why do I rip my mask off in sleep and cpap questions?

[axxell6307]

There are some online cpap supply websites that do take insurance.
Verus
Liberty Medical
American Home Patient
Apria
and there are others
but what you need to do is get a list of cpap suppliers that YOUR insurance will work with and then make a decision as to which supplier to use.
So YOU need to contact your insurance and get a list of DMEs (either brick and mortar store or online) and then go through the list to see which one you wish to use.

Most of the places like cpap.com or cpapsupply or similar online suppliers keep costs low by not getting involved with insurance and waiting for insurance to pay. It costs money to bill insurance and wait for payment.

But you will have to use a supplier that has a contract with your insurance company if you want to get the best reimbursement rate.
So you have to get a list from them and then choose one and start the process.

Awesome. Thanks. Which route do you think would be most likely to land me an Apap? Having my primary write me an rx for it and possibly order it for me through a dme, or seeing a sleep dr and going the normal route of having them order me a machine?

[Pugsy]

If it were me I would probably ask my regular primary doctor to write the RX for exactly what I wanted.
Then I could used any DME (or online supplier) that works with my insurance. Having the RX state exactly the brand and model (be careful that you know the exact model number or name) and having the doctor sign the "dispense as written" side of the RX insures that the DME has to fulfill the RX as written.

Here's the real deal...an apap is a cpap...it just has the additional mode where the pressure can auto adjust.
The HCPCS billing code for regular cpap/apap is the same E0601. DMEs could supply apaps if they would just do it with a generic cpap RX but they don't always want to do that because of profit margin.
Now some DMEs supply apaps as a matter of standard practice but not all do....but they could legally do it if they just would.
Just set the apap to cpap mode at the Rx'd pressure and be done with it.

I would try to avoid having to go back to a sleep doctor unless insurance throws a fit (sometimes they do if it has been a long time since original sleep study) or I was having problems I wanted to run by a sleep specialist.

Check with your insurance to see if they are going to require anything other than a current RX...heck maybe even your old RX is still good with them. Mine was written for "lifetime".
Insurance companies can have different policies so you need to find out what policy yours has.

[Pugsy]

You might want to read this even though you aren't brand new to cpap therapy.
https://maskarrayed.wordpress.com/what- ... me-part-i/
It talks a little bit about DMEs and HCPCS codes and what to expect.
Insurance companies don't pay by brand or model...they pay by that HCPCS billing code. They don't care if it is a cpap or apap or has data. They just go by that HCPCS code and E0601 covers the most bare bones basic cpap to the full data apap.
They pay the same no matter which model or brand...so that's how come DMEs try to dispense the cheapest they can get away with so that profits are maximized.

[Pugsy]

Don't forget to factor in the deductible (if you have one) that needs to be met before the insurance pays a dime.
If your deductible is high and it's unlikely you will meet it otherwise you might be money ahead to just buy online.
Do the math.

[axxell6307]

Don't forget to factor in the deductible (if you have one) that needs to be met before the insurance pays a dime.
If your deductible is high and it's unlikely you will meet it otherwise you might be money ahead to just buy online.
Do the math.

Deductible will probably be met by the end of month. It's only about $1500 and I'm getting pretty close already. Physical therapy and many dr appts and an mri yesterday.

[axxell6307]

I found out that even using my insurance, it will cost about the same since dme charge so much more, plus aetna requires compliance data checks. Thus, I'm going to purchase it without insurance. I see this DreamStation Auto CPAP DSX500T11 on amazon for $385. Is there anything wrong with going with one of those? The seller has decent reviews. 95% positive over last 12 months and out of 58 total ratings.

One thing I wonder is how old that machine is and if I ever needed parts for it, would it be difficult to get those? Any downside to buying off amazon vs cpap.com?

Also, I can't find anywhere that it indicates the data that this machine gives, such as leaks, ahi's etc. Does it definitely give those?

Thanks again.

[Pugsy]

Also, I can't find anywhere that it indicates the data that this machine gives, such as leaks, ahi's etc. Does it definitely give those?

That particular model number definitely will give you the data you want.
You have to learn model numbers and that model number tell me it is a full data machine.

One thing I wonder is how old that machine is and if I ever needed parts for it, would it be difficult to get those?

Respironics machines usually have a little code on the model number sticker that tells its birthday but the DreamStation is the latest model in the Respironics line and there's not much chance of it or any of it's parts becoming unavailable for quite some time. Even when Respironics changes to a new model line they still produce replacement parts for the older machines for years and years.
I wouldn't worry about that part of your purchase at all.

I see this DreamStation Auto CPAP DSX500T11 on amazon for $385. Is there anything wrong with going with one of those?

No huge reason that I can think of.
Main disadvantage might be if you end up needing something done under warranty (which is 2 years) down the road but the likelihood of that happening is very slim.
If you feel better knowing for sure you have warranty back up then some place like cpap.com or secondwindcpap.com might be a better choice.
I figure that when I buy at such reduced prices that I sort of take on part of the risk and I am okay with it myself.
If having a warranty was critical then I would go down the other road and pay more for a machine.
BUT if you get this machine and you do end up with some sort of warranty issue and the seller can't or won't help..you still have options...there's a place I know of that can do warranty work on these machines.
Only catch is you have to pay for shipping to them. That again is something I always thought of as simply part of the risk I assume when I buy a machine at a discounted rate.

Now of course you do have the Amazon backing...so that's a plus.

I would say go for it. It's a great machine and will do what you want and it's an extremely good deal.
If Amazon had a seller offering a similar deal on my particular model machine...I would be all over it.

[axxell6307]

Also, I can't find anywhere that it indicates the data that this machine gives, such as leaks, ahi's etc. Does it definitely give those?

That particular model number definitely will give you the data you want.
You have to learn model numbers and that model number tell me it is a full data machine.

One thing I wonder is how old that machine is and if I ever needed parts for it, would it be difficult to get those?

Respironics machines usually have a little code on the model number sticker that tells its birthday but the DreamStation is the latest model in the Respironics line and there's not much chance of it or any of it's parts becoming unavailable for quite some time. Even when Respironics changes to a new model line they still produce replacement parts for the older machines for years and years.
I wouldn't worry about that part of your purchase at all.

I see this DreamStation Auto CPAP DSX500T11 on amazon for $385. Is there anything wrong with going with one of those?

No huge reason that I can think of.
Main disadvantage might be if you end up needing something done under warranty (which is 2 years) down the road but the likelihood of that happening is very slim.
If you feel better knowing for sure you have warranty back up then some place like cpap.com or secondwindcpap.com might be a better choice.
I figure that when I buy at such reduced prices that I sort of take on part of the risk and I am okay with it myself.
If having a warranty was critical then I would go down the other road and pay more for a machine.
BUT if you get this machine and you do end up with some sort of warranty issue and the seller can't or won't help..you still have options...there's a place I know of that can do warranty work on these machines.
Only catch is you have to pay for shipping to them. That again is something I always thought of as simply part of the risk I assume when I buy a machine at a discounted rate.

Now of course you do have the Amazon backing...so that's a plus.

I would say go for it. It's a great machine and will do what you want and it's an extremely good deal.
If Amazon had a seller offering a similar deal on my particular model machine...I would be all over it.

I'm nervous lol. That deal is a 3rd party seller. There has to be a reason why it's $200 cheaper than everywhere else. There is another seller on amazon with 100% ratings and fulfilled by Amazon and it's $560. A lot more money, but I'm leaning toward that, since Amazon IMO is so much easier to deal with than 3rd party sellers. This is a tough decision... Are you familiar with 3rd party sellers on Amazon policies? Does Amazon get involved with warranties, refunds, replacements etc, or is it strictly dealing with the seller?

[Pugsy]

This is a tough decision... Are you familiar with 3rd party sellers on Amazon policies? Does Amazon get involved with warranties, refunds, replacements etc, or is it strictly dealing with the seller?

I don't know about 3rd party sellers. No experience there of any significance.

Amazon isn't going to get involved with warranty stuff unless you buy the extended warranty and even then I don't now how it would work with cpap machines which come with a 2 year warranty anyway.
This is where you have to decide how much of the "risk" you are willing to take on your own and save money up front.
I look at it this way...spend it now for sure or maybe not spend it later or maybe spend it later.
Amazon isn't a DME and they aren't going to do what cpap.com or secondwindcpap.com does when a machine craps out. Amazon is just a go between.

This place can do warranty repairs for the Respironics (and they can now do ResMed too) machines. I have personally used them for warranty work. They are good people.
http://acbio.com/
I am a risk taker when it comes to machines and saving money. I go in with the idea I am saving X number of dollars and if something breaks then I get to pay part of that savings back for getting it fixed. If you aren't comfortable with that attitude then be prepared for more conventional purchase from someone who is also assuming some of the risk (and that's why it costs more). That's part of the reason the DME gets more money...they are taking on some of the risk too.

Failure on these machines is rare but it does happen.
If it were me...I would still go with cheapest and know that acbio.com is available if a problem comes up and the seller wasn't in a position to resolve it for me. I am okay with that risk. If you aren't then pay more up front and let someone share the risk with you.
I have owned probably 12 different Respironics machines over the years. Only one have I had any trouble with that required some checking into. I buy cheap because I want some new feature that so and machine has and then I see another one and I sell the older one. Since I buy cheap I sell cheap and use the money for the next machine.
Everyone is happy...I get a new machine....someone else gets a used machine at a greatly reduced price and everyone is happy.

[axxell6307]

This is a tough decision... Are you familiar with 3rd party sellers on Amazon policies? Does Amazon get involved with warranties, refunds, replacements etc, or is it strictly dealing with the seller?

I don't know about 3rd party sellers. No experience there of any significance.

Amazon isn't going to get involved with warranty stuff unless you buy the extended warranty and even then I don't now how it would work with cpap machines which come with a 2 year warranty anyway.
This is where you have to decide how much of the "risk" you are willing to take on your own and save money up front.
I look at it this way...spend it now for sure or maybe not spend it later or maybe spend it later.
Amazon isn't a DME and they aren't going to do what cpap.com or secondwindcpap.com does when a machine craps out. Amazon is just a go between.

This place can do warranty repairs for the Respironics (and they can now do ResMed too) machines. I have personally used them for warranty work. They are good people.
http://acbio.com/
I am a risk taker when it comes to machines and saving money. I go in with the idea I am saving X number of dollars and if something breaks then I get to pay part of that savings back for getting it fixed. If you aren't comfortable with that attitude then be prepared for more conventional purchase from someone who is also assuming some of the risk (and that's why it costs more). That's part of the reason the DME gets more money...they are taking on some of the risk too.

Failure on these machines is rare but it does happen.
If it were me...I would still go with cheapest and know that acbio.com is available if a problem comes up and the seller wasn't in a position to resolve it for me. I am okay with that risk. If you aren't then pay more up front and let someone share the risk with you.
I have owned probably 12 different Respironics machines over the years. Only one have I had any trouble with that required some checking into. I buy cheap because I want some new feature that so and machine has and then I see another one and I sell the older one. Since I buy cheap I sell cheap and use the money for the next machine.
Everyone is happy...I get a new machine....someone else gets a used machine at a greatly reduced price and everyone is happy.

Thanks for the referral. My family has broken machines. Will look that company up.

I went ahead and ordered the amazon fulfilled drRespironics dx500t11 model for $560. I can't wait to get it and look at my stats.

Question. I prefer nasal masks and have those. Using nasal mask, if one's mouth was to open and allow air to shoot out of mouth, what machine stat would report that? "Mask seal"? I really want to stick with nasal mask, but need to make sure I get proper therapy with it. I can breathe pretty well through my nose, so I hope it's not a problem. A typical day for me, I'll have one nostril 100% clear, and the other one half clear, and they will take turns being clear and half stuffy. It never causes me to feel like I must mouth breathe though unless I'm sick.

[Pugsy]

If you are losing much pressure out the mouth it will show up in the leak graph.
Give me a few minutes and I will get you a report that shows a good example. My last night's report.
I need to get an image uploaded so that I can share it and you will see what I mean.
It's from a different machine than yours but the leak graphs all refer to the same general principle and will show up on SleepyHead.

You do need to use the software to see it though. It's not readily apparent on the machine's LCD screen leak data or the lame Respironics DreamMapper website data.
See about software here
https://sleep.tnet.com/equipment

Give me a few minutes and I will come back and edit this post to include my report.

Okay...your leak graph from the Respironics machine in SleepyHead is going to show 2 lines and I am using a ResMed machine so I only get one line but any large leaks will show up as a graph area and on the Events graph (top graph) you will see gray flagging in the LL line on that events graph. Fairly easy to spot.
I am pretty sure this was mouth opening leak because the mask never moved. It's not horribly long in terms of duration and I slept right through it so I don't care.
Mouth opening and allowing the air to exit out through open lips will show up as a leak.
When I evaluate leaks (no matter where it is coming from) I look at
1..how long did it last
2..just how "bad" was it
Last night roughly 7% of the night was spent in large leak territory. That's roughly 30 minutes out of 7 1/2 hours of sleep and as you can tell it wasn't 30 minutes continuous but was broken up in smaller segments some very brief and some not so brief.
I slept right through it and I don't sweat the small stuff like this.

[axxell6307]

If you are losing much pressure out the mouth it will show up in the leak graph.
Give me a few minutes and I will get you a report that shows a good example. My last night's report.
I need to get an image uploaded so that I can share it and you will see what I mean.
It's from a different machine than yours but the leak graphs all refer to the same general principle and will show up on SleepyHead.

You do need to use the software to see it though. It's not readily apparent on the machine's LCD screen leak data or the lame Respironics DreamMapper website data.
See about software here
https://sleep.tnet.com/equipment

Give me a few minutes and I will come back and edit this post to include my report.

Okay...your leak graph from the Respironics machine in SleepyHead is going to show 2 lines and I am using a ResMed machine so I only get one line but any large leaks will show up as a graph area and on the Events graph (top graph) you will see gray flagging in the LL line on that events graph. Fairly easy to spot.
I am pretty sure this was mouth opening leak because the mask never moved. It's not horribly long in terms of duration and I slept right through it so I don't care.
Mouth opening and allowing the air to exit out through open lips will show up as a leak.
When I evaluate leaks (no matter where it is coming from) I look at
1..how long did it last
2..just how "bad" was it
Last night roughly 7% of the night was spent in large leak territory. That's roughly 30 minutes out of 7 1/2 hours of sleep and as you can tell it wasn't 30 minutes continuous but was broken up in smaller segments some very brief and some not so brief.
I slept right through it and I don't sweat the small stuff like this.

Awesome thanks. I'm sure I'll have more questions later after I digest this. One question is will disconnecting hose or mask to use the bathroom show up as large leak section? Do you turn off your machine before you remove your mask or hose? Do you also wait to turn it on until after your mask is already on?

Also, I still can't tell which machine I have. I googled online my model 1051085 and don't see it anywhere. I'm trying to attach a pic of my label here. I'm trying to determine if my old machine is capable of giving me any stats at all. I can tell you I got it in 2008 so I think it's a remstar m series 07-08. What you think?

[Pugsy]

I suggest turning the machine off if you get up in the middle of the night to go to the bathroom or whatever.
If you let it continue to blow it makes a lot of noise (not good for anyone else in the bedroom) and it messes with the leak numbers a bit. It's easily seen on the graphs but turning it off is just quicker and simpler. It shows as a really big leak spike.

You can turn it on manually or there is a setting called "Auto ON" that when it is set to ON the machine will come on when it senses your breathing on the other end. Your choice on what you want to do. Not critical either way.
You need to do any mask fitting under pressure anyway.

I am familiar with the M series. It was my very first machine back in 2009.
That model number seems to point to the M Series Plus CPAP machine...it doesn't have any useful data on it.
If you don't see the word "Pro" or "Auto" anywhere on the machine then there's no useful data available.

Go here and request the manual for your new DreamStation machine and read up on the features.
http://www.apneaboard.com/adjust-cpap-p ... tup-manual
Instructions for requesting via email are about 2/3 down the page.
Make sure you request this model just like this
Philips-Respironics DreamStation Auto CPAP
You will get a manual that contains the various models...we call them combo manuals.
Read the manual...there's some really good information in it that should explain a lot of things for you and if you need something clarified further you can come here and ask.

[OkyDoky]

Awesome thanks. I'm sure I'll have more questions later after I digest this. One question is will disconnecting hose or mask to use the bathroom show up as large leak section? Do you turn off your machine before you remove your mask or hose? Do you also wait to turn it on until after your mask is already on?

Also, I still can't tell which machine I have. I googled online my model 1051085 and don't see it anywhere. I'm trying to attach a pic of my label here. I'm trying to determine if my old machine is capable of giving me any stats at all. I can tell you I got it in 2008 so I think it's a remstar m series 07-08. What you think?

Leaving the machine running while the mask is disconnected will show as a leak. I would just turn off/on. Some people leave the mask on and just disconnect from the hose.
Look on your machine for a model or REF# such as DS100,DS200, or DS400 then you can also check this site to identify. https://sleep.tnet.com/cmd.class?class=mseries

[axxell6307]

I suggest turning the machine off if you get up in the middle of the night to go to the bathroom or whatever.
If you let it continue to blow it makes a lot of noise (not good for anyone else in the bedroom) and it messes with the leak numbers a bit. It's easily seen on the graphs but turning it off is just quicker and simpler. It shows as a really big leak spike.

You can turn it on manually or there is a setting called "Auto ON" that when it is set to ON the machine will come on when it senses your breathing on the other end. Your choice on what you want to do. Not critical either way.
You need to do any mask fitting under pressure anyway.

I am familiar with the M series. It was my very first machine back in 2009.
That model number seems to point to the M Series Plus CPAP machine...it doesn't have any useful data on it.
If you don't see the word "Pro" or "Auto" anywhere on the machine then there's no useful data available.

Go here and request the manual for your new DreamStation machine and read up on the features.
http://www.apneaboard.com/adjust-cpap-p ... tup-manual
Instructions for requesting via email are about 2/3 down the page.
Make sure you request this model just like this
Philips-Respironics DreamStation Auto CPAP
You will get a manual that contains the various models...we call them combo manuals.
Read the manual...there's some really good information in it that should explain a lot of things for you and if you need something clarified further you can come here and ask.

Is that any different than the pdf manual from the manufacturer I already have?