No new machine for me. :(

[joeattardi]

Hi all,

Sorry I've been away for a few days; I've been traveling and just got back yesterday. My ongoing saga to get a better machine has reached a dead end. I finally heard back from my doctor. He is not going to give me a prescription for an S9-series machine because he thinks "the insurance won't pay for it". I tried to make my case for the data card monitoring, etc., but he wouldn't budge.

It looks like I'm stuck with my "tattletale" S8 Escape II. The DME supplier won't budge without a prescription, and the doctor won't give me one. Even when I looked into buying direct, CPAP.com still requires a prescription. Am I out of options?

[Wulfman]

Hi all,

Sorry I've been away for a few days; I've been traveling and just got back yesterday. My ongoing saga to get a better machine has reached a dead end. I finally heard back from my doctor. He is not going to give me a prescription for an S9-series machine because he thinks "the insurance won't pay for it". I tried to make my case for the data card monitoring, etc., but he wouldn't budge.

It looks like I'm stuck with my "tattletale" S8 Escape II. The DME supplier won't budge without a prescription, and the doctor won't give me one. Even when I looked into buying direct, CPAP.com still requires a prescription. Am I out of options?

Please read carefully........

Your doctor HAS to give you your prescription!!! Didn't you get one with your present machine? If you have a generic "CPAP" prescription, you can purchase an APAP/Auto machine from CPAP.COM or CPAPAuction.com.

I was browsing through the Auction site earlier and saw a whole bunch of S9s in the Auto CPAP section.


Den

[joeattardi]

Your doctor HAS to give you your prescription!!! Didn't you get one with your present machine? If you have a generic "CPAP" prescription, you can purchase an APAP/Auto machine from CPAP.COM or CPAPAuction.com.

I never saw the actual prescription, but I think it was for a specific machine, or at least a specific class of machines.

[brazospearl]

Joe, so now's the time to get the actual prescription in your hand. Your doctor is required by law to provide that to you if you ask. Once you have it in your hand, let us know exactly what it says and we'll help you from there. While you're getting stuff from the doctor, get a complete set of ALL the data from your sleep study. You are legally entitled to have that, also.

[carbonman]

While you're getting stuff from the doctor, get a complete set of ALL the data from your sleep study. You are legally entitled to have that, also.

....and then I'd be looking for a doc that cared about my health
and well being.....instead of someone or some company's bottom line.

[Wulfman]

Your doctor HAS to give you your prescription!!! Didn't you get one with your present machine? If you have a generic "CPAP" prescription, you can purchase an APAP/Auto machine from CPAP.COM or CPAPAuction.com.

I never saw the actual prescription, but I think it was for a specific machine, or at least a specific class of machines.

Then, it's about time to get it!!! It's good for "life" when purchasing from online sellers.
As long as it says "CPAP" or "NCPAP", you can get an APAP as I mentioned before.
As mentioned, if your doctor refuses to give it to you, he's in violation of HIPPA laws. Same thing with copies of your sleep study.

You COULD get a copy of it from the DME who gave you your present machine.


Den

[PetrusKy]

He is your soon-to-be-ex-doctor anyway so there's no need to be diplomatic any more. Demand that prescription because it's your right and report him if he doesn't give it to you. You can always find a new doctor to write you one, that's easy.

[joeattardi]

Thanks for the advice, everyone. I just left a message at my doctor's office requesting that they fax a copy of my prescription to me, "for my own records".
In the meantime, is it worth the effort to call up my insurance company and ask them if the higher machine would be covered?

If it isn't, if I can't get an S9, is an S8 Elite II or S8 AutoSet II still worth fighting to get? I know the data card is not a standard format, but from what I've read on here it's still possible to access and analyze the data.

[brazospearl]

Yep, call the insurance folks. They'll be able to tell you the replacement schedule for your equipment. It'd be great if they picked up all or part of the cost. In any case, either the S9 or S8 Auto would provide more data than your current machine. If you can't swing getting the S9 the S8 Autoset would be a good alternative. Good luck!

[jules]

the problem isn't with the insurance company most likely - it is with the DME and profit -

if you have a traditional type plan, the DME gets the same $$ whichever machine they give you - APAP with all bells and whistles, bottom of the line CPAP - (different $$ for bipaps)

in a HMO things change

[joeattardi]

Hey guys, I just got a fax from my doctor, but I don't think it's the actual prescription (it has the Praxair logo on top). It says "CONFIRMATION OF ORDER/PRESCRIPTION RENEWAL FORM".

It doesn't mention any specific class of machine. Would it be easier for you guys if I scanned and attached a copy? (with my personal info blurred out of course)

[jules]

you need to upload onto a site like photobucket and then use IMG commands

[jules]

also I think cpap.com has in its FAQ what is needed on the Rx for them to accept it - check that out

[joeattardi]

OK, here it is.

[Hawthorne]

Loks to me like it could be a "good to go" prescription. With it you should be able to purchase a straight cpap machine or an auto (2 machines in one) at any DME or online.

What do others think?