Hopefully getting a new APAP

smyles · Post by **smyles** » Sat Dec 03, 2005 10:47 pm

Hi Gang,

I've been trying to get my DME to send me a new APAP w/heated humidifier that my doctor agreed to write on my prescription. I have Cigna PPO. When I called them, they told me to call "Gentiva" who I assume is their DME. This all reminded me of my first experience getting my current CPAP through Apria Healthcare and the "fun" I experienced with their "fine" organization!

When I called Gentiva, they told me to call "CareCentrix" who apparently is their respiratory DME. After being "bounced" between offices (it seems each office I called was the "wrong" location) I finally was told that an APAP was on it's way to my home...

I was surprised by the comment. When I asked a few questions, like "which brand/model", when, ...how! The person told me that they would send me a Respironics RemStar APAP w/heated humidifier. When I told them I've been using a RemStar Plus with a heated humidifier for the last three years, she responded that they've made changes in the RemStar and that the himidifier won't work with the new RemStar Auto.

In addition, when I asked her about C-flex, she told me that they didn't know what that was, but that the RT who would come to my home would explain how to use the APAP.

A few questions for you...do all of the RemStar Auto's come with C-flex already built in? Or, do I have now have to "beg" for C-flex too! Do they manufacture RemStar Auto w/o C-Flex? Are the new RemStar's smaller than my current 3 year old RemStar Plus?

Have you ever heard of Gentiva or CareCentrix????

Confused in California!!!

sleepyinsunnyvale · Post by **sleepyinsunnyvale** » Sat Dec 03, 2005 11:18 pm

I went through exactly the same situation with CIGNA/GENTIVA/CARECENTRIX last month.
CIGNA has been my health ins for the past 4 years. I think they're great! They had been paying for my APAP from APRIA through GENTIVA. GENTIVA informed me that they are switching to CARECENTRIX (actually APRIA told me. GENTIVA never bothered to tell me of the change). I called CARECENTRIX several times and got different stories depending on who I spoke with. One person said I needed a new Rx. Another said the one from my original Dx was fine (4 year old). One person said I needed a letter of medical necessity which I have but that wasn't good I needed a new one. They then wanted my Dr to call them before faxing the Rx and other documentation.
I then called CIGNA and they said it was OK for me to buy the APAP on my own and submit a claim to them. However, I would only get 60% coverage rather than 80% since it would be out of network. I felt it was well worth the hassle avoidance so I did it. I figured I probably ended up the same either way. CARECENTRIX probably would have charged CIGNA 2X what I paid from cpap.com. 20% of CARECENTRIX = 40% of cpap.com

CollegeGirl · Post by **CollegeGirl** » Sat Dec 03, 2005 11:26 pm

I have a RemStar Auto, and it has CFlex. I'm fairly sure they don't make them without CFlex anymore. Good luck!

sleepyinsunnyvale · Post by **sleepyinsunnyvale** » Sat Dec 03, 2005 11:37 pm

The Respironics web site shows 2 types of APAP units available, with AND WITHOUT Cflex.

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CollegeGirl · Post by **CollegeGirl** » Sun Dec 04, 2005 12:24 am

Sleepy - right, but I think all newer autos come with Cflex. Right?

sleepyinsunnyvale · Post by **sleepyinsunnyvale** » Sun Dec 04, 2005 12:39 am

As long as the cfex feature does not add cost to the unit it would make sense that Respironics would include it on every new APAP designs since it can be turned off for those who don't want it (like me).

Guest · Post by **Guest** » Sun Dec 04, 2005 9:21 am

You will probably get the older model if they're stuck with that stock. DME