Got my prescription yesterday

[mlim650]

Hi,

I jot my prescription in the mail yesterday and would like your opinion on two APAP machines I have shortlisted: Puritan Bennett 420E and Respironics M Series Auto with C-Flex.

1) The PB420E do not have feature like the C-flex that I used during my tilteration study. (set to 2)
2) Software friendliness.
3) Ease of use.

I did my study with the Optilife mask and would like to purchase that for my daily use.

My presciption:

Equipment prescribed:
CPAP:1
Prescribed pressure: 7cm of H2O
Hours of Use: 8 hours
With Sleep: Yes
Ramp time: 5-30 mins
Humidifier: Heated

Your advice and opinion is greatly appreciated. Thank you.

[wolftracker]

if you go to a brick and mortar dme
you will not get an apap with that script
the script has to say apap on it for them to give you one

if you get it a cpap.com you probably can get a apap.

my .02

wolf

[mlim650]

Thanks for your comment.

There is a note in my prescription **Use Local Durable Medical Equipment Company Only**.

Why is that?

[Catnapper]

I would say that your keyboard to the computer is local.

Catnapper

[john44077]

I wont get my sleep study results for 2-3 more day's. My primary care doctor who i also happen to work has never written a script for a cpap. He just knew i needed the sleep test and how great i felt afterwards. What sould i have him write on it? C Pap with heated humidifer? The presure #'s i need? Thanks John

[NightHawkeye]

Hi mlim650,

If software friendliness and ease of use are what's most important to you, then you might prefer the PB420E. The Respironics software can be a bear to install and use. Reports on the PB420E Silver Lining software are good. Also, the PB420E is the lightest and most compact of all the APAPs. A year ago there were numerous reports of infant mortality with PB420's though, but I don't recall seeing any complaints recently.

As for C-flex, at your prescribed pressure of 7 cm, I doubt that it will make much difference to you.

There is a note in my prescription **Use Local Durable Medical Equipment Company Only**.

If it's part of the prescription stationary, then it's there because a local DME provided your doc the prescription pads gratis. If your doc wrote it in, then he had no business doing so. Either way, it's not legally binding! (And some folks wonder why I gripe about physicians all the time.)

Regards,
Bill

[Slinky]

This is the way "I" understand it. (Hopefully one of our RTs will jump in and better advise you).

Have him write the script for the SPECIFIC AutoPAP the two of you decide on plus the pressures. You will need BOTH IHP and EXP pressures listed for an AutoPAP. Should also include "Heated humidifier". And since the Optilife is a relatively new mask that should be specified as well.

That is the ONLY way you are going to get exactly what you want from a local DME. Especially needed are the IHP and EXP or the DME can justify claiming you do NOT need an AutoPAP. The C-Flex is entirely different than a set EXP. You need to have a scripted EXP. 4 or 5 would be satisfactory as the C-Flex of 1 would be roughly equivalent to a reduction of 1 cm of pressure from your IHP of 7 cms.

That

**Use Local Durable Medical Equipment Company Only**.

would torque my jaws no end and the doc and I would be having one extended discussion about that!!!! I'm guessing he added it because he doesn't have the software and capability to check the data and would need a local DME to download the info and FAX him the printouts. If YOU have the software YOU can do the download and printouts to provide him and then there is no need for the local DME.

HOWEVER, I would explore my options w/the local DMEs you have the option of using and if you find a good one, humor your doctor and use them. A good local DME "can" be an asset! Plus it keeps your doc happy.

[snoregirl]

Mlim,

I agree that notation about local DME only is not binding. I also agree that with that script you will have a really hard time (if it is even possible) getting an APAP frm a local DME. Need a range and the script to say APAP. If your insurance works with Bill my insurance you may be ok with that script and you can definately get an apap from Cpap.com with that script.

John,

What you need on the script and depends on what you want and whom is going to pay.

For a local DME with insurance....

If you want CPAP it has to say CPAP and a pressure, and heated humidifier, and if you want a specific machine or cflex it should say that too. Also patient's choice of mask, nasal or full face, so you get a choice, not the cheapest.

If you want APAP, you need the script to say APAP and a Range of pressure (for example 10 - 13) as well as heated humidifier and any other options/brands you want. Same on the mask.

To buy from CPAP.com you need a script that says CPAP or APAP (either will do for an APAP and that is about all, don't even need your pressure if you are planning to set the machine up yourself (it is easy). No prescription needed to purchase the humidifier or the mask...

[snoregirl]

Another note to john. Do your financial calculations to make sure that using a local DME is actually saving you any money.

[BrianRT]

[quote="mlim650"]Thanks for your comment.

There is a note in my prescription **Use Local Durable Medical Equipment Company Only**.

Why is that?

[Slinky]

BrianRT, forgive me for gainsaying a professinal sleep RT - BUT - if the script doesn't at the very least specify a fully data capable xPAP the local DME could very well provide a compliance data capable machine only.

And thus IF it is this person's family doctor writing the script it is HIGHLY unlikely that he/she has the software and capability of downloading the data, compliance or efficacy, etc. So if the patient doesn't get a fully data capable machine AND the necessary software (and reader if needed) AND the patient purchases online rather than from a local DME "WHO" is gonna supply the compliance and therapy results?????

[BrianRT]

(I'm hoping I understood your question, Judy)
Most machines I've dealt with, NON-auto, have compliance data you can get from the screen, such as total hours, number of nights greater than 4 hours, etc.

The sleep docs I know of have the software and reader at their office and can read your card there. I agree that most family docs don't get that specialized.

Yes, for a local DME, it HAS to say APAP, otherwise you'll get a standard. My understanding is that Cpap.com don't differentiate and a CPAP RX is all you need to get an auto or standard.

The RX above is for a standard CPAP, but if you wanted an auto, you could go online and get around that.

[john44077]

Thank's everyone for the advice.

[mlim650]

The prescription is printed by the Sleep Study clinic and signed by a different physician than the one I visited with. I will try to call the sleep clinic people tomorrow to see if I can get a different script that would allow me to purchase an APAP.

So I gather that I would at least need the EXP and IHP pressures to be indicated in the script? Funny thing is that I use C-flex during the study. I would expect such a reputable clinic would know better.

When I called my DME previously, before I receive my presciption, I was told to fax my prescription and insurance card to set up an appointment. In your opinion, should I sort this out with my sleep clinic before contacting my DME? I'm concern that once they have my prescription and if I got a new one they would not "honor" the new script.

[Slinky]

Well, personally, I would have "all my ducks in a row" BEFORE I approached a local DME w/the script.

I "believe" that all the Respironics xPAPs capable of C-Flex are fully data capable. C-Flex "does" provide exhalation relief by either 1 cms, 2 cms or 3 cms as I understand it. (I have a Resmed product w/EPR instead of Respironics w/C-Flex).

An AutoPAP is a different machine than "just" a CPAP altho they fall under the same HCPCS code for billing purposes and are reimbursed at the same amount (altho they cost the DME more and cut into their profit margin).

The two machines you have indicated as your choices are both AutoPAPs.

And I got you mixed up w/John whose family doctor is writing his xPAP script, rather than the sleep lab writing yours. My apologies if I confused the issue for either of you.