Very upset with CPAP provider

[Terryg]

Got my Cpap machine December 27 2016. Paid my copay toward rental and mask etc. of $200. We have aetna insurance have had them for about 5 years now. Followed instructions I was given when I picked up cpap machine from medical office. For the first 2 weeks things seemed to go well and I was begining to be able to wear the machine for a full night. Took some getting use to. Suddenly I noticed one night that a few things had changed. 1. The machine didnt come on automatically when I put on the masked and breathed. I had to push the power button now. 2. The pressure seemed to be increased. Hurt my head and made my ears pop. felt like my head was going to explode wearing it. I was never told my dosage and couldnt remember the original settings. I would only wear it 5 to 30 minutes a night now and give up. Skipped a few nights and tried again same results.

Called Cpap provider twice with no answer. I work odd hours and its hard for me to catch the during thier work hours.
So today I get a call 02 15 2017 about 45 days of having the machine. Its the guy that rented the machine out to me. First he ask how my cpap thearapy is going and he is doing a follow up. I say Ive been having some trouble with the machine and I had been trying to contact them. He said well actully now that i have your file pulled its says you switched insurance on 01 01 2017 and are now with united health care? I said no I havent changed I dont know why you would have such info. I still have aetna. He tells me that its a good thing he talked to me today that if I didnt get the machine back to them by next week I would be billed for it. I really didnt know what to say. Other than this is the first time Ive heard this and I havnt got any phone calls or mail concerning any unpaid bills from them. He says he will get with billing and try and find out whats going on. Ok no problem call me back when you talk to them.

2nd half of the conversation. He pulls up my perscription and says its suppose to be on 8. Its not on 8 its on 20 now. He tells me he didnt change but someone else had and he didnt know why but he would put it back on 8 for me to just unplug the machine and plug it back in and it would be back on 8.

So my wife thinks they adjusted the machine to where I couldnt use it because they thought they werent getting paid.
Shes upset because Ive had a hard time sleeping the past month and the machine is at fault or the person who changed the perscriotion without me knowing. I too feel like Ive been taken advantage of. What if this was another type of medical device and the provider decided to up the dose because they where not getting paid? Seems pretty fishy to me and Im not sure what if anything I should do.

[Julie]

Could you please provide the name of your machine - all words on top of it - and what type of mask you have. I ask because apart from generally needing to know that anyway in order to help, the number 20 happens to correspond to the default high # of most autopaps and 'just' being at 20 (the low setting being different, whether 8 or not) would not be wrong. But if you have a plain Cpap (vs auto) and it's set at 20, or if the low setting on an auto has somehow been pushed to 20, then something would definitely be wrong, whether or not your insurance had anything to do with it. However, if you do have an auto machine, the prescription for the low setting being at 8 and the high one at 20 (prior to the trouble you had when things suddenly changed), then something else (mechanical) would definitely be wrong. But I would also contact your insce. co. to find out what they say as the explanation given to you re the change in companies sounds very strange in any case.

[Guest]

1. The machine didnt come on automatically when I put on the masked and breathed. I had to push the power button now.

That is often caused when the mask leaks the cpap can't feel you breathing. Press the mask into your face when trying to start the cpap then adjust the straps to seal any leaks.
btw - pushing the button is not a bad thing. NOTE: the auto start also has to be set up in the menu. Push the button until you get things sorted out.

Leaks can also cause the pressure to rise if you have an auto. Are you sure you didn't go into the menu to look around (we all do it) and accidently change the pressure? That's not a bad thing just be sure to write ALL of the settings down before changing even one thing.

Can't begin to answer your insurance problem you will have to contact them. Sometimes you can get answer at their website.

[OkyDoky]

You need to learn about your machine. When you give us the machine info, we can help you get the Clinical Manual for it. That's the manual that the providers use and you don't usually get to see. With that manual you can learn how your machine works. Ask questions here and read the threads in the top announcements section. As you learn, you will feel like you are more in control.

[Pugsy]

You need to also contact your insurance company yourself...find out exactly what their requirements for cpap usage are so that they will pay for the machine.
45 days isn't a normal time frame for the insurance company to deny coverage from lack of usage.
Heck, even Medicare allows for 90 days.
The requirements are normally......during the first 90 days a person must use the machine at least 4 hours for 70% of a 30 consecutive day period. Your insurance may require something else but you need to ask them yourself...DMEs can't possibly know off the cuff what each insurer's requirements might be.

[terryg]

Its a dreamapper by respronics. Read the manual all settings are locked by medical provider. Insurance issue has been resolved the supplier made a mistake.

[EdNerd]

I would also be very curious as to how they got into your machine to change things - if indeed that is what happened, and why they did such things without notifying you. They're supposed to have some way of monitoring your usage, yes? If your machine has a wifi or cellular modem, are they seeing your data? Did they see the rise in pressure? Did they manipulate the pressures?

Even if there's a much more reasonable explanation, I would be asking to see the data they have and get their side of the story on this. And if they don't have any data, then how does anyone know whether you are in compliance should the insurance balk at paying out?

Ed

[OkyDoky]

Its a dreamapper by respronics. Read the manual all settings are locked by medical provider. Insurance issue has been resolved the supplier made a mistake.

What model of DreamStation? Give us a REF# and we can tell you if you don't know. The Clinical manual I talked about above shows you how to access the menu that is locked. You can get that manual here. http://www.apneaboard.com/adjust-cpap-p ... tup-manual
Scroll down to section 3 and follow their instructions for them to email you one.

[Pugsy]

Read the manual all settings are locked by medical provider

You read the wrong manual...there's no way to lock anything...you just have to know the little secret button pushing combination that gets you into the settings area.
Follow OkyDoky's advice and get the other manual that explains the little secret button pushing stuff.

[Janknitz]

Most CPAP's come with a modem that allows remote access nowadays. So someone with your DME may have monkeyed with the settings, turning off the autostart feature and changing the pressure.

When you get the manual you can see how to put the machine in "airplane mode" so nobody has control over it except you. If the DME needs compliance data, they can contact you to allow them access.

[amandah72]

report your DME to your insurance company. They take these things very seriously and will mail them a stern letter to knock it off or call them directly. You can be on that call too listening in.