WHY IS MY DME COMPANY LYING?

[jobe2433]

So I switched DME companies about a month ago because the last company really did not seem to know alot and did not care to help me. I have had a straight cpap for 7 months that my insurance is paying on as a rental agreement. last week my doctor change my pressure from 8 to 14.5. Once this happened I was having a hard time adjusting to the new pressure and breathing in and out. The doctor has since ordered me a new APAP machine in hopes the varying pressure will make it alot easier for me. The DME just called me today saying well your insurance has just denied the claim for a new machine since your other machine is just 7 months old. So I call my insurance company for the 4th time asking why they would tell me they would pay for the new machine and then tell my DME they would not. After doing research on their end they informed me my DME never called to get anything approved or even to check benefits. I confronted the DME about this and they told me they just assumed this would be the case! It seems to me they do not understand I am not getting a new machine because I just want one. What am I missing. Do they not want my business? UGH sorry for the rant just so frustrated.

[Muse-Inc]

Why do they lie? Because they can...we're mostly so brain-addled, we can't tell they're lieing.

[GumbyCT]

It's ALL about money.

[Cuda]

I would just ask the DME to run it and explain your insurance has approved it unless you feel uncomfortable with that DME. What machine did you have? Did you consider using the the "ramp" feature? Your machine lists it as a feature. You want to make sure your mask can seal at maximum pressure (14.5) but the ramp feature can start you off much lower and increase a little at a time while you fall asleep.

[ozze_dollar]

I would change my DME. What will they do next. If you stay watch everything they do.

[ems]

I would change my DME. What will they do next. If you stay watch everything they do.

Ditto!

[Alshain]

I hate to contradict your doctor, but an Apap isn't what you need to solve this particular problem. You.need a CFLEX/EPR machine. An Apap increases pressure based on detected events to help reduce events. CFLEX or EPR allow you to exhale easier by detecting the breathing rythym and reducing the pressure immediately before the exhale. Since your problem is coping with the pressure, this is what you need. I'm not saying Apap won't help too, but not for this issue. Soaps can come with CFLEX (Aflex) and EPR too.

[jobe2433]

thank you guys for your responses, Alshane the apap machine I would be getting has cflex listed. I wonder if thats what they are planning to use?

[rested gal]

Jobe, if they give you an Autopap machine with C-Flex, be sure it is this machine:

Philips Respironics System One REMstar Auto

and not this one:

Philips Respironics System One REMstar AutoIQ

Be SURE it does not have "IQ" in its name.

[jobe2433]

Thank you rested gal. Why do you say this? Is the IQ machine no good?

[archangle]

Thank you rested gal. Why do you say this? Is the IQ machine no good?

The AutoIQ machine is not an Auto CPAP, according to the manufacturer. Long story, and something we haven't really gotten the full story on yet. Some of us here are very unhappy with what we hear about the AutoIQ.

Do not let them give you a Respironics machine unless it's a "Philips Respironics" machine. Click on the link for my CPAP machine in my equipment list below to see what they look like.

If it's a ResMed machine, make sure it's an S9, not an S8. Do not accept a ResMed Escape Auto, only the S9 AutoSet.

The other choices give you much less data to track your therapy.

Re: Why does the DME lie?

A scorpion wanted to cross a river but couldn't swim. He saw a fox getting ready to cross the river. He asked the fox to carry him across.

The fox said, "you'll sting me and I'll down."

The scorpion said, "don't be silly, we'd both drown."

The fox thought about it and said OK.

Half way across the river, the scorpion stung the fox.

As he became paralyzed and started to sink, the fox said, "why did you do that? Now we're both going to drown."

The scorpion said, "I'm a scorpion. It's my nature."

[SMenasco]

I'm due to replace my current S8 Cpap next month. The medical people I deal with only handle Resmed. What is the difference between the Resmed Escape Auto and the S9? Thanks.

[cflame1]

which S8 CPAP do you have? Is it the Escape or the Elite?

[SMenasco]

It's the Elite.

[Gerald]

Jobe.........

Rested Gal is giving you correct information. Follow her lead and you'll be OK. She is a thousand times more credible than any DME.

The DME's will lie to you because they want more money from you and/or your insurance company. They'll spin you in every possible direction.....and they do it on purpose.

Rested Gal is the voice of authority. I view her as the "Mother Superior" of this forum. What she says is incredibly valuable.

Go for it!

G