Newbie questions

[benchie]

I am a new cpap user. My doctor recommended an outfit to supply the cpap unit and accessories and I've been using it for 2 months.

My question to you well rested folks is this. I have a very high deductible insurance plan, so I am particularly price sensitive. The company I'm renting the unit from it charging me about $250 per month for the rental of the rentable components (for a unit that looks like it retails for $500), has charged me for the non-rentable parts (humidifier, face mask...) and they apparently charge $250 each time they download data from my unit to give to my doctor or insurance company (that seems ridiculously high to me). It seems obvious to me that I should buy the unit myself rather than rent it, but my doctor does not have the software (or interest in getting it) to download the data. Here come the questions....Where is a good place to buy my own personal unit and who will I use to download the data if my doctor won't do it?

Thanks,
Mark

[kaiasgram]

Hello and welcome benchie. My insurance did not cover any cpap equipment so I had to buy everything out of pocket. I bought (and continue to buy) everything I need from the sponsor of this forum, cpap.com. They are top notch, as others here will attest to.

A lot of people simply download and use their software and print out reports to take to the doctor. Many doctors are ok with this. I was thinking you wouldn't have to worry about downloading data for insurance compliance purposes if you buy your own machine -- but I'm not sure if you have to prove compliance in order to use your insurance for ongoing supply and replacement costs. Depending on your insurance coverage you may want to do some comparison pricing -- some have found that buying supplies online costs the same as or occasionally even less than their insurance copay.

If you go private pay all the way then you won't have to get or pay anyone to download data ($250? ) -- you can download software compatible with your new machine, monitor your therapy, and bring reports to your doctor when you have an appointment.

[benchie]

Thank you very much for that helpful reply Kaiasgram! My being able to download and use the software myself is a great solution to my problem. What surprised me was that my doctors office was unable to provide any guidance at all as to how someone who owned their own unit could download the data. The were also surprisingly disinterested when I said that it was important to me to find the most cost effective way to pay for the cpap set-up. Considering that they prescribe cpaps to people everyday, you would think they would be a good source of information...not so. You have been much more helpful than my doctor!

You are right that I may not have to prove compliance with the insurance company, but I still will run the expense of the unit through my insurance just because it will apply to my deductible.

Thanks again!

[Pugsy]

If you do the math....with insurance and DME costs going towards the deductible how does it compare to out of pocket buying from some place like cpap.com?
In other words what is the total you will have to pay the DME? How many months at $250 before the machine is paid for?
4 months would be around $1000 but 10 months would be a whole lot more.

Also what machine do you have? Brand and model?

[Sheriff Buford]

Benchie: it appears you are realizing the amount of disinterest you are receiving from your doctor. Trust me, this is only the tip of the iceberg. Yes, there are some good doctors out there that will make every effort to help you, but they are far and few in-between. Folks here can testify to bad experiences they've had with their doctors and DME's. Educate yourself here. Become very sensitive to your health and take charge. As Pugs said, do the math. Over the long haul, it may be cheaper to purchase your machine outright. Download the "Sleep-head software" on this site and monitor your progress at regular intervals. Make sure you can return your mask to exchange for a different one within 30 days. Bring all your issues to this forum. You can succeed at this!

Sheriff

[benchie]

Also what machine do you have? Brand and model?

What I have looks like, PR System One REMstar BiPAP ST Machine, cpap.com lists it for $1899. Although I paid the DME for the humidifier already, so i guess I don't need to buy that part of the machine.

[Pugsy]

What I have looks like, PR System One REMstar BiPAP ST Machine, cpap.com lists it for $1899. Although I paid the DME for the humidifier already, so i guess I don't need to buy that part of the machine.

Ah, the higher end machine and that explains the hefty monthly cost.
Did they tell you how long you need to pay the $250? Do the math for sure.

You can use EncoreBasic software. Look in UncleBob's signature line for information on where to get it.
memberlist.php?mode=viewprofile&u=38643
Read the Help section for information on how to use the software.
EncoreGuide link this will show you examples of what you will see. For a different machine than yours but the basics are the same.
http://www.healthcare.philips.com/pwc_h ... _Guide.pdf

You can also use SleepyHead. If you have Windows 7 or Vista when you install it instead of double clicking on the setup files to start the install do a right click of the mouse and choose "run as administrator". This eliminates a little headache with the one update you will be getting.
I have SleepyHead links in my signature line.

[Guest]

Thanks! Great information!

[jencat824]

Welcome!

A thought if you are buying is 'secondwindcpap.com' they have gently used pap machines & there are some great machines at very good prices. If you want new, I'd use cpap.com, they are also good in the pricing. Just make sure you get a fully data capable machine. And, the F&P ICON looks great sitting on your nightstand, but STAY AWAY FROM THE ICON. You want one of the really great machines listed by the users of this forum. Pugsy gives great advice on which machines are best. There is also a great resource, I'm posting a link below, that helps you make informed choices when buying a machine.

http://maskarrayed.wordpress.com/

If you need advice, just post here & the knowledge members here will help you. I found this board a couple of months ago, I've been on CPAP 12 yrs and have learned more in 2 most that I have since I've been on the hose. Good luck,
Jen

[Pachyderm's Nose]

Benchie, I'm going to mention this because it's how all my insurances have worked. Even when I am fulfilling my deductible amounts all my stuff is run through my insurance before I pay any bills. Since almost all insurance companies have set payment schedules for items or have negotiated discounts with suppliers I receive an explanation of benefits that shows original charges, network discouts, amount covered by insurance, and the amount I owe. I know my DME was charging $250+ as monthly rental on my S9Autoset but my explanation of benefits shows a payment amount of about $90. If I hadn't met my deductible this is the amount I would pay, not the full $250. If my DME tried to charge me the full price and I informed my Insurance company the provider would be dropped like a hot rock. So check your insurance and make sure you are not overpaying for stuff.