New user, many questions :)

[ArmandXP]

Hi all,

My name is Terry. I just moved and have a new primary car physician and I've had the worst time sleeping for the last few months. My friends have always told me I might have sleep apnea, but I've always been too afraid to go for the sleep study. Well, the last few months of falling asleep while driving, and getting eight hours of sleep every night, have changed my mind.

So my Dr. sent me for a sleep study last week. That went ok. I felt a lot better after wearing the mask for half the night. My insurance company Cigna, had the sleep study all done in one night, split without the mask, and then with. So, I survived that. The sleep Dr. sent the results to my primary. They signed off on it, I guess, I haven't been back to my Dr. yet, and they sent what the sleep Dr. needed. He called me Friday and referred me to a local equipment company, they called later that day and said they were waiting on approval from Cigna and hopefully Tuesday they would be able to come to my house with delivery.

I know nothing about machines and haven't even really talked about my diagnosis with my primary. When the equipment company calls me, will they give me any choice, or will Cigna decide what I get. I don't really know, if there's any terrible equipment out there, or not. Any help or suggestions are greatly appreciated, since I really don't know a lot right now. I've actually learned more on this board in the last two hours, than I have from anyone I've spoken to over the phone. Do I talk to the sleep Dr. or my primary if I'm not happy with the equipment? It's all a little confusing. I've never really used my insurance for anything in the last 15 years, so I feel very naïve about it.

Thanks again for all the help and can't wait to hear from ya!

[Pugsy]

Read this
http://maskarrayed.wordpress.com/
and this
http://maskarrayed.wordpress.com/what-y ... me-part-i/

DME will likely try to tell you that you don't have a choice but you do.
The two main machine manufacturers are Respironics and Resmed. I would suggest that you target your machine information search with those 2 machines. Both have easy to obtain and use software and both offer more comprehensive data available and use regular SD cards for data storage.

Ask up front about mask swapping policy. Most manufacturers offer 30 day free trial of their masks and that is per mask but often DMEs set their own in house rules for mask swapping. It isn't right but they do it.

And yes, there are machines that you don't want and we call them "bricks" because they don't gather any useful data that would help you in evaluating your therapy....like something as simple as leaks.
In the ResMed line...avoid anything with the word "Escape" in the model name.
In the Respironics line...it's a little harder to understand the model names but the "Plus" in the name is a machine to avoid.
Normally I just tell people to avoid any model number below 450. Model numbers are a bit easier to understand and see.

If your pressure needs are rather high you might even be needing a bilevel machine which offers extra exhale relief.

[ArmandXP]

Thank you, that was most helpful! Wish I would have been smart and studied this a little more before I first talked with the DME. When they call me Monday, I will ask them a lot of these questions. Thanks! Great links!

[chunkyfrog]

In the meantime, study, for your own sake.
If you must endure a wait to get the best fitting mask and the machine with the right features and therapy feedback,
it is all worth it. Don't let them back you into a corner; be firm. They are working for YOU, if not, somebody else will.
Welcome.

[mountainmaam]

The members of this forum are awesome! You are doing the right thing my researching first. I am battling with my DME, because I did not educate myself first. Now I know that she did nothing to help me.

If you do not feel comfortable with your DME, get another! Very best of luck!

[ArmandXP]

The members of this forum are awesome! You are doing the right thing my researching first. I am battling with my DME, because I did not educate myself first. Now I know that she did nothing to help me.

If you do not feel comfortable with your DME, get another! Very best of luck!

I'm going to call the DME and see what they say about the equipment and if I have a choice, or if I have to call the Dr. to have a new scrip sent over, if necessary. At the point I'm at, with my sleep, I'll use anything that works. I've never felt so terrible in my life, not getting a good nights rest.

[BlackSpinner]

When talking to your DME remember that they make used car salesmen look like a group of honourable trustworthy guys.

Do not sound desperate and don't take a brick. You need efficacy data in case you have problems. It is like have a life jacket on, most of the time you don't need it, but when you do, your life depends on it.

Print out the details of the machines you are willing to take and have the information with you.

[ArmandXP]

So, I'm thinking I'm going to get a call from a certain DME company, and I get a call from Care Centrix, who is handling the claim from Cigna. They are giving the scrip. to American Home Patient. So, I try calling them to get any information, and they state they haven't received my information. Try calling Care Centrix back, and just get sent to an answering machine. So aggrevating when you are told so many differnt things in such a short amount of time. I never use my insurance for anything, but it's extremely aggrevating to say the least.

I guess I'll just keep calling and bugging them until they get sick of hearing from me.

[SleepWellCPAP]

Hello ArmandXP,

Congratulations on going to the sleep lab. Falling asleep at the wheel must have been quite nerve racking. What a lot of people aren't aware of is that you can actually fall asleep with your eyes open. Dr Dement did experiments on drowsy people by taping their eye lids open.

The fact that you say you felt a lot better after only a half night titration is a very good sign. Hopefully you'll get your equipment sooner rather than later. Carecentrix by the way, is an intermediary that pays for your PAP device over a period of time. CC is usually 10 months. So if your insurance pays at 80%, you'll have a copay of about $15 each month over that period. The rest of the set up, ie heater, tubing, filters, mask etc., that will be purchased initially.

As far as machine type, the recommendations that have been made so far are very good. Especially with regard to data capability. Having good data is invaluable if you start to have problems. Regarding who to call with equipment problems, depending on the question of course, I would try your DME first then sleep doc second.

Good luck and do keep posting you progress. It will be very interesting to hear how you are doing.

Jim

[ArmandXP]

Hello ArmandXP,

Congratulations on going to the sleep lab. Falling asleep at the wheel must have been quite nerve racking. What a lot of people aren't aware of is that you can actually fall asleep with your eyes open. Dr Dement did experiments on drowsy people by taping their eye lids open.

The fact that you say you felt a lot better after only a half night titration is a very good sign. Hopefully you'll get your equipment sooner rather than later. Carecentrix by the way, is an intermediary that pays for your PAP device over a period of time. CC is usually 10 months. So if your insurance pays at 80%, you'll have a copay of about $15 each month over that period. The rest of the set up, ie heater, tubing, filters, mask etc., that will be purchased initially.

As far as machine type, the recommendations that have been made so far are very good. Especially with regard to data capability. Having good data is invaluable if you start to have problems. Regarding who to call with equipment problems, depending on the question of course, I would try your DME first then sleep doc second.

Good luck and do keep posting you progress. It will be very interesting to hear how you are doing.

Jim

I think I have some good news early....I talked with a Respiratory Tech with the DME and wanted to know what equipment I would be getting. He told me the Panasonic. I told him I'd been researching on here and would really like the ResMed S9 Auto, and he said they usually give the other system because they buy a lot of stock of them. He said he does carry the S9 auto and it would not be a problem, if that's what I wanted. I couldn't believe how nice he was. I was totally expecting the used car salesman treatment, but this guy was very honest and seemed to care about what I wanted. I can't wait till Friday to get things a going.......So excited and will keep everyone updated on here. I'm 100% in for life! My insurance through Cigna pays 100% I have no copays, so that is a plus also, even if it's rented for a while.

[SleepWellCPAP]

Hello ArmandXP,

Wow, that is good news for sure!

Please keep posting how you are doing. It will be very interesting to see how things turn out.

Good luck!

Jim

[ArmandXP]

Hello ArmandXP,

Wow, that is good news for sure!

Please keep posting how you are doing. It will be very interesting to see how things turn out.

Good luck!

Jim

I will after Friday, and hope to be an active member on here for a long time! Super excited to finally get some real sleep!!!!!

[BlackSpinner]

I told him I'd been researching on here and would really like the ResMed S9 Auto, and he said they usually give the other system because they buy a lot of stock of them. He said he does carry the S9 auto and it would not be a problem, if that's what I wanted. I couldn't believe how nice he was. I was totally expecting the used car salesman treatment, but this guy was very honest and seemed to care about what I wanted. I can't wait till Friday to get things a going.......So excited and will keep everyone updated on here. I'm 100% in for life! My insurance through Cigna pays 100% I have no copays, so that is a plus also, even if it's rented for a while.

Make 100% sure it is the S9 AUTOSET and not the escape Auto when you get your hands on it. Go to our hosts site and find the images for both and print them off and the details of what they do and their differences.

[ArmandXP]

Make 100% sure it is the S9 AUTOSET and not the escape Auto when you get your hands on it. Go to our hosts site and find the images for both and print them off and the details of what they do and their differences.

Yep, already printed out everything in advance.

[ArmandXP]

Been such a productive wonderful day today!!! Went to my DME to pick up my equipment. I had talked to the respiratory tech over the phone about wanting the S9 Auto, when I got there he had the right one there, set up to go for me. We talked for over an hour and he was such a nice, informative, smart guy. He told me straight up that they have more warranty issues with the Panasonic brand over the Resmed, but his company buys the other in bulk and they usually hand those out. I appreciate someone honest and straight up. So, I'm very excited about sleeping tonight. Hope all goes well. Will report in later in the weekend.

P.S. He also told me my insurance company just wants a compliance check in 30 days (only checking once), so he said he would call me and I could give him the numbers from the machine over the phone.....That's pretty cool! If I did start having problems, I could set up for my card to be read and see what was going on. I told him I downloaded some software to monitor it myself, and he was quite surprised. Told me to let him know how it goes for sure.