software and monitor myself. Since my insurance doesn't cover any of the equipment, she gave me the # for a DME but told me to buy it wherever I can get the best price. Then we moved onto the 9 pages of non-sleep study lab results we had to go over...

Back at my office, I called the DME. Mostly to see just how outrageous their prices were. I spoke to a nice young woman who was reasonably helpful. Their prices were high, but not as horrendous as some accounts I've seen here. She offered me a used (don't know # of hours) REMStar Auto C-Flex with heated humidifier for $750. Which isn't that bad - except that cpap.com charges $725 for the same thing brand new. When I asked about the software she told me that I could probably order it from the manufacturer for "thousands of dollars." Their mask prices average about $50 higher than cpap.com for the masks I'm interested in. She'd never heard of the Aura but said she'd be happy to order one for me. She's looking into the price of a new PB 420E for me and calling me back. Overall, she was pleasant and more helpful than I expected, but I'm still not buying from them. I think I'll make an appt. to try on several masks, pick the one I like best, then order everything from cpap.com.

I'm glad to have the results. While I can't say I'm excited about getting an APAP, I am excited about the possibility of getting my life back.

[Brent Hutto]

Overall, she was pleasant and more helpful than I expected, but I'm still not buying from them. I think I'll make an appt. to try on several masks, pick the one I like best, then order everything from cpap.com.

Yeah, that'll teach them to be real helpful to the next tire kicker.

Seriously, if you do that you ought to at least buy one measly mask from them. If they talk to you repeatedly on the phone, look up information for you on products they don't stock and then let you try on their masks (which they can not then sell as new because you've had them on) why would you want to screw them out of a sale? Is your 50 bucks somehow more valuable than an hour of their time plus having to eat the cost of their masks you try on?

Here's an experiment. Ask CPAP.COM to send you several of their mask, use their forum, ask a bunch of question of their experts and then send it all back and see if you can find the one you want a couple bucks cheaper from some guy with a 1-800 number and a catalog. I'm sure they will really appreciate the opportunity to provide pre-sales support for somebody they never met.

[txtornado]

Brett, you do have a point and perhaps if the DME does end up spending a significant amount of time/effort on me I may just go ahead and buy a measley mask from them. But as of yet, they have spent a total of 5 minutes on the phone with me during one call and looked up a couple things on a computer, so pardon me not having developed a sense of customer loyalty to them.

Since you've so politely offered me some advice, let me return the favor. Perhaps you should try reserving judgement and not being so negative towards people you've never met and know nothing about. The value of money is relative and you are not in a position to know how much (or little) that $50 in savings might mean to me and my family.

[Brent Hutto]

I'm not judging you but rather the behavior you were proposing. If money is an issue (and it is for most of us) then CPAP.COM is an excellent vendor. I just wanted to point out that your plan involved unfairly taking advantage of another business's good nature. I'm sure you'll end up doing the right thing.

[Snoredog]

BUY your machine from cpap.com, it will cost you less, machine comes with a 2yr warranty, get a used machine and you don't get the warranty.

Also do you want a machine that someone else has used? I wouldn't. What if they had TB or some other disease? You simply don't know and there is no way to sterilize the machine within reason.

You can use your existing presription to order the autopap you want and software.

I've had machines go bad in the past and getting cpap.com to process the return/replacement was a breeze. All you need to do is:

1. Order the machine of choice on-line paying with credit card.
2. Order the machine with the Heated Humidifier, you will need that.
2. Order the mask of choice (they have sizing charts on-line).
3. You can also order the monitoring software or order it later doesn't matter.
4. After placing the order, just fax over a copy of your prescription to cpap.com.

That's it.

Order tonight your machine will show up at your door in about 7-10-days depending on your location. A new machine will come with the Clinical manual so you can make your own changes, I'd bet money that your local DME would KEEP the clinical manual so they can charge you for changes. Look on their estimate, they are probably charging you for machine, hose or items individually that come with the machine.

As for the machine, I suggest the Remstar Auto with Cflex. Masks are kind of personal item, what I like you may not. But in the nasal masks the Resmed UltraMirageII is pretty popular so is the Activa along with the Swift.

[Moogy]

Order tonight your machine will show up at your door in about 7-10-days depending on your location. A new machine will come with the Clinical manual so you can make your own changes, I'd bet money that your local DME would KEEP the clinical manual so they can charge you for changes. Look on their estimate, they are probably charging you for machine, hose or items individually that come with the machine.

Actually, since the original poster lives in central Texas, like me, a cpap.com order should arrive in only two days, even if you don't pay for faster shipping. Their office is in Houston. I have ordered from them twice, and it was about two working days each time. (UPS doesn't deliver on weekends, so you can't count Sat. and Sun.)

I got great service!

Moogy

[Goofproof]

You are lucky you don't have to play the DME game, I wouldn't bother them at all, and they could save their valuable time for people not willing to do their own homework. CPAP.Com is the way to go, I had to use the DME, so the Insurance lost and so did I, they spent more time looking for the owners manuel (They probably sold the good one on Ebay, and lost the junk one), than they did on mask selection.

They just gave me a FF Mask, and said this looks like the right size, make it work. So I did! One thing about a FF Mask, no mouth leaks to worry about so you receive the needed treatment. You just have to use, Mind over Matter, If you mind, you have to convince your Mind, it doesn't Matter, your doing it and that's that.

As long as you have to put up with the pain, go for the maxium gain.

_________________

CPAPopedia Keywords Contained In This Post (Click For Definition): cpap.com, DME

[The Youngs]

Actually, UPS does have Saturday delivery if you pay extra. I ordered the Remstar Auto from cpap.com (actually billmyinsurance.com) on Friday morning, by 4pm the paperwork was complete (they had to get my doctor to sign for an auto) and by 10am the next morning (Saturday) it was on my doorstep - and we live on the East coast! Had to pay extra for shipping, but after waiting 3 weeks for the sleep lab results, knowing they would show awful apnea, getting the APAP fast was worth it!

[CheezWiz]

[quote="txtornado"]Brett, you do have a point and perhaps if the DME does end up spending a significant amount of time/effort on me I may just go ahead and buy a measley mask from them. But as of yet, they have spent a total of 5 minutes on the phone with me during one call and looked up a couple things on a computer, so pardon me not having developed a sense of customer loyalty to them.

Since you've so politely offered me some advice, let me return the favor. Perhaps you should try reserving judgement and not being so negative towards people you've never met and know nothing about. The value of money is relative and you are not in a position to know how much (or little) that $50 in savings might mean to me and my family.

[txtornado]

Being tight for cash does not give anyone the right to treat others poorly, steal, or vandalize others property. As stated before, once they pop open a mask, they are out $$.

Not that I owe anyone an explanation, but just to clarify - when I asked the DME about different masks, the woman I spoke with said about two of them (ComfortLite 2 and Mirage Swift), "I don't know if we have that or not. Our reps drive around with a bag full of masks so I don't always know what they've got." I interpreted that to mean that their reps drive around with a bunch of demo masks. Seems logical to me that you should be able to try these things on with no commitment to purchase as mask fit seems to be a very personal thing. Is that a correct assumption? I don't know. I'm not an expert in how this process works. I'd bet you're not either. But I wasn't planning on having them special order a bunch of stuff for me to try on.

Is trying on a demo item from a store you know you're not going to purchase from the most correct thing to do? No. But it's hardly stealing or vandalism. If the situation really is that any mask I tried on would then be "ruined" and a total loss to the company, that's another story. But the statement I made was based on the assumption that they have demo masks and the worst thing I'd be doing was wasting a few minutes of someone's time. Again, maybe not the nicest thing in the world, but not a crime. Salespeople make pitches and do demos all the time for people who don't purchase. It's a part of the business.

Why didn't I go into all this in my original post or my response to Brent Hutto? Because it's flippin' ridiculous, that's why. It was one or two sentences out of three paragraphs, and not the main point of my post. But since I take great offense at being characterized as a vandal and thief, I felt the need to expound upon my original statement.

Now I'm done with this thread. Enjoy your time up on that high horse.
[/quote]

[sleepylady]

TxTornado,

One thing the DME may not have mentioned, is that many charge separately for the headgear for the masks. My DME charged quite a bit for the mask portion and then quite a bit for the headgear. All told, it was very ridiculous. Also, when I tried on masks at my DME they would get them off the shelf and have me try a certain one on. I tried on three total that day. Ok after I didn't like the first one, she put it back on the shelf. No I'm not kidding. So Brent, DME's do indeed sell masks that may have been tried on by other people. I also was able to take one home at a time to "test drive" it and found I went through FOUR. I gave them back four masks that I'm sure they used for another patient.

Now I don't have a sleep specialist either, and my doctor is absolute aces. I did try a regular CPAP in the beginning and then tried upping the pressure. After that didn't work, I called my doctor and said I'd like to try an APAP and explained my reasoning. She wrote out a script seeing how my logic made total sense. Now I've only ordered software and masks from cpap.com, but found them to be aces to work with. Whatever machine you decide on will be great. I have a P&B 420e APAP and absolutely love it. My DME tried to give me a song and dance that the software was thousands of dollars also. I said, oh really, I can get it online for $99. Her response was ohhhhhhhhhhhhhhh. I have the software and am glad I do.

Best of luck and let us know what type of equipment you ended up with.

Melinda

[Midnight Son]

Contributing to our collective education, I was given the insurance billing codes that were relevant for my prescription. Unlike CPAP.com where you buy a CPAP unit (comes with hoses, with or without humidifier), and a mask (comes with headgear, etc) the insurance billing codes parse this same purchase into numerous chargeable elements. The following were the codes relating to my prescription:

A7034 Integrated. Mask
A7035 Head Gear
A7036 Chin Strap
A7037 Tubing
A7038 Disposable Filters
A7039 Non-disposable Filters
E0562 Heated Humidifier
E0601 CPAP Unit 15 months rental, then own

Most insurance companies have negotiated rates for these codes, so the DME business model appears to be charge as many codes as you can and provide the cheapest equipment fullfiling the minimum need. Nothing particularly surprising about this, but I was shocked at the markup (440%) versus purchasing the equipment at CPAP.com pricing. With a 50% co-pay I am much better off buying the equipment directly, without insurance, than using the insurance coverage and DME. In this case I get what I pay for, and it eliminates the DME incentive to select the minimum equipment. I'm glad I found this forum prior to visiting the DME or I wouldn't have understood the difference.

[CheezWiz]

Being tight for cash does not give anyone the right to treat others poorly, steal, or vandalize others property. As stated before, once they pop open a mask, they are out $$.

Not that I owe anyone an explanation, but just to clarify - when I asked the DME about different masks, the woman I spoke with said about two of them (ComfortLite 2 and Mirage Swift), "I don't know if we have that or not. Our reps drive around with a bag full of masks so I don't always know what they've got." I interpreted that to mean that their reps drive around with a bunch of demo masks. Seems logical to me that you should be able to try these things on with no commitment to purchase as mask fit seems to be a very personal thing. Is that a correct assumption? I don't know. I'm not an expert in how this process works. I'd bet you're not either. But I wasn't planning on having them special order a bunch of stuff for me to try on.

Is trying on a demo item from a store you know you're not going to purchase from the most correct thing to do? No. But it's hardly stealing or vandalism. If the situation really is that any mask I tried on would then be "ruined" and a total loss to the company, that's another story. But the statement I made was based on the assumption that they have demo masks and the worst thing I'd be doing was wasting a few minutes of someone's time. Again, maybe not the nicest thing in the world, but not a crime. Salespeople make pitches and do demos all the time for people who don't purchase. It's a part of the business.

Why didn't I go into all this in my original post or my response to Brent Hutto? Because it's flippin' ridiculous, that's why. It was one or two sentences out of three paragraphs, and not the main point of my post. But since I take great offense at being characterized as a vandal and thief, I felt the need to expound upon my original statement.

Now I'm done with this thread. Enjoy your time up on that high horse.

Opinion Mode On:
All we can see here are words. That is a very limited perspective. We can only take words at their face value and what I read had a dishonest intention. I am not afraid to voice my opinion when I see something wrong. IMHO, that is a big issue with our society today. Everyone is so concerned with not offending someone, hurting feelings, or simply taking some personal responsibility in a situation that they walk on by and try to pretend they did not see anything. Such an attitude has nothing to do with how many hands a horse adds up to. I am glad that you did elaborate.
Opinion Mode off:

Your assumptions may likely be incorrect. I had the same assumption but each time I tried on a mask the DME popped open a brand new unit. I felt guilty about that and still do. I even asked him to put my name on the other two and send them my way at 6 and 12 months. I am glad that I did because another assumption that I had turned out to be wrong as well. Trying on a mask does not help a lot. I narrowed my selection to the top three masks from here and other discussion boards. I tried them on connected to my machine and on the bed. I even laid back and rolled around. They all felt about the same and I picked the one with the least vision obstruction. When I hooked up and went to bed, everything was different. Until you have been in it for a while, you really do not have an understanding of how it fits or how it might be better. Now I look forward to getting the Ultra2 FF mask because of the way its forehead support is designed.

Doing this alone is going to be a tough task. The folks around here are an invaluable source of info. Don't be afraid to PM questions to individuals if you feel uncomfortable posting it on the public forum.