Just got diagnosed

[dh37]

Just got diagnosed with a home test from a sleep center.

My main questions revolve around the DME and sleep center, vs what I've gleaned from reading here (so far just skimming a few threads)

About me:

• Horrible snoring
• Not overweight
• Male, born mid-1960s
• Not "sleepy" but rather lots of fatigue, plus what feels like at least a moderate amount of brain fog
• Other meds: one SSRI (history of anxiety depression)

Diagnosis

• Went to PCP; got referral to sleep center (no other medical conditions, bloodwork normal, no heart disease, etc)
• Did home study with belt, nasal canula, pulsox
• Called when I hadn't heard anything; they said I have severe OSA

What I want to know:

People here put a great emphasis on pushing on logistics (e.g. choosing the DME, etc), as well as self-management (looking at stats coming off the device). At the beginning, can I just use the DME the sleep center uses? The sleep center already sent the DME (Apria) the prescription.

My gut instinct is to micromanage this stuff, because (1) I hear horrible things about DME's, (2) I think the medical system in the US does an atrocious job at coordinating care, (3) a lot of the CPAP tweaks people discuss here appear to involve a lot of user-level involvement (settings adjustments based on readings).

Right now though I'm leaning towards just getting started with the assigned DME and seeing how that goes. Is that a reasonable way to start? I'm assuming if things are terrible (choice of machine, service, etc) I can get things reversed.

Reason I don't want to get overinvolved right now is I have very little free time (two small children, both me and my wife work, no support system for helping with kids, etc).

In closing, from the little I've seen so far this is a great site and great community.

Cheers,

S

[klm49]

Just make sure they give you a data capable machine and preferrably an APAP.

[OkyDoky]

Welcome,
I started out with Apria just like you because I didn't know anything other than what the doctor said. I got a good machine because of the one my doctor ordered. I paid it off over 13 months then quit using them. All of my supplies and other machines, I have bought on my own. I didn't have any billing problems with Apria just headaches, initial mask problems and no one to help me, resupply orders sent when I was away, ect.

Finding this forum was where I learned how to get over ever hurdle I met. So you already have a head start.
Learn about the different types of machines and be sure you get a full data capable one. https://sleep.tnet.com/cmd
The ResMed and Respironics are the biggest companies.
Call the DME and see what machine they have for you then ask here about it. Don't take a machine that is not full data capable.

[dh37]

Call the DME and see what machine they have for you then ask here about it. Don't take a machine that is not full data capable.

From an earlier conversation with the clinic, it sounds like the machine will upload the data in some manner so that the MD can look at it to monitor. But, without knowing much about these things, that doesn't logically imply I have access to the data. Is there concise description for what constitutes full data capable?

[dh37]

I paid it off over 13 months then quit using them.

Is that "rent to own"? Are most contracts like that?

Re Apria, I already googled them. Sounds like they're just horrible beyond words.

[OkyDoky]

From an earlier conversation with the clinic, it sounds like the machine will upload the data in some manner so that the MD can look at it to monitor. But, without knowing much about these things, that doesn't logically imply I have access to the data. Is there concise description for what constitutes full data capable?

Some machines only record compliance data so they can tell if you are using it, and that is what the DME is most concerned about so they get their insurance payment. A full data machine breaks down your AHI into Obstructive, hypopneas, Centrals and this is important if something changed down the road. With the NO data machines even the doctor cannot get this data to evaluate. When you have a machine for 5 or more years you want the most versatile.
What the DME is talking about is a cellular connection that is built into most machines but it can be compliance or full data.
If you have regular Obstructive sleep apnea. Look for
Resmed Airsense 10 For Her (not just for Her) This one has 3 modes CPAP, AUTO, AUTO for her.
ResMed Airsense 10 Autoset has 2 modes CPAP, AUTO
If you just need straight CPAP pressure both of these will do that but also give you the other options if needed.

Respironics DreamStation make sure it is the AUTO and not just the CPAP (not full data model)

Asked Apria the machine model name and let us know.


As far as the 13 months goes that is how Medicare pays and I didn't have Medicare but many insurances go by their schedules. Contact your insurance company to see if they rent or buy. I would do this before calling DME.

[LSAT]

I paid it off over 13 months then quit using them.

Is that "rent to own"? Are most contracts like that?

Re Apria, I already googled them. Sounds like they're just horrible beyond words.

Don't under any circumstances leave Apria your Credit Card Number. If you are insured, you will get a bill from Apria. If you give them your CC, they will be sending supplies you may not need. Many of Apria's problems involve sending the wrong merchandise and billing.

[Okie bipap]

If you are using insurance, check with your insurance company to find a list of approved DME suppliers. Also, ask your insurance company of it is an outright purchase, rent to purchase, or continuous rental. If you have a continuous rental, it is usually cheaper to purchase the machine your self.

[dh37]

If you have a continuous rental, it is usually cheaper to purchase the machine your self.

Are you saying that an out-of-pocket (without using insurance) purchased machine might be cheaper than the copays/deductibles that go towards a rented machine covered by insurance?

[Nick Danger]

If you have a continuous rental, it is usually cheaper to purchase the machine your self.

Are you saying that an out-of-pocket (without using insurance) purchased machine might be cheaper than the copays/deductibles that go towards a rented machine covered by insurance?

Yes!

[Okie bipap]

If you do a rent to own, it is usually for thirteen months. If you do a straight rental, it will go for years. You need answers from your insurance company, not the DME. Apria is known for lying to their customers. Take anything they say with a grain of salt. Depending on your deductable, it may be cheaper to purchase from an online DME. Brick and mortar DMEs normally charge more than online suppliers. If you purchase through your insurance, your copay is based on the price your insurance company has negotiated, not what the DME "charges" them. For example, the DME we got my wife's machine from "charges" $657.86 a month and Medicare pays them $79.93, with my portion being $20.39. Every major insurance company negotiates rates with the DME.

[D.H.]

If they gave you a rent-to-buy arrangement, I would stick with Apria for thirteen month; until the machine is paid off. Then you can continue with Apria or use any DME that your insurance will cover.

Make sure they give you an APAP and a humidifier (preferable the Dreamstation Auto or the ResMed AirSense 10 AutoSet, Both of these machines have a very similar looking non-automatic version, so be careful what you're getting.

[Cardsfan]

Hi and welcome to the group. You will want to get a copy of your prescription for yourself to keep. That way, you can always send it to any DME and online supplier that you want to. You are not limited to using just one DME. Lots of us buy items from our sponsor. www.cpap.com and other places. The other paperwork you need to ask for is a copy of your sleep test report results. It may come in handy some day.
Check with your insurance to make sure Apria is in network.