Don't need to be in compliance

[Cubbiebear]

When I took my sleep study test I knew I would need a CPAP then had the Titration study done. I began reading this forum that taught me a lot before I ever bought my CPAP. I decided I would not allow anyone to control MY machine by afar thru cellular/Cloud. I also would not be compliant for anyone no matter what. No one had a right to change or monitor my CPAP. I attempted to go thru two different Pulmonary Specialists and left them when I was told I would be expected to be compliant. I then spoke with my PCP who said he could order what I needed based on my studies. I attempted to go through two different companies..Lincare & Apria. They both argued with me that I had to be compliant for insurance. I repeated myself over and over that I was going to pay up front for the CPAP not using insurance. They both argued I had to go through insurance regardless if they paid or not so I was in compliance, dumb people never understood I guess. I told them both in no uncertain terms what they could both go do. I found a place that my son told me about cpap.com that I could buy my CPAP and all supplies with just my doctors order for it, they didn't accept insurance and didn't care about any compliance. My PCP is following me with the CPAP if you want to call it that. I have not spoken to him since I got it and won't till next month when I go in. He told me what to watch for and if any changes to call the office. He did not need to monitor me or see anything. He believes a patient should be in charge if they are capable of doing so and I am. Had I been forced to be compliant I would have chosen not to use the CPAP.

Does anyone else have any similar situations?

[D.H.]

If you pay yourself, you can do as you wish.

However, you're leaving money on the table.

[kteague]

I hope you didn't let all us rebel rousers on here get you more on the defensive than necessary. One aspect of compliance is to meet usage requirements to qualify for insurance coverage. When we talk about CPAP machines, that's usually what's being talked about. The compliance period is usually fairly brief. When we talk about compliance with a doctor, it could well be construed as an issue of following the doctor's plan of treatment. If I were a doctor and a patient in essence told me it was none of my business whether I was following their instructions, I would tell them then they didn't need me. They want to know if we take meds as prescribed, etc. and this is no different. I would only being concerned with compliance monitoring if I planned to not be compliant. Now, I'm with you on not wanting my machine monitored and maybe even settings changed remotely. I'd probably ask them to do it old school and take the card in for them to get the data. Now, if insurance weren't involved, there's little reason to bother with it at all. I've gotten varied reactions from doctors I've been assertive with about my treatment. One nearly blew a gasket. Another was ok once she saw my changes were based on machine data and achieved desired results.

[Cubbiebear]

I hope you didn't let all us rebel rousers on here get you more on the defensive than necessary. One aspect of compliance is to meet usage requirements to qualify for insurance coverage. When we talk about CPAP machines, that's usually what's being talked about. The compliance period is usually fairly brief. When we talk about compliance with a doctor, it could well be construed as an issue of following the doctor's plan of treatment. If I were a doctor and a patient in essence told me it was none of my business whether I was following their instructions, I would tell them then they didn't need me. They want to know if we take meds as prescribed, etc. and this is no different. I would only being concerned with compliance monitoring if I planned to not be compliant. Now, I'm with you on not wanting my machine monitored and maybe even settings changed remotely. I'd probably ask them to do it old school and take the card in for them to get the data. Now, if insurance weren't involved, there's little reason to bother with it at all. I've gotten varied reactions from doctors I've been assertive with about my treatment. One nearly blew a gasket. Another was ok once she saw my changes were based on machine data and achieved desired results.

Actually it was 50/50 learning from you rebels. LOL! I have enough in me already & my Mom called me a rebel growing up because things had to be "my way." I fully understand compliance and wanted/needed no part of it which is why I chose to pay for everything bypassing my insurance, my choice. I keep my CPAP on Airplane mode and it doesn't bother me at all having to press the button everyday saying I want it still. My PCP explained what he wanted me to look for, the levels and call him if needed. Every morning I read my report on the machine. I take the SD card out a few times a week and view it thru Sleepyhead. For me this is a perfect setup. I believe insurance companies have no right to meddle with our health...just stick to selling policies. My doctor (PCP) and me know whats best.


D.K.- Money well lost for me.

[Pugsy]

Money well lost for me.

There's no price tag on the "hassle factor".
My insurance has never bought me a machine. I buy my own privately. The hassle factor cost...avoiding it has been priceless for me.
Now I do use my insurance for my once every 6 month new mask allowance. My DME is cool with this arrangement. They get to make a little money off me and to be fair they have offered their help with whatever machine I might be using at the time. He's amazed at some of the killer hot deal prices I get and just laughs...especially when I told him I found an ASV machine to play with.

I pay for my insurance and for that reason I elect to at least use it for a couple masks a year. I don't use it for replacement supplies very often because I simply don't need replacement supplies as often as they are allowed.

[herefishy]

I divorced my sleep doc when the DME said I needed a letter from him to get a new mask, and he charged me $25 to write the letter. No way. I've never been back to the DME or the doc. Just get my stuff from e-bay.

[Cubbiebear]

Herefishy- I buy my supplies on Amazon..cheaper than where I originally bought them. I will peek at EBAY. They make you think you need a prescription but you don't for supplies.


Pugsy- Thanks.... I love my insurance but not for everything. By playing with the ASV machine do you mean using it or tinkering with the mechanics of it?

[mrcrayola]

Hi Cubbiebear. My experience is a little bit similar in the frustration category. I asked the DME to bill me for the full payment of the machine so I could get reimbursed from my flexible spending account. They wouldn't do it. My guess is they want to drag out the "relationship" for as long as they can so they can keep hitting me up for replacement supplies, etc. It was even a challenge to get them to send me an invoice for the monthly billing so I could submit those for reimbursement.

The Philips machine has a modem which I presume is for monitoring purposes, although I haven't talked with my sleep neurologist since he prescribed the titration (?) study (conveniently offered via his practice). However, Philips sets the modem default to 'on.' You can turn it off in the settings, but the machine switches it back on automatically after a few days. Very annoying!

Finally, my GP is somewhat dismissive of CPAP therapy (and septum surgery), so if I ever get ticked about PAPing, I can always find a sympathetic ear.

Cheers!

[Pugsy]

By playing with the ASV machine do you mean using it or tinkering with the mechanics of it?

.

I used it to treat my OSA...I have NOT had a problem with centrals.
It can be used to treat OSA but it's a real expensive way to treat OSA. Do to the way it responds differently to OAs it had some advantages that I just liked. You've heard the expression "more than one way to skin a cat"...well there's more than one way or one machine to treat OSA.

I don't ever tinker with anything mechanical anymore. I am really good at taking something apart but totally suck at putting it back together so I don't mess with anything mechanical. Last time I tried that I was going to put a new cartridge in my kitchen faucet...which should be simple to do. Ended up totally screwing it up and had to go buy another faucet and the one I trashed had cost me over $200. I learned my lesson with anything mechanical so unless it was trashed anyway I just don't tinker with machines.

[prodigyplace]

By playing with the ASV machine do you mean using it or tinkering with the mechanics of it?

.

I used it to treat my OSA...I have NOT had a problem with centrals.
It can be used to treat OSA but it's a real expensive way to treat OSA. Do to the way it responds differently to OAs it had some advantages that I just liked. You've heard the expression "more than one way to skin a cat"...well there's more than one way or one machine to treat OSA.

I don't ever tinker with anything mechanical anymore. I am really good at taking something apart but totally suck at putting it back together so I don't mess with anything mechanical. Last time I tried that I was going to put a new cartridge in my kitchen faucet...which should be simple to do. Ended up totally screwing it up and had to go buy another faucet and the one I trashed had cost me over $200. I learned my lesson with anything mechanical so unless it was trashed anyway I just don't tinker with machines.

You can just add it to the "Honey-Do" list
My wife wanted me to plant a fence post this weekend. Let's just say we found the water line from our well & pump to the house.

[Pugsy]

My wife wanted me to plant a fence post this weekend. Let's just say we found the water line from our well & pump to the house.

Count your blessings. At least it wasn't a network of underground telephone cables.

[D.H.]

Someone once suggested that "compliance" should be limited to insurance and legal terminology, and the term"adherence" should be used in the clinical setting. In this way, the latter word should not carry a threatening connotation.

If you're adherent you might need your money because you can live a long time.

[prodigyplace]

My wife wanted me to plant a fence post this weekend. Let's just say we found the water line from our well & pump to the house.

Count your blessings. At least it wasn't a network of underground telephone cables.

Actually I got the 240 Volt power cable underneath the pipe too. Fortunately the pump was not running at the time.
A check valve kept the water from the house flowing. The low pressure cutoff switch protected the pump. Hopefully i will have running water when I get home this evening.

[Janknitz]

I'm going to say ONE THING in defense of Crapria and LinDon'tCare (probably for the first time ever!) and that is that IF you have Medicare or a contracted insurance company they are correct that it may be illegal (Medicare) or a violation of their contracts with your insurer to sell a CPAP machine to you directly and bypass your insurance. This is to prevent these DME's from scalping people who don't know how their insurance works. But I'm not sure you'd want to buy through them anyway because their prices are ridiculous fantasies.

Sounds like you've already done this, but if not, have your doctor write a prescription for what you want, then you can buy it online from our hosts or another vendor or find a good used machine. It's easy enough to set up yourself, use Sleepyhead to monitor yourself and your keeper of a doctor to troubleshoot.

It is a good thing to empower yourself to take charge of your health. Welcome to the Rebellion!

[LSAT]

Hi Cubbiebear. My experience is a little bit similar in the frustration category. I asked the DME to bill me for the full payment of the machine so I could get reimbursed from my flexible spending account. They wouldn't do it. My guess is they want to drag out the "relationship" for as long as they can so they can keep hitting me up for replacement supplies, etc. It was even a challenge to get them to send me an invoice for the monthly billing so I could submit those for reimbursement.

The Philips machine has a modem which I presume is for monitoring purposes, although I haven't talked with my sleep neurologist since he prescribed the titration (?) study (conveniently offered via his practice). However, Philips sets the modem default to 'on.' You can turn it off in the settings, but the machine switches it back on automatically after a few days. Very annoying!

Finally, my GP is somewhat dismissive of CPAP therapy (and septum surgery), so if I ever get ticked about PAPing, I can always find a sympathetic ear.

Cheers!

Do you have an airplane mode?