Can they take my CPAP MACHINE AWAY???

[eeckel]

As someone who just got through the 90 day compliance period I have great empathy for you and your situation. It is rough knowing big brother is scrutinizing your usage but not helping to solve problems. There has to be a better way to get started on CPAP.

[ems]

Something's broken. Putting patients through h*ll like this is shameful. If they'd taken my CPAP away (which they tried yesterday by sending someone out to pick up the machine without notifying me) not only would I have to be dealing with my elderly mother's life and her E.R. docs (which has been a constant for many moths) but my own health, too -- and all because my data showed 3% lower than the required compliance rate without taking extenuating circumstances.


I can't type here what I'm really feeling about what you are saying. 3% lower than it should have been and you had to go through all this... incomprehensible!!! And, apparently, it varies from state to state b/c as I said earlier I think my doctor wrote to Medicare. For sure, no DME person called or came to get my machine.

I think this is one of the worst stories about DMEs that I've read here.










Again, thanks!

I got a new Resmed S9 and the provider read the data. Despite trying very hard to comply, my numbers fell short (but not too short) of compliance numbers (they downloaded the data from my machine) and I got no warning. I've been struggling with the headgear, too, which the company knew about.

The provider is picking up the machine TOMORROW. My doc's office and medicare both said the same thing.

I was told by Medicare that if I want the machine I can buy it. Does anyone know of a rental company for CPAP machines I can get in the interim because this mess is going to take a while to resolve. Or maybe there's another solution?

Thanks

[Musica]

[quote="archangle
Thanks[quote/]
How long have you had the machine? I think you have 90 days to meet the 70% in 30 days requirement. Do you think you actually failed the 4 hours per night for 30 days, or is it possible they made a mistake?[quote/]
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To answer your question, I called today. My score was 67% and the requirement was 70% == that was only 3% short of their required score. Fortunately, after many calls, MANY calls, I was told they'd extend it for another 30 days. I'm grateful but it sure took a lot out of me making all those calls, some even three way calls between the insurer and the DME.

I wouldn't wish this fiasco on anyone which is one of the reasons I'm posting this message. Good luck newcomers.

[Musica]

You can always lock your door and not answer the doorbell when they arrive until the issue is resolved. I highly doubt that they will get a warrant to gain acess to the machine.

Dave

Too funny! I'd probably get a bill for $950 in the mail if they didn't get it back when requested, but I did call to be sent the scores, and as I mentioned elsewhere in this message forum, my score was 67% and the minimum for compliance was 70%. Considering how exhausted I've been with my own health problems AND going to the ER with my elderly mother a lot, you'd think they'd make allowances before picking up the machine unannounced. Fortunately, they gave me another 30 days.

Let's see if they send me the scores...should be interesting to see their business practices in action.





https://www.youtube.com/watch?v=WhWavua-1FI

[Musica]

You can always lock your door and not answer the doorbell when they arrive until the issue is resolved. I highly doubt that they will get a warrant to gain acess to the machine.



my guess is that after one or two failed attempts,they will send you a bill for the machine.

Dave

If they bill you, they'll probably bill you the "uninsured patient" ripoff rate, which may be 2 to 3 times higher than the insurance patient rate, and 4 or more times higher than the online supplier rate.

I was told I'd get an extra 30 days. If they deny what they're saying I will then get a phone to record ALL calls with their consent -- for ALL calls, not just medical. Seems there's a lot of inept people answering phones without proper training -- they'll point fingers saying "the other person was wrong". So, if I have it recorded, they can lie but the answer will be there via their own voices. How can they contest that? Does anyone know of a phone that records -- just in case I need one to protect myself? If EVERYONE had one then people wouldn't be so glib with their answers when responding to a serious medical question!

[zoocrewphoto]

Glad you were given an extra 30 days.

Now, to the compliance issue. You mentioned trouble with your headgear, but nothing specific. You need to be compliant for this next 30 days, so tell us what troubles you are having so that we can get this problem fixed quickly and keep you compliant.

You mentioned that you have been using cpap for 5 years. Were you having trouble then? If not, has something changed? Did you have a different mask before that you liked better?

If you are not sure that you can get 4 hours of use per night, then definitely wear it during the day while watching tv or reading a book. ANything to make sure get that 4 hours per day.

What hours do you normally sleep? Do you average the same amount of hours per night? Are you only getting a few hours of sleep per night, so you have fewer hours to be successful in? Do you have struggle a lot to keep it on while sleeping?

Hopefully, the problems you have been having can be solved or at least reduced enough so that you can meet compliance on this try.

[MidnightOwl]

Thanks so much. AFTER MANY, MANY calls, I finally called the department that has the test results. I was 67% compliant and 70% compliance is required. They're giving me 30 days more. The privider also said they get phone calls like mine EVERY DAY.

Something's broken. Putting patients through h*ll like this is shameful. If they'd taken my CPAP away (which they tried yesterday by sending someone out to pick up the machine without notifying me) not only would I have to be dealing with my elderly mother's life and her E.R. docs (which has been a constant for many moths) but my own health, too -- and all because my data showed 3% lower than the required compliance rate without taking extenuating circumstances.

I'm sorry for what you're going thru and I'm very glad you got an extension.

I'm curious. Your first post mentions medicare but more recently you talked about your insurer? Are you medicare advantage? If so you should probably specify or else the information you get on requirements could be totally wrong.

I think they ARE taking in account all the extenuating circumstances that can happen in a person's life. If you think about it the standards you have to meet are really very low. Four hours on slightly more than 2 nights out of 3. That allows for a lot of nights where you never use it at all -whether you're at the ER, have a bad cold, a power failure, a broken mask that takes some time to get replaced, or new user adjustment problems (which doesn't apply to you). And they only require you use it for half a night when you do use it - which takes care of those late nights. If they weren't making allowances they'd be expecting you to prove you used it closer to 8 hours a night every single night.

Perhaps you can keep a log of how long you use it each night. That way you'll know if you have a problem before the end of the next month and you'll be able to fix it before it's too late.

[Musica]

Thanks, these are good questions but running to the ER a lot with my mother and dealing with her health problems has been the #1 issue in my life. I think I've been falling asleep without realizing it (TV and everything on) because I've been so exhausted. Things are a bit more settled now but despite all the mayhem I was able to get 67% of the 70% required. The rest won't be very difficult at all.

I think, because I've always been a mouth breather, the pillows aren't a good idea anymore. My hunch is that mouth-breathers shouldn't have to retrain themselves. Look what happens to kids who are left-handed who were taught to use their right hands. It was an unwise choice parents made decades ago only to find it was the wrong choice.

Glad you were given an extra 30 days.

Now, to the compliance issue. You mentioned trouble with your headgear, but nothing specific. You need to be compliant for this next 30 days, so tell us what troubles you are having so that we can get this problem fixed quickly and keep you compliant.

You mentioned that you have been using cpap for 5 years. Were you having trouble then? If not, has something changed? Did you have a different mask before that you liked better?

If you are not sure that you can get 4 hours of use per night, then definitely wear it during the day while watching tv or reading a book. ANything to make sure get that 4 hours per day.

What hours do you normally sleep? Do you average the same amount of hours per night? Are you only getting a few hours of sleep per night, so you have fewer hours to be successful in? Do you have struggle a lot to keep it on while sleeping?

Hopefully, the problems you have been having can be solved or at least reduced enough so that you can meet compliance on this try.

[Musica]

My score was 67% compliance. The minimum is 70%. I wasn't too far off. I'm still wondering why picking up my machine was so urgent. Also, Medicare gave me 30 extra days. When my DME said no, I called back medicare and they said no also. I asked if the woman who allowed me an extra 30 days was wrong. I was told, "Yes, she was wrong." I don't know why medicare reps can give two different answers to the same question, but that's America and how people are trained. Nowadays to get an answer we have to choose from the best two out of three and then pray!
It's ghastly!

Ever feel like telling a professional to Google it? Would you believe MANY doctors don't know what PubMed is? Why? Because they don't look up information. Very frightening!

Thanks so much. AFTER MANY, MANY calls, I finally called the department that has the test results. I was 67% compliant and 70% compliance is required. They're giving me 30 days more. The privider also said they get phone calls like mine EVERY DAY.

Something's broken. Putting patients through h*ll like this is shameful. If they'd taken my CPAP away (which they tried yesterday by sending someone out to pick up the machine without notifying me) not only would I have to be dealing with my elderly mother's life and her E.R. docs (which has been a constant for many moths) but my own health, too -- and all because my data showed 3% lower than the required compliance rate without taking extenuating circumstances.

I'm sorry for what you're going thru and I'm very glad you got an extension.

I'm curious. Your first post mentions medicare but more recently you talked about your insurer? Are you medicare advantage? If so you should probably specify or else the information you get on requirements could be totally wrong.

I think they ARE taking in account all the extenuating circumstances that can happen in a person's life. If you think about it the standards you have to meet are really very low. Four hours on slightly more than 2 nights out of 3. That allows for a lot of nights where you never use it at all -whether you're at the ER, have a bad cold, a power failure, a broken mask that takes some time to get replaced, or new user adjustment problems (which doesn't apply to you). And they only require you use it for half a night when you do use it - which takes care of those late nights. If they weren't making allowances they'd be expecting you to prove you used it closer to 8 hours a night every single night.

Perhaps you can keep a log of how long you use it each night. That way you'll know if you have a problem before the end of the next month and you'll be able to fix it before it's too late.

[MidnightOwl]

Thanks, these are good questions but running to the ER a lot with my mother and dealing with her health problems has been the #1 issue in my life. I think I've been falling asleep without realizing it (TV and everything on) because I've been so exhausted. Things are a bit more settled now but despite all the mayhem I was able to get 67% of the 70% required. The rest won't be very difficult at all.

That's good to hear. But remember your health is even more important than the compliance numbers in the long run. So try to use it all the time. I read before sleeping. And when I'm really tired I can just fall asleep. The only way I can make sure I use the cpap every night is to put it on immediately when I get in bed even if I'm not planning to sleep right away. Perhaps you can try something like that with the tv.

I think, because I've always been a mouth breather, the pillows aren't a good idea anymore. My hunch is that mouth-breathers shouldn't have to retrain themselves. Look what happens to kids who are left-handed who were taught to use their right hands. It was an unwise choice parents made decades ago only to find it was the wrong choice.

I think the idea behind the "retraining" is that some people are only breathing through their mouths because they aren't getting enough air due to the apnea. And that once the apnea is treated by cpap they won't need to do that anymore. Also some people, including me, find full face masks less comfortable and harder to keep from leaking. However if you think you will sleep better with a full face mask by all means try one. It might be better to wait until after your 30 days are up however.

[zoocrewphoto]

Thanks, these are good questions but running to the ER a lot with my mother and dealing with her health problems has been the #1 issue in my life. I think I've been falling asleep without realizing it (TV and everything on) because I've been so exhausted. Things are a bit more settled now but despite all the mayhem I was able to get 67% of the 70% required. The rest won't be very difficult at all.

I think, because I've always been a mouth breather, the pillows aren't a good idea anymore. My hunch is that mouth-breathers shouldn't have to retrain themselves. Look what happens to kids who are left-handed who were taught to use their right hands. It was an unwise choice parents made decades ago only to find it was the wrong choice.

Before, you mentioned something about the headgear and the dme not helping you. Do you still need help figuring that out? Do you just need a different mask? Anything that you are struggling with will hold you back.

You will also have to force yourself to make sure you mask up every night. If you think you may fall asleep while watching tv, you can either mask up while watching tv, or set a timer to force you to get up and move to the bed with your machine. You have a lot to lose if you don't master this now. I doubt they will extend it again.

[49er]

As hard as not having insurance is, reading this thread makes me realize how lucky I am not to have to worry about compliance. In spite of my efforts, I would have failed big time. My heart goes out to you Musica.

Anyway, I wanted to remind people that Musica needs to use the machine while sleeping to meet the compliance requirements. Running it while reading or doing another activity besides sleeping will not be allowed as according to Caesar, the machine can make the distinction.

49er

[zoocrewphoto]

Anyway, I wanted to remind people that Musica needs to use the machine while sleeping to meet the compliance requirements. Running it while reading or doing another activity besides sleeping will not be allowed as according to Caesar, the machine can make the distinction.

No, that is incorrect. The machine cannot tell whether you are awake or not. It only knows whether somebody is breathing into it or not. You can't just have it on with nobody attached. That doesn't count. But if you are awake with it on, it will count.

As for actual helping her health, then yes, it does need to be used anytime she is asleep. I struggle with that a bit myself. I have started setting a timer while I watch tv so that if I doze off, it will wake me, and I will know I need to get my mask on. Otherwise, I may go several hours before I wake up and realize I messed up. I am past my compliance phase, so for me, it is all about treatment. I know I feel better when I use it all night.

[MidnightOwl]

My score was 67% compliance. The minimum is 70%. I wasn't too far off. I'm still wondering why picking up my machine was so urgent. Also, Medicare gave me 30 extra days. When my DME said no, I called back medicare and they said no also. I asked if the woman who allowed me an extra 30 days was wrong. I was told, "Yes, she was wrong."

I'm sorry I missed this before. What is your next step? Do you need another sleep study? Can you appeal this? Good luck.

[MidnightOwl]

Anyway, I wanted to remind people that Musica needs to use the machine while sleeping to meet the compliance requirements. Running it while reading or doing another activity besides sleeping will not be allowed as according to Caesar, the machine can make the distinction.

49er

The machine CANNOT tell the difference between wake and sleep. That's one of the limitations on the accuracy of the AHI it reports. It just assumes you are asleep if it is running and you are wearing the mask. It can tell if you run it while not using it whether it's sitting in another room or you left it on while you ran to the bathroom - those are called "blower hours" as opposed to "usage hours"