Conversation with DME today

[sleeplessinthevalley]

Wow! I called a local DME today to get info about machines and policies today. I am very disappointed with her responses. She told me that no one they service uses an APAP, no need. No need to read your data...the Dr. takes care of that. No one has problems with mask fit.

Even though they would be a lot more convenient to go to than over the mountain to C'Ville I am going to run the other way. Thank goodness for this website or I would just accept her responses as being the gospel truth. New users need to come armed with lots of info so they are not taken advantage of.

[Janknitz]

Aren't you glad you know all this BEFORE they stick you with a brick of a machine???

Sounds like you may have already read it, but if not, be sure to check out my blog post called "What you need to know BEFORE you meet your DME."

[Pugsy]

She told me that no one they service uses an APAP, no need. No need to read your data...the Dr. takes care of that. No one has problems with mask fit.

Let me go get my boots on because the BS is getting deep.

So sad that this response does not surprise me. And even if doctor "did take care of that"... what can he take care of if the machine offers no data..

There are decent DMEs out there, just keep looking.

Even if inconvenient to travel to initially, worth it in the long run because with proper setup and care, visits to DME don't have to happen often.

[Kilgore Trout]

Wow! I called a local DME today to get info about machines and policies today. I am very disappointed with her responses. She told me that no one they service uses an APAP, no need. No need to read your data...the Dr. takes care of that. No one has problems with mask fit.

My DME told me patients were unable to get software and read the data, that I need special equipment to read my card. Took 10 minutes after being pointed in the right direction. My DME talked me out of an auto machine, playing on my exhaustion and want to feel better right away.

Don't trust them, they're just salespeople who don't know the law, and they're not doctors. Your doctor can write your script for a specific machine, and if the DME says no, call your insurance company and ask for a list of them in your area. My first DME told me they would to pick the machine if there wasn't a specific model on the script. I told them were they could put it... and I consider the slimeball I got my machine from to be an improvement.

[Mary Z]

Kilgore Trout. Don't be too disappointed- there's nothing wrong with a CPAP machine. If you fail at CPAP and the doc writes you a new script they'll have no choice but to honor it and give you a BiPAP or AUTO. Plenty of us do fine with just CPAP. Just because a machine says AUTO it's not a better machine.

[Pad A Cheek]

Could you be referring to the Shenandoah Valley and Charlottesville? If you are, PM me, I live over the mountain as you say.

I wish you great luck with your DME search.

Karen

[Janknitz]

Kilgore Trout. Don't be too disappointed- there's nothing wrong with a CPAP machine. If you fail at CPAP and the doc writes you a new script they'll have no choice but to honor it and give you a BiPAP or AUTO

The DME may honor a new prescription for an auto, but once your insurance has paid for one E0601 machine, you're out of luck for getting your insurance to pay for another in most cases (it's always worth asking). A BiPAP possibly (because it has a different billing code), but not an auto. Sorry.

CPAPs are fine for many, many people--you may not need the auto at all.

[archangle]

Anyone who sells a non-Auto CPAP machine is ripping you off. The cost for an auto machine is not that much. An auto machine has the capability of determining the correct pressure for you to use automatically with you sleeping at home instead of having to spend big bucks on an in-lab sleep study that may not tell you that much anyway. An auto machine, used properly, is like having a sleep study every night.

If the doctor, sleep specialist, or DME gives a darn about your therapy, they would never consider anything other than an auto machine. They would set the machine to do your prescribed pressure, then set it to auto adjust a few points higher or lower. Then they would read the data card and figure out your best pressure. Even if they wanted to do manual CPAP long term, they would use an auto machine to see if your therapy is working and to see what the right pressure is.

You can get the software to read the data on Philips Respironics or ResMed CPAP machines if you buy the right machine. Some machines that DMEs call "data capable" are a scam. They only record how long you've turned the machine on and used it. The better machines not only record this "compliance" on-off data, but also record on how well you're breathing through the night.

I wouldn't settle for anything less than a Philips Respironics REMstar Series One Auto or a ResMed S9 Autoset. Be careful, because there are a lot of confusingly similar names. Also be sure to get a heated humidifier.

It's insane to prescribe anything but an auto machine. All the autos will do manual CPAP if desired, and most of the auto machines record a lot more useful data than the non-auto machines do.

[GumbyCT]

but once your insurance has paid for one E0601 machine, you're out of luck for getting your insurance to pay for another in most cases (it's always worth asking). A BiPAP possibly (because it has a different billing code), but not an auto. Sorry.

Cigna (and some others who dictate DME's) may have an agreement with the DME that should the prescription change during a certain period (2yrs or so) that the DME will provide the new equipment at no additional charge. An auto is also E0601.

I know this happened to me when I had Cigna/Apria and the sleep tech coordinated everything for me to go from a Plus model to an auto. A used auto but hey I was excited to 1) have data 2) get an auto.

So there IS hope.

[LinkC]

I upgraded to an Auto in my second month of a rent-to-own deal. It took a specific 'script and the RTO period started over (So, basically, the DME got 2 extra payments/copays from BCBS and me.) But neither Ins or DME balked at it.

[chunkyfrog]

I used my S9 Elite from August 2010 to January this year--very good machine.
But. . . I was starting a weight loss program, and did not want varying pressure requirements to sabotage my journey to good health.
I INVESTED in my S9 Autoset from CPAP.com. My pressures have indeed changed; as has my mask fit.
I now have to re-do my search for the right mask.
Once I have satisfied my deductible, I intend to USE the local DME to get my best fit mask--again.
I know about the 30 day return policy; and intend to use it.

[GumbyCT]

I think it is always best to have a make/model specific prescription. That way the DME doesn't have the wiggle room with a non-specific script.

If they say they don't carry that model ask them to order it or else take your money elsewhere, they will likely give you more troubles about other things later. You just need to check with your Insurance first, they also might like to know if the DME won't order what you want/need. Any DME can order other brands whether masks or machine IF they want your business.

I think it is easier to get the script written for what you want so you won't have to argue. But if you already have your machine you may have to do both argue and get specific script. Try the script first.

Good Luck

[Lizistired]

When the lab calls and asks "where to fax your script?", tell them you will pick it up. It should also come with your study and titration reports. Then make a copy or two so you can keep the original. You want it in your hand when you are shopping, not the DME's.