I have a meeting with my DME...

[Gparr]

...tomorrow at 1:00 and she is NOT going to be happy!

It's amazing what one an learn by reading here!!! You all have treated me well and have aided me in my new journey on CPAP.

I shall be asking my DME tomorrow to switch out my 3 week old F&P ICON to a Resmed S9 Autoset with humidifier and climate hose. I know she is going to say NO... as that is what she told me on my first visit 3 weeks ago...however...I just had breakfast with my GP this morning...he has agreed that if she says no to my request, he will write a prescription for the Resmed and write to dispense as written. Man...it's good to know some people in high places.

So...here is to hopefully owning a new machining soon...

[hyperlexis]

Good luck with that DME.

However you will likely be very disappointed. They gave you an auto machine per your prescription, which adjusts itself by computer to the pressures it senses you need. It's not a fixed cpap. That's likely all your prescription ordered. "Auto CPAP at pressures X and Y."

Unless the script expressly said supply X brand machine and model, the DME will say it filled the Rx as ordered. Then if the DME failed to perform and gave you the wrong machine, you would have a very strong argument to demand they replace the machine as prescribed.

You probably want a machine with more data capability, but that's not the point of the script, or the concern of the DME, or the insurance company who reimburses for the machine. Your doctor likely just said give an auto machine at these pressures. No more and no less. The DME did this. An insurer wont re-pay for a whole new machine just to get a fancier machine to allow you to look at data at home.

The problems with DMEs (at least all the DMEs I dealt with - and even the manufacturers' local reps) is that none I dealt with would allow 'test drives' of their cpap machines before buying. So a new user never really has the chance to use different brands before picking one he or she likes the best. Things like noise, displays, exhalation relief systems, etc., all differ, slightly, between units. But no, you don't get a chance to try them and return them before buying. You take it, you own it.

The Fisher Paykel Icon machine you have is really not a bad machine at all. It is an auto machine, has a humidifier, and even has a heated tube. It may not have all the data tracking that the Cadillac machines may, but it certainly doesn't make it a bad machine at all. There are plenty of people using (successfully) far more basic, less fancy machines than what you have been given. So don't lose sleep over your Icon...

Alternately, you can always buy a new, higher level machine for cash if you really want to.

Good luck!

[Gparr]

Thanks for your response.

If she says no..my doc will rewrite the prescription for the Resmed...would that not be good enough?

Why can't I simply turn it in before the 30 time period and move on to another DME who would honor that?

Give me some clues here...I want a machine that I can take control and tach what is happening...not sending in the info every 3 months to have somebody say I have complied.

[Gparr]

In addition...what would happen to my current unit if I did spend the money and purchased my own? I will certainly not keep it...just thinking...

[StuUnderPressure]

Your problem might be whether or not the DME has already processed the claim with your insurer AND whether or not the insurer has already paid it.

You might have better luck trying to get the SAME DME to switch the machine.
But, I am guessing that ResMed machines are NOT carried by that DME.
OR, it would cost them too much to just order 1 machine from ResMed, if they do not regularly order from ResMed.

[hyperlexis]

Thanks for your response.

If she says no..my doc will rewrite the prescription for the Resmed...would that not be good enough?

Why can't I simply turn it in before the 30 time period and move on to another DME who would honor that?

Give me some clues here...I want a machine that I can take control and tach what is happening...not sending in the info every 3 months to have somebody say I have complied.

I doubt it -- again it's a 'you bought it, you own it' mentality. I vaguely recall my DME saying if there were problems there may be a chance to try another machine within a set number of weeks, but that was only after speaking to the manager at the DME at length. But they refused to let me try an S9 for a week, then try a PR60 for a week, then an Icon, etc... It was pick one, and if it's really horrible, we'll give you a shot at a second, but that will likely be it.

The DMEs are really touchy about these things because once used, the machine becomes damaged goods essentially, a used, dirty machine they cannot re-use with another patient paying for a new machine. So the DMEs try at all costs not to go through this.

Each machine, even the Cadillac machines, have their own significant flaws and good points. You need to learn about all units before deciding. Because you will be stuck with it for a long time. And, is it worth it when your Icon is still a pretty good unit?

There is a possibility they may take it back if you tell them how horribly dissatisfied with the machine you are, and then you and your MD are going to have to make darn sure you ask for the one you really, really want. No backsies on that one.

The DME may go along or may not. But worth a shot. Good luck.

And FYI, you will still have to send the chip in or use a modem to show you complied no matter what machine you get. Insurance demands it and rightly so.

[Janknitz]

I'm sorry to say that I have to agree that you are going to have a difficult time swapping one auto machine for another at this point. You'd have a stronger argument if they gave you a CPAP brick and your doctor wants you to have APAP and/or full data capability for your treatment needs. But you already have an APAP with efficacy data--you didn't get a data-less brick. You just want a fancier one.

They gave you a brand new machine, and your only reason for wanting to swap it is to get the Cadillac instead of the VW. They both drive and get you where you're going. And now the VW is used, so they can't sell it for full price anymore, nor can they get enough money to keep up their profit margins if they give you the Cadillac. It's a lose-lose situation for them, why would they want to help you??? And your GP is not a sleep medicine doctor, so they probably won't even notice if he stops referring patients to them--if he ever referred anyone to them in the first place.

I'm not saying not to try, but I would be very surprised if you are successful, other than the possibility of ending your capped rental (if it is a capped rental) with this DME IF you can find a DME who will provide the ResMed S9 Auto under the circumstances. BE VERY CAREFUL ABOUT BURNING YOUR BRIDGES WITH THIS DME UNTIL YOU ARE COMPLETELY CERTAIN ANOTHER DME WILL PROVIDE WHAT YOU WANT--You don't want to get stuck with NO machine or an out of pocket bill.

Are you on Medicare and in a competitive bidding area? That's a new development that may further complicate the ability to get the machine of your choice and limits your choice of DME's as well. It pays to know that before you go into your meeting with the DME, because that seriously reduces your chances of success.

The machine you have is a good one, so it wouldn't be the worst thing in the world to be stuck with it, or if you're really unhappy with it, there's always Craigslist or Secondwind.com.

[Gparr]

Thanks for your comments!!! I appreciate your honesty!

I will certainly give it a good try! I am one that does not necessarily like confrontation...however the worst thing they can say is no. I will certainly not burn any bridges!!!

The machine is currently being "rented"...I guess for the one year then purchased outright? I don't fully understand it. So worst case...after it is purchased I can always pay out of pocket and get the unit I want for the long term.

[vic]

Just curious, what pressures are you set at ? Will the Icon tubing fit the S9 ?
You may want to get some type of read out on your compliance You have had the Icon 3 weeks.

[Gparr]

Vic,

I honestly don't know my setting parameters...although I know it starts at 5.

My compliance right now is 92%... Although since day 7 it has been 100%.

Hope this helps...

[vic]

You may need that information going forward. Insurance requires it. Get a copy if you change machines.

If you pap unit was an antibiotic..............would you go from the generic to the name brand.
My point is.........you seem to be doing fine on the Icon. Why play with success.

[DreamDiver]

There is also this scenario:
If you are in a typical rent-to-own DME situation, the machine is currently almost a month old. If something went wrong with the IKON in that time, they would certainly take it back and replace it, but it would be replaced with a used one already on hand with about as many hours on it. They don't have to give you a new machine to replace your existing used IKON. The contract would go on as before.

If the reason for changing to another machine is customer choice, they don't have to give you a brand new S9 autoset. It's entirely possible they will give you a used S9 autoset with about as many hours on it as your existing IKON. This would be considered a reasonable commercial endeavor since your IKON is already used too.

In other words, you might get an S9 on doctor's orders, but it might not be a new one. If it's not a new machine, you shouldn't be asked to sign a new contract, since you'll be trading like for like as far as fair usage is valued. If you are asked to sign a new contract for a used S9, call your insurance company to find out if that's fair to you from their standpoint while you're in the DME's office. If it is a new S9, you may be asked to sign a new contract, beginning the rent-to-own scenario from the beginning. You might even want to call your insurance on that one too.

Read all the small print and fees before signing anything.

[Gparr]

I posted a few minutes ago...but for some reason it did not show up.

I have returned from my meeting. My DME has stated since I am renting my current machine she did not see any issues switching to the Resmed S9 Autoset. She will make a phone call and get back to me so,entire tomorrow.

In response to Dreamdiver...I am in agreement with you...I am not asking for a new unit...to be fair just give me one with like hours and I would be happy.

Time will tell...

[DreamDiver]

I am in agreement with you...I am not asking for a new unit...to be fair just give me one with like hours and I would be happy.

Good luck!

[Janknitz]

I have returned from my meeting. My DME has stated since I am renting my current machine she did not see any issues switching to the Resmed S9 Autoset. She will make a phone call and get back to me so, entire tomorrow.

That's AWESOME! I'm glad to hear it. I like to be wrong sometimes.

Hopefully they won't call you and say "sorry, no can do".
AND, beware of the "bait and switch". Confirm that it's a ResMed S9 AutoSET, NOT an escape Auto, before signing anything or leaving the DME.