DME VS Doctor

[jgriddle]

My doc prescribed the Remstar auto M w/ C-flex and my DME said thay had problems with this machine in the past and wanted to sub this one with one they suggesteded. Have anyone ever had this problem with this or is it just my poor luck to go to this DME?
Thanks
Jerry

[mindy]

Hi,

I'd want to know what they are going to substitute before I accept it. Make sure it's a fully data-capable machine!

Mindy

[Wulfman]

The ONLY thing I would let them substitute what your doctor prescribed would be the Auto with A-Flex.
Otherwise, they're only going to SCREW you by giving you something from the bottom of the barrel as far as capabilities go. They're trying to feed you a line of BS to make more profit.

If they continue to have a "problem" with that, go back to your doctor and have him/her insist on the Auto with A-Flex (which also has C-Flex).....either with a new prescription or whatever it takes.

DON'T BE A VICTIM!

Den

[rested gal]

The only thing I'd not want to get with an M machine (cpap/bipap/autopap) is the M series integrated heated humidifier.

I'd get a separate Fisher & Paykel HC 150 heated humidifier. It can be used with any brand or model of machine. It would work fine with the M series REMstar Auto with C-flex (or with A-Flex, for that matter.)

Any other brand of autopap the DME could possibly substitute would NOT have an exhalation pressure relief feature while the machine was working in "auto" mode.

The DME probably wants to substitute a machine called the resmed S8 Autoset Vantage with EPR. If you asked them about pressure relief during exhalations, the DME would tell you, "Oh yes, it has exhalation pressure relief...that's the EPR." BUT, resmed's "EPR" feature cannot be turned on in auto mode. You have to be using the Vantage in straight cpap mode to use its exhalation relief feature -- EPR.

At this time, Respironics makes the only autopaps that offer a pressure relief setting (C-flex and A-Flex) during each exhalation.

If I wanted an autopap that can give relief from pressure each time I exhaled, I'd insist on one of these Respironics machines:

1. the older (pre-M series) REMstar Auto with C-flex
2. the M series REMstar Auto with A-flex
3. the M series REMstar Atuo with C-flex

or...I'd go back to my doctor and ask for the prescription to be re-written for one of these Respironics bipap machines:

1. the older (pre-M series) BiPAP Auto with Bi-Flex
2. the M series BiPAP Auto with Bi-flex

As I mentioned earlier, if I got any of the M series machines, I'd not get the M series integrated humidifier for it. I'd get the separate F&P HC 150 heated humidifier.

With the older (pre-M) Respironics machines, the integrated heated humidifier for them is fine.

[6PtStar]

jgriddle, the Respronics "M"series has very few problems. The only real problem all the "M"'s have is that the humidifier chamber is a bit prone to leaks if you take it apart very often other than that they are great machines. If I was going to get the "M" auto I would try to get the Auto with Aflex. It will run in Cfles or Aflex mode. Some feel that Aflex is a great improvement in comfort. With out knowing what they want to give you I would supect that they are using tho old "bait and switch" routine to give you a cheeper machine so they can make more profit. It is real common in the DME world. Post what they want to give and we can tell you more.

Jerry

[Slinky]

Other than the Respironics M Series Auto w/A-Flex NONE of the other autos, including the Respironics M Series Auto w/C-Flex, provide expiration relief in auto mode.

IF they offer you the Resmed S8 AutoSet Vantage there is NO problem w/filling and detaching the humidifier as far as leaks as the M series has had. And both are much easier to do w/the Resmeds plus there isn't the external power source and wires to contend with.

I have both the Resmed S8 AutoSet Vantage (w/EPR in straight CPAP mode only) AND the Resmed S8 Elite w/EPR (which is a fully data capable straight CPAP) and I love them both.

But then my scripted pressure is only 8cms and I don't need or use the Ramp OR the expiration pressure relief features and so wouldn't need the Ramp, A-Flex or C-Flex of the Respironics either.

The ONLY advantage I see to the Respironics CPAPs or AutoPAPs is the new patient specific EncoreViewer software. The ONLY difference known between the patient specific Encore Viewer and the clinician's EncorePro software is that you cannot change your pressure w/the EncoreViewer software. Resmed does not have a patient specific software and cable reader but the clinician's software, AutoScan 5.7 or the newer, ResScan, and cable reader are available at cpap.com and elsewhere if you search for it.

The Puritan Bennett GoodKnight 420E is an excellent autoPAP but doesn't have expiration pressure relief in auto or straight CPAP mode. The software is readily available.

[ozij]

Other than the Respironics M Series Auto w/A-Flex NONE of the other autos, including the Respironics M Series Auto w/C-Flex, provide expiration relief in auto mode.

Respironics autos with both C-Flex and A-Flex offer expiration reilief in auto mode.

O.

[DreamStalker]

Beware of that DME as Den has pointed out and respond as RestedGal has suggested.

Gook luck!

[rested gal]

Other than the Respironics M Series Auto w/A-Flex NONE of the other autos, including the Respironics M Series Auto w/C-Flex, provide expiration relief in auto mode.

Respironics autos with both C-Flex and A-Flex offer expiration reilief in auto mode.

O.

ozij's right.

The ONLY difference known between the patient specific Encore Viewer and the clinician's EncorePro software is that you cannot change your pressure w/the EncoreViewer software.

That's the main difference. However, another important difference (if a doctor or DME will expect to download the card in the future) is that the EncoreViewer software that Respironics developed for patients does not erase the data from the Smart Card after a download. The normal action of Encore Pro is that the data is erased after every download unless one knows to change a system setting.

[GumbyCT]

The only thing I'd not want to get with an M machine (cpap/bipap/autopap) is the M series integrated heated humidifier.

What she said.

And it is NOT just leaks, mine does NOT leak, never has. Don't get me going on M series humidifier - my bp goes into overdrive.

Suffice it to say, RG is wise beyond her years. Just memorize the list she posted.

ps. I find the A-flex easier than the C-flex (more natural on exhale). oh & if your DME is Apria, run!!!

[7diverdog7]

Having owned a DME business and retired this year I recall the primary roll of the DME supplier is to fill the Dr,s RX. If there is a question about the equipment, talk to the Dr. Don't infer that the prescriber does not know what he or she is doing.

[GumbyCT]

Having owned a DME business and retired this year I recall the primary roll of the DME supplier is to fill the Dr,s RX. If there is a question about the equipment, talk to the Dr. Don't infer that the prescriber does not know what he or she is doing.

Am I wrong thinking that the doc IS the prescriber ??
Isn't the DME required to provide what the doc ordered? Not just provide whatever is on sale THIS week?

So nodding in agreement, Yes - "the primary roll of the DME supplier is to fill the Dr,s RX."

[jules]

I think when you open the "fill the Rx" with generic substitutes then all hades breaks loose.

More docs need to write DO NOT SUBSTITUTE on their Rx's and stand by that.

I think the phrase "patient's choice" needs to be clarified too when dealing with DME's - too often "patient's choice" becomes DME driven and isn't the "patient's choice" after all because the DME refuses to special order it.