Intro & getting the right device tips (newbie)

[chrisiscitrus]

Hi everyone,

I was diagnosed with mild OSA with an AHI of 6 and with 15 arousals and awakenings per hour in February and am finally getting in for titration and hopefully will receive a PAP soon afterwards. I've read through the WIKI pages about DME suppliers and insurance as well as machine choices. When I call local DME suppliers, they typically say "We only carry ________ and/or ________" which are typically Resmed or Philips devices which are in the "not recommended" portion of the "machine choices" wiki. When I ask specifically about the Airsense 10 autoset or Dreamstation Auto, the customer service reps (which were all very helpful and friendly, btw) said that "it would depend upon what your doctor recommends", suggesting that unless the doctor straight up recommends an auto CPAP device, they'll just give me one with fixed pressure and limited data capabilities.

Now, I've never met the Sleep Doctor, and I'm guessing I won't meet her again when I go in on Thursday. My question is, how can I have a Doctor to prescribe a particular device if I've never met them? If I don't see the doctor, can I insist to the DME that I get an Airsense 10 Autoset despite not necessarily having the "auto" recommendation on the prescription?

Sorry if these have been answered before. I've done some searching on the forum but figured that an answer specific to my needs would be beneficial to me.

Thanks in advance everyone,

Chris

[khauser]

Ask the doctor to recommend what you want. Most I've dealt with are more than happy to do so. I fire the others, LOL.

After my sleep study I asked my primary care if he would write the prescription the way I wanted. It was that easy.

Resmed makes Airsense, and Philips makes the Dreamstation, so there might be a miscommunication happening.

[Julie]

Tell the staff you need to see the doctor because you want a certain prescription and won't take no for an answer except from him/her personally.

[zonker]

Hi everyone,

ask for the machine in my sig. be firm. if your sleep doctor won't write it for what you want, find a doctor who will.

ANY doctor can write a script for a cpap machine and it will be honored.

good luck to you and come see us when you get your new machine.

[Pugsy]

Read this
https://maskarrayed.wordpress.com/
and this
https://maskarrayed.wordpress.com/what- ... me-part-i/
while the models are a bit outdated the premise behind them hasn't changed.

All cpap/apap machines use the same billing code for insurance E0601...all of them no matter if they are the no data bricks or fixed cpap only models or the auto adjusting capable apap models.
Insurance pays by billing code...not brand or features.
Since insurance pays by billing code they are going to supply the machine that costs them the least wholesale so they make more money.
Good old American greed. They will tell you that they can't supply apap because the RX is for fixed pressure. That's BS...they could indeed supply the apap and just set the machine in cpap mode (all apaps have at least cpap fixed mode and auto adjusting mode)...they just don't want to because they don't make as much money.

Now some DMEs routine will dispense the apap version and just set it to cpap mode as a matter of standard practice because they can and they realize that often auto mode is handy for any number of reasons. Those DMEs are hard to find but they are out there.

But if you ask the doctor to be specific as to brand and model and mark the RX "dispense as written"...the DME has to do it. They have no choice. Some doctors will just do it and not fight you about....some are stick in the muds and won't and you don't really want those doctors anyway....too stuck in the dark ages and on power trips.

Insurance pays X amount of dollars for E0601 billed out machines. DMEs will want to maximize their profits by selling you the one that costs them the least. Profit margin is the primary focus but they will blame your insurance and everyone else and not admit to the greed thing.