How to adjust pressure on REMstar plus with c-flex

Dingus · Post by **Dingus** » Sat Dec 11, 2004 9:32 pm

I was told how to do this when I bought the machine but I have not needed to adjust until now and have forgotten how. I have lost a lot of weight and need to lower the pressure a little...

Thanks
Dingus

IllinoisRRT · Post by **IllinoisRRT** » Sun Dec 12, 2004 1:43 pm

I would contact your DME provider- IMO, patient's shouldn't be adjusting the pressures themselves. It should be done by someone such as a respiratory therapist who can then doublecheck the pressure with a manometer.

wading thru the muck! · Post by **wading thru the muck!** » Sun Dec 12, 2004 4:15 pm

Christine,

For those of us without insurance how much should we expect to pay a DME/RRT to check our machine and make an adjustment for us.

Thanks for posting on this forum. It's great to have a person with your background commenting here.

IllinoisRRT · Post by **IllinoisRRT** » Sun Dec 12, 2004 7:37 pm

Honestly, if your machine was purchased at our store, I would do it for free with a doctor's prescription. I haven't had to deal with any patients who walked in without having purchased the machine from us, so I don't know if I technically COULD do it if that were the case. However, knowing my boss, he'd have me do it anyway (in case doing you a favor might make you more likely to buy supplies from us down the road).

wading thru the muck! · Post by **wading thru the muck!** » Sun Dec 12, 2004 8:57 pm

Thanks Christine,

Interesting, the way you answered that question. I'm interested why it would be a concern about servicing a machine that you did not sell. I appreciate that you felt at your place you would go ahead and do it. But my concern in general is why the connection between purchasing equipment and receiving medical services. In the USA I can walk into a medical facility anywhere and receive medical services for a fee without regard to where I'd received these services before. Why would this be different at a durable medical facility.

I really appreciate your taking the time to help those of us out here better understand your piece of the medical services pie.

IllinoisRRT · Post by **IllinoisRRT** » Sun Dec 12, 2004 9:25 pm

I don't really know why it would be different, if the machine was purchased. Now that you mention it, it probably isn't any different. I haven't been in the business that long, and like I said, I've never had it happen...maybe I will ask my boss tomorrow and see what the "real" answer is.

wading thru the muck! · Post by **wading thru the muck!** » Sun Dec 12, 2004 9:46 pm

Christine,

Thanks for the reply.

To be clear, I don't in any way mean to be critical of you or your DME company. I'm just refering to the industry in a general sense.

I think you were probably right in your original answer regarding the general DME experience of a lot of people. The whole durable medical equipment segment of health care is odd to me. Most of the Docs know very little about the equipment and most of the DMEs treat the "patient" as though they are not even a customer, I guess because the insurance company is the one with the money.

The patient is left feeling like a second class citizen, like a young child being shuffled through the system.

Maybe what I'm telling you is a good thing for you. There's no competition when it's bad competition. Somehow though I think you care how things turn out for everbody. That's why you're here and that's why I ask you the questions.

Thanks

snamvar · Post by **snamvar** » Sun Dec 12, 2004 10:44 pm

Hi,
There is an older discussuion on how ro set the pressure for the Remstar pro. I think it would also work for Plus.
http://cpaptalk.com/viewtopic.php t=287&highlight=remstar+pressure

rested gal · Post by **rested gal** » Sun Dec 12, 2004 11:51 pm

Since health care providers probably face all kinds of liability issues, I can kind of see where a store's policy might be to not do anything to a machine that someone just walked in carrying - with no prescription on record. If they touched the machine at all, even to do such a simple thing as check the pressure with a manometer, who knows what they would then be liable for? Sounds farfetched, but heck...in this ridiculously litigious society I can see store owners not wanting to get involved in any way with these machines unless they had already gotten paid very well indeed for selling the equipment and had a certain amount of responsibility to service what they had sold. It's too bad, because as Wader pointed out, it makes things difficult for employees like Christine, for example, to really help people as much as she obviously would like to.

wading thru the muck! · Post by **wading thru the muck!** » Mon Dec 13, 2004 6:58 am

r g,

What I'm trying to get at is in all other areas of healthcare a provider would open themselves up to liability if they didn't treat a patient that came to them in need or at least made sure they were treated by another facility. I guess I wouldn't have a problem with the way things are if you were just buying the equipment from the DME, but it's more than that. Often the Docs don't know about the equipment and leave it up to the DME. At that point they are no longer just an equipment supplier and have become a healthcare provider subject to an obligation to treat a patient in need. I'm on my soap box about this because I was just shocked when I experienced this in obtaining my equipment. That's why I turned to cpap.com to make my purchase and receive the wonderful support they give. Pretty pathetic when you can get much better service from a DME half way across the country via phone/email than you can get from a local business just down the street.

Can you tell I'm worked up on this subject.

Thanks again to all who have commented.

davidtwotrees · Post by **davidtwotrees** » Mon Dec 13, 2004 8:01 am

Dear Muckie.
[would be nice to have a name.......smiles]
My sleep doc and the DME are all pretty well meaning, I think, but it is a bit of a bueracracy-you have the Dr and his staff, the floating dme, and to top it off the insurance co. who is like a silent partner with a whole other set of rules and guidelines.
I know you are uninsured. I quit ironworking in '93 and lost that great health insurance. I went until 01 without insurance [8 years] so I know how it feels to be without, as well as seeking treatment with no insurance. The people in the Drs office looking at you like a bug when you say you are self-insured! I finally found a program that forces the insurance cos to take on people who have no life threatening illness' and can afford to pay. I am self employed.
I guess the gist of my post is that the providers literally don't want your cash money. Sounds as if you are trying to view it from a capitalist business idea. There is no competition in the healtcare industry. And that is why it is so great to hear that cpap.com is filling a niche for those in need, or those that don't want to wade thru the muck of the healtcare industry.

wading thru the muck! · Post by **wading thru the muck!** » Mon Dec 13, 2004 8:24 am

Hi David,

I do have insurance that I pay a LOT of money for. In return I expect to get treated as I should when I'm spending MY money. I didn't get treated that way at the half a dozen or so local DMEs I called prior to jumping through all the insurance hoops necessary to be able to purchase from cpap.com. I have not regreted it for a moment. My concern is that poor service from local DMEs is a common thread on all the cpap forums. This is a problem for the community of people on cpap. As I see it it is a defect in the way healthcare is provided to us users and until we demand better service it will continue.

Are you in the northwest "burbs" of Chicago? I'm just across the WI/IL border.

Thanks for contributing your comments to this subject.

Steve

IllinoisRRT · Post by **IllinoisRRT** » Mon Dec 13, 2004 9:35 pm

I started to reply at work but didn't want to get in trouble!

In reference to our earlier "conversation" Steve, I asked my boss and he said that I could reset a pressure for anyone who walked in the door as long as they had an order in hand from the doctor.

That being said, I want to comment on something to defend myself and the field in general. When it comes to what I do, we talk alot about doing what's best for the patient, and in most cases we do, but in lots of other cases, our hands are literally tied. By the dreaded insurance company. We have a contract with one company where I cannot even see a patient without a specific order and lots of red tape. Our contract with them states that we can only provide Respironics equipment (which I actually like). I probably shouldn't have ordered the Oracle for the patient like I posted before, but in that case I did "the right thing". It's a double edged sword, really. I want to do the right thing for the patient, OF COURSE. That's why I entered the field in the first place, that's why I'm here. But, I also want to keep my job. I have a husband and a son. Do I think I do a good job? Absolutely. Would I like to have a little more freedom to do a better job. You'd better believe it. I know that there are bad apples everywhere, but I really believe that medical professionals are unhappy with the way they are forced to do their job. And yes, I feel like sometimes we are forced to do things a certain way, but it's also a job that pays the bills and provides us with, ironically enough, the dreaded insurance.

::stepping off soapbox::

chrisp · Post by **chrisp** » Mon Dec 13, 2004 10:26 pm

So what you are saying is this: Since the insurance company calls the shots, the only way to save a buck is to go on the internet . If the person had been given an auto unit the question needn't be asked. Oh well history repeats itself. Sorry you're in the middle Christine. So we get the shaft and we're angry at you and its all because of some fat insurance dud. Its not fair...So how do you adjust the pressure on a remstar w/c flex. I dont have one myself..I won't tell ....

Cheers,

Chris

wading thru the muck! · Post by **wading thru the muck!** » Mon Dec 13, 2004 10:40 pm

Christine,

No need to defend yourself, your activity on the forum is defense enough that your motives are good.

My criticism is regarding a "gap" in the healthcare chain in regard to how Durable medical equipment is dispensed. Be it the fault of the insurance companies or others it leaves the patient low on the "food chain" when the patient should be at the top.

I know that you make extaordinary efforts to make things work for your patients. But this and other forums are full of people who have been left to suffer with inferior or malfitted equipment.

Doesn't it seem that the system is broken when people like myself (and others prominent on this forum) have received much better results by taking charge of our own healthcare and educating ourselves enough to choose the equipment that we know will work for us. All of this inspite of what the professionals recommend or I guess as you say are contractualy obligated to "recommend" in the best interest of their patient.

I'm curious why does this insurance company you refer to only allow Respironics machines. My Puritan Bennett 402E was much less expensive than the Remstar auto and it suits my needs much better. I do not dislike the remstars but for the features and the money I chose the PB. I don't want that choice taken away from me because some insurance company executive got taken out to more fancy lunches by the Respironics rep.