Insurance tells me Apria is wrong

jimmer24 · Post by **jimmer24** » Mon Jul 25, 2011 1:52 am

I contacted my insurance about Apria telling me I would have to eat the humidifier for my brick. They told me that since this is the first time that I am going on a cpap machine that the provider has to give me 180 days to decide whether or not I wish to purchase either the cpap or the humidifier. They will call Apria Monday and explain this to them. So if all goes well, I will soon have a new s9 machine with humidifier. Thank you all for alerting me to the fact that the machine they tried to saddle me with was an older model and not what any of us would want. Talk to you all later. Jimmer24

Sheriff Buford · Post by **Sheriff Buford** » Mon Jul 25, 2011 5:58 am

Fight for the autoset. My original DME was bought out by Apria. I am not thrilled in my dealings will them.

Sheriff

Pugsy · Post by **Pugsy** » Mon Jul 25, 2011 6:01 am

Make sure the S9 doesn't have Escape anywhere in the model number. The Escape does offer one bit of data, hours of use only. Sometimes DMEs will say "Yeah it offers data, see the SD card". True statement to a point. It just doesn't offer full data.

The S9 Escape Auto offers hours of use and single data AHI but no leak, flow or other data. So I would avoid it also.

ChrisT · Post by **ChrisT** » Mon Jul 25, 2011 7:18 am

I have found that the branch of the DME providers can vary greatly in the service that you receive and the advice you are given. I have a really good savvy RT at the one I frequent which is a four hour round trip drive from my home and in another state. Recently I went to another branch to pick up a new machine because it was closer to my sleep center which is a 7 hour round trip. Never again. That RT tried to give me an outdated machine and wanted me to buy a new humidifier. She also wanted me to switch to her branch so she would make the profits from equipment. I went right back to my original DME branch and they took the older machine back and got my money back for the humidifier and got me the newer machine that went with my old humidifier which was actually cheaper. I learned a lesson. You get to choose which DME branch you use so find one that is easier to work with. It seems the integrity in the staff in some is lacking. I have had nothing but trouble over the years with a competitor who's bookkeeping and pressure tactics are just too difficult to handle so I stick with the same DME you are using but I am careful which branch I use.

Hope you find one you like. ChrisT

Alshain · Post by **Alshain** » Mon Jul 25, 2011 7:24 am

ChrisT wrote:I have found that the branch of the DME providers can vary greatly in the service that you receive and the advice you are given....

I will agree with this. I've heard nothing but complaints about Lincare but I won't use anyone else. I've tried 3 now in the 6 months I've been using CPAP and the level of service from Lincare was astoundingly better from Day 1. I can only assume the branch I'm lucky enough to have actually cares compared to other in the same company.

LSAT · Post by **LSAT** » Mon Jul 25, 2011 8:45 am

Once I had all of my equipment, the DME I use is irrelivant to me. For the past 2+ years, I only go to the DME for supplies. As long as they bill properly, I'm happy. I don't need their service or advice for anything.

nanwilson · Post by **nanwilson** » Mon Jul 25, 2011 9:08 am

Lsat is right!!!!! except I don't go to them for anything, I buy my supplies online, wherever I get the best price.

Roger2 · Post by **Roger2** » Mon Jul 25, 2011 9:17 am

jimmer24 wrote:I contacted my insurance about Apria telling me I would have to eat the humidifier for my brick.

I also have Apria as they bought my former provider (Praxair) who I had been with for 6 years for my oxygen needs. When Apria brought the cpap machine out they told me the same thing, i.e. that I would rent it for a year under SSA guidelines at which time I will own it.

I cant imagine someone from Apria told you that you have to eat part of the cost. By the way, what is a “brick.” I have seen that word used here several times but have not yet found out what that is.

Roger

The Texan · Post by **The Texan** » Mon Jul 25, 2011 9:25 am

Alshain wrote:
ChrisT wrote:I have found that the branch of the DME providers can vary greatly in the service that you receive and the advice you are given....
I will agree with this. I've heard nothing but complaints about Lincare but I won't use anyone else. I've tried 3 now in the 6 months I've been using CPAP and the level of service from Lincare was astoundingly better from Day 1. I can only assume the branch I'm lucky enough to have actually cares compared to other in the same company.

I have found the same thing.....I now use Norco in Meridian and am very pleased with them, but the Norco office in Mountain Home, just 60 miles away, has a very nasty reputation, which in a way surprises me, being a Military town. I guess management may have something to do with how you are treated and if a new manager come aboard, I may find things changing, but I hope not.

Alshain · Post by **Alshain** » Mon Jul 25, 2011 11:28 am

Roger2 wrote: By the way, what is a “brick.” I have seen that word used here several times but have not yet found out what that is.

It's a non-recording CPAP. It's a slightly unfair name, since it really does it's job, which is to apply pressure... but it tells you and your doctor nothing about your nights sleep, and since in most cases recording CPAPs aren't a lot more expensive, it earns the name.

archangle · Post by **archangle** » Mon Jul 25, 2011 12:14 pm

Alshain wrote:
Roger2 wrote: By the way, what is a “brick.” I have seen that word used here several times but have not yet found out what that is.
It's a non-recording CPAP. It's a slightly unfair name, since it really does it's job, which is to apply pressure... but it tells you and your doctor nothing about your nights sleep, and since in most cases recording CPAPs aren't a lot more expensive, it earns the name.

A non-brick CPAP machine will record data on your breathing. It will tell you if you stopped breathing, and may categorize breathing problems into things like obstructive apnea, central apnea, hyponea, periodic breathing, etc. It will tell you how much air you're leaking that gives you a clue whether your mask is leaking. Better machines will actually record flow waveforms showing graphs of each breath through the night. You can look at a flow waveform and see heavy and shallow breathing, how long your apeas lasted, ragged or irregular breathing, etc. If it's an autopressure machine, it will show your pressure as it changes through the night.

You need software to see a lot of this data, but most non-brick machines will tell you a few things in numbers on the display such as "AHI," which tells how many "events" you have per hour.

This info can be very useful to you or your doctor to determine how your treatment is doing and to adjust your treatment. It's like having a mini sleep study every night. With a brick, you need to guess at the pressure based on how you feel. You may even have to pay for another sleep study if you have a brick, while a data capable machine might have allowed your doctor to check you and adjust your therapy at home.

A "brick" just puts out air pressure and gives you no info on how your treatment is going. It may record when your machine is turned on for compliance. Many slimebag DMEs will tell you a brick that records hours is "data capable" because it has an SD card, but all the card does is record when you've used the machine so you can prove that you did 4 hours a night to meet "compliance" goals for insurance.

A "brick" can give you good therapy. Not too long ago, they were all bricks. It's just that, for about the same price, you can get a machine that actually monitors your therapy.

A brick machine is like going into the hospital for a heart attack and getting treatment, but they don't hook you up to an EKG machine during your stay. The doctor just comes in every so often and listens to your heart with a stethoscope. Full time recording EKG machines are available, but the hospital(DME) doesn't bother to use them because it costs them more money to buy the EKG.

GumbyCT · Post by **GumbyCT** » Mon Jul 25, 2011 1:08 pm

I am not surprised about the mis-information. For those who don't understand... even if you don't buy supplies from your DME you will need them for other things such as when it comes time for warranty/repair, a loaner, or for another machine (3-5yrs). Plus if they lie to you about this how could you believe anything else they tell you?

Why would you continue to give them your money? This guy is getting the shaft cuz that last guy turned the other cheek.

Have you not read the ThomasMcKean thread?
viewtopic.php?f=1&t=65843

Hope That Helps

jimmer24 · Post by **jimmer24** » Mon Jul 25, 2011 8:32 pm

I talked to Apria today and told them that my insurance assures me that they are supposed to give me 180 days to decide if I wish to purchase both cpap and humidifier. They started out denying this fact but at the end they let me keep the humidifier for the machine they first issued me and they will supply a new humidifier for the new s9 machine I will be getting on Wednesday free of charge. I think that this says they were afraid to go against what the insurance said but In any case I will have both a good non brick cpap and humidifier. They will not take the old humidifier back so I guess I will have to figure out what to do with it. Thank you all for helping me through this. Jimmer24

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