I went to my new ENT/Sleep doctor

[Tino2You]

Hi everyone,
Thanks for all the help last week when I pulled the charts to give to my new ENT/Sleep doc. I gave him the summary and compliance reports from both rescan and sleepyhead. He actually took the time to look at both and asked questions about SH. I also gave him a couple of daily detailed reports from SH. He asked how I came to the pressure settings I was now using (I gave him a copy of my sleep study) and was honest and told him I changed it and as my AHI is almost always below 1 and I use the machine about 8 hours a night he agreed.

I told him my concern that my S9 has over 16,000 hours on it and it is making more noise than when it was new. He told me the insurance no longer covers five year replacement. They will only replace it if it stops working. I told him that could happen whenever I wished as it wouldn't take much to drag it off the nightstand in my sleep but I was thinking about getting a new one next spring.

He recommended that i get a new sleep study next spring. He coordinats with a sleep center where the study takes place, the doc there has a pre study interview and a post study appointment with a machine recommendation (to be filled by Apria...le sigh). My last study was just that, a study with a report that my old ENT turned into a script.

Has anyone else had a study like this?

Thanks,
-tino

[Hang Fire]

Has anyone else had a study like this?

What do you mean "a study like this"? What you described is just an ordinary titration study.

[chunkyfrog]

Call your insurance and ask THEM.
Doctors usually are not up on insurance coverage.
It is not their job.
If you are in a poopy HMO, and the answer is no, buy one yourself.
Grayghost, secondwindcpap, and others may have affordable machines.

[bwexler]

The only reliable answers will come from your insurance company and then only if they are in writing and cite the paragraphs in your policy that cover the answers to your questions.

Once you get reliable written answers to several questions

Will I require a new sleep study to get a new machine?
Can you do an in home sleep study?
Get a list from the insurance company of in network DME providers.
Get in writing what the insurance company will pay if you go out of network.
Does the insurance company require a rental period, if so how many months?

I have probably missed one or two more, but this should get you started.

[BlackSpinner]

You AHI is under control so why do you need a new sleep study?

[chunkyfrog]

Logically, heck no.
Insurance-wise, logic be damned!

[klv329]

Maybe a backup s9 from craigslist....seemed to be a few in the area at ok prices. One for 175 with 2100 hours ... can't seem to cut and past right now. Of course, ccl purchases don't come with certain risks....

There it is, nice narrative at least,

https://washingtondc.craigslist.org/nva ... 55610.html

[SewTired]

I sympathize. It was the same thing for my family member to get a new wheelchair. Insurance company would only replace if it wasn't fixable any more. How is he supposed to function WHEN HE CAN'T WALK!? Do you know what he did? He APPEALED and got the new wheelchair (the old one will be used in the slush and snow until it actually does crap out). So, my recommendation is to file an appeal with your insurance company stating that it is unreasonable for you to wait until your machine fails when it is so old already and well past the expected life expectancy of the product (which is 14,000-15,000 hours). You could not function more than a night or two without a machine, but would be forced to wait weeks for one. Anyway, give it a shot.

[Sir NoddinOff]

I sympathize. It was the same thing for my family member to get a new wheelchair. Insurance company would only replace if it wasn't fixable any more. How is he supposed to function WHEN HE CAN'T WALK!? Do you know what he did? He APPEALED and got the new wheelchair (the old one will be used in the slush and snow until it actually does crap out). So, my recommendation is to file an appeal with your insurance company stating that it is unreasonable for you to wait until your machine fails when it is so old already and well past the expected life expectancy of the product (which is 14,000-15,000 hours). You could not function more than a night or two without a machine, but would be forced to wait weeks for one. Anyway, give it a shot.

Hmmm... that's an interesting case.

[Tino2You]

Sorry it took so long to reply. I hate when life gets in the way of fun.
To start, I have two machines. I have an S9 brick as a travel machine. I was concerned that the insurance company changed the rules..(concerned not surprised). I was also surprised that they would only replace the machine if broken. As I told the doc to his face, "it can always fall off the night stand".

His request for the sleep study was twofold. One so he has a base line of my Apena. The second would be ammo against the insurance company to use to get a new machine. It is not scheduled till April so there is sufficient time for my AutoSet to "fall off" my nightstand.

-tino