first conversation with DME

sleepyinO · Post by **sleepyinO** » Fri May 23, 2008 11:06 am

I just talked to the RT at the DME where my doctor sent the order for my APAP. I made an appointment for next week and asked him what brand of machine I would be getting. He said (without answering my question) that I would only be using the APAP for two weeks, so that they can find out what pressure I need and then consult with my doctor about getting a CPAP. Is this usually how it works?

He did mention that the two weeks with the APAP are complimentary, which makes me wonder if this is their way of luring you in and then trying to shove a P.O.S CPAP off on you. On the other hand, if the APAP doesn't help, then I guess I'm not out any money...

Any comments/suggestions would be greatly appreciated.

Thanks!

Brian

bap40 · Post by **bap40** » Fri May 23, 2008 11:27 am

Yep, you got it right. Actually they use the auto machine to find the best CPAP setting for you. Then they do give you, usually, a bare-bones CPAP machine. Most people on this board will tell you that you need a data-capable machine and that is different from just compliance data, although some RT's will try and tell you different. In order for one to get the best treatment you do need a data capable machine and you usually have to fight to get it. These machines give you all sorts of valuable information. Mask leaks, AI, HI, AHI, snores, the times of any of these events. This way you KNOW what things you need to tweak for the best therapy. With non-data machines all you can do is guess and never really know what is going on.

Good Luck

Slinky · Post by **Slinky** » Fri May 23, 2008 12:23 pm

The thing you need to do right now is call your insurance company and ask them what local DME CPAP suppliers they are contracted with. Hopefully you will have the option of more than one.

With more than one option you can "shop" the local DME suppliers your insurance is contracted w/to get the equipment you want (w/in reason), find the most lenient mask exchange policy and a DME RT you are comfortable working with.

rtkeat · Post by **rtkeat** » Fri May 23, 2008 6:43 pm

I am an rt and work in a dme and the other poster are right. My industry if rife with corruption. Here is the low down small local dme dont buy cpaps by the palet so they have pricing issues but they often give better customer service..not always but often. Large dms ( apria lincare rotech) get better pricing on the equipment but will try to set up programs where you get a mask and supplies every three months and will limit your access to the rt.
It is in your best interest to have a hot rod machine that is capable of multipul modes...cpap apap and there is cflex and aflex to think about as well. It sounds like your doctor is using the local dme to perform the titration part of your sleep study. Jump on this oppurtunity as it is free but keep in mind that the dme is marketing your doctor to get the referal. I would ask the doctor after the titration is complete to write your script for an apap. The respironics m series apap is capable of both cpap and apap mode and comes with cflex and aflex versions. Ask to experience both cflex and aflex if you can. Here is the way the insurance works they pay a fixed price for the cpap no matter what you get..so it is in the dme's best interest the sell a cheap machine and thus widen the profit margin so you always have to fight to get what you want. Often a dme will try to charge you cash to make up the difference sometimes up front sometimes post set up. You need to shop around and grill them up front keeping in mind that it is a very competitive market and someone is going to do what you want to get the business.

snoregirl · Post by **snoregirl** » Sat May 24, 2008 8:30 am

WOW!! A currently employed RT who is willing to tell it like is it. Better not let your employer figure out you are posting here

CUatX · Post by **CUatX** » Sat May 24, 2008 10:45 am

Ditto what rtkeat said! I just went through the selection process, and after the having the "big guns" infer that I was a stupid redneck incapable of making decisions and to "just trust them", I chose a locally-owned DME. (Could it have been that I was wearing overalls, had just visited my mare, and had horse-s*** on my boots?)

The difference in willingness (nay, eagerness) to work with the patient was amazing.

I just started xPAP, so it'll be interesting to see how things go.

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rested gal · Post by **rested gal** » Sun May 25, 2008 4:11 pm

Hi neighbor, CUatX.

I'm in NE Tennessee, too. Been around horses a lot.

Hope all is going well for you!

CUatX · Post by **CUatX** » Mon May 26, 2008 6:54 am

And a great big horsey hello to you also! What's your discipline, & what do you ride? Right now I'm between riding horses (I have one retired QH pasture queen), do some training-level dressage, and am in Bristol.

Needsdecaf · Post by **Needsdecaf** » Mon May 26, 2008 7:04 am

I would just like to add that not all of the large DME's are filled with jokers, etc. My local Apria office has been pretty good to deal with.

Of course, if I hadn't been here I wouldn't have known what to ask for, but being informed, they have offered very little resistance in ordering extra masks, switching me to a pro, etc.

Slinky · Post by **Slinky** » Mon May 26, 2008 7:09 am

Ha! We have two red dun QH mares: a 27 year old we've had since a weanling and a 7 year old we got as a coming 3 year old. We also have a 12 year old Paint gelding.

My daughter started in 4H w/an 18 year old chestnut QH mare, a Leo granddaughter. When we lost her to sand colic we bought a 7 year old bay grade mare who seemed very much like a Morgan. We lost her to sand colic at 22 whilst my daughter was in the hospital trying to hold on to her first born. The old red dun mare we got as a weanling is a Spanish Clipper granddaughter. I"m not a fan of Paints or geldings so don't know much about him or his background.

Daughter does Dressage, Drives and Reining. We have a gorgeous Lady's Brougham for driving. Two granddaughters are now in 4H and daughter is putting in her second stint as a 4H Leader w/a highschool classmate as her co-leader. She's never been big time showing, just local Open, Color and Breed shows and nearby county fairs.

Youngest granddaughter is "into" jumping and wants to do vaulting but no nearby instructors for either. *sigh* Oldest granddaughter is a double lower leg amputee and is most interested in Dressage but it is proving a challenge whilst the western discipline w/"more saddle" is more her forte. Still she won't give up on the Dressage. The sad part is that the old mare can do it all for her but at 27 we can't keep working her all day at the shows as she's done for years in almost every class.

RestedGal was into the higher levels of the horse world. I was into dog showing (as was RestedGal) whilst my daughter was into the horse showing so I'm more a by-stander, groom and go-fer at the horse shows.