Smart Card Problem - No Data

sundance12 · Post by **sundance12** » Thu Nov 16, 2006 7:07 pm

thanks to all of you who answered my posts 11/13, well my clinician got busy and looked for the hybrid mask, i know he did this as he gave reference to all inquires, he said some people are still having problems with them, such as headgear, chin flap, bad fit on chin cup, also 2 sleep labs locally used 2 of them for a few days, but patients could not use them, and sleep lab did not care for them for now, maybe later they will come up with a fix, still would like to try it, you were right,medicare will not get me another machine, my clinician said that medicare does not pay for auto- set machines period is this correct?tomorrow my clinician is gonna come over and do a home sleep study of some sort , dont know what that entails, i may have to wear a monitor or something, this was ordered by my sleep dr, as i am not driving much yet, maybe this will show why iam am having a lot more apneas, i do not have a auto -set so i dont know whats going on in the mornings, i have a resmed s7 lightweight, and a humidaire humidifier , i wear a swift pillow mask, and i am a bad mouth breather, have deviated septum, am so discouraged with no progress after 17 mo,i think i will be owner of my cpap soon, i said i would take ownership on it when time is up, clinician said he asked medicare if they would pay for a hybrid, when and if i should be able to try one and they said probably not thanks so much for all your replys, i look forward to this forum as i live alone,sundance12 ,

CollegeGirl · Post by **CollegeGirl** » Thu Nov 16, 2006 7:28 pm

John, you didn't answer what Den says - on the "date line" that shows the report you just downloaded - that box the reports are listed in is scrollable. Did you scroll all the way down?

Forgive us for asking, but we've had more than one person not realize that.

John Galt · Post by **John Galt** » Thu Nov 16, 2006 7:32 pm

Yes, I have scrolled down. I've used this software for a couple of months, so I have quite a bit of historical data. I've only occasionally had problems accessing my data, and it has usually been because I didn't seat the smart card properly. But, as you saw above, the system is suddenly not recording data. I'm pretty familiar with how to download, how to access reports, etc.

I have erased my card and I will see if that somehow clears things. I hope it works, but if it does, I will be a bit perplexed about why it worked.

CollegeGirl · Post by **CollegeGirl** » Thu Nov 16, 2006 7:34 pm

John - I'm with you. I'd be perplexed. Erasing shouldn't make any difference at all. I have no idea why it's not recording - that's bizarre.

dsm · Post by **dsm** » Thu Nov 16, 2006 7:38 pm

John,

I recently dusted off my Remstar Auto & ran with it for 2+ weeks. I
also wanted to monitor nightly data so like you were, was surprised that after night 1 I couldn't get any data off the card even though it plugged into the machine ok. I then went through a whole lot of tests using several cards & eventually got them all working & recording but one did play up but only on the Remstar Auto, this same card worked fine in the Infineer reader & when used in a Bipap Pro2 & Bipap S/T.

Here are some of the experiences & tests (I'll just refer to 2 cards even though I tried 4) ...

Card #1
- worked fine in Remstar (beeped on entry, showed icon)
- EncorePro 1.5 gave an error when trying to read this card

Card #2
- EncorePro could read it but Remstar gave an error when it was inserted

Eventually I adopted this process which seemed to work consistently ...

Card #2
- Created a patient record in EncorePro
- Selected this patient (double clicked it)
- Inserted the card into the Infineer
- Selected Card Utilities & erased the card (this step took several goes with 1 card)
- Performed a 'card setup' & made sure the data matched the patient info (you do not need to enter the actual serial # of the machine although it asks)
- Performed a create prescription and set the machine for AFLE 11 14
- THIS CARD WORKED & got used for several days but each day I only needed to select the patient record, & then insert the card & download data, I did not need to do the erase/setup/prescription process again once I got both sides accepting this card

Card #1
- After doing the above (took a couple of goes) Encore recognized the card & its patient data
- BUT the Remstar Auto sometimes accepted it & other times didn't
- A Bipap Pro 2 had no trouble accepting it

Of the other 2 cards, they all eventually behaved the same way as #2.

It took more than one go of working through this procedure but in the end 3 were fine was was marginal.

Good luck

DSM

#2

I had a lot more problems that the above implies, but after a few shutdowns & restarts & persistence, did get the above simplified process to work consistently apart form the one card that behaved badly with the Remstar. At one ponit I had 1 card that worked with both EncorePro & Remstar Auto & 3 that gave problems with one or the other. If EncorePro could erase it, Remstar would reject it sometimes with a C1 other times with a C5 error.

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CPAPopedia Keywords Contained In This Post (Click For Definition): bipap, Prescription, auto

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CPAPopedia Keywords Contained In This Post (Click For Definition): bipap, Prescription, auto

rested gal · Post by **rested gal** » Thu Nov 16, 2006 7:42 pm

Sundance, I think the DME may be telling you wrong about what Medicare will or won't cover.

My uncle, who has been on Medicare for at least the past ten years was able to get an autopap (Respironics REMstar Auto with C-flex) a year or so ago...through Medicare. He had been on straight cpap for about ten years. All it took was having his doctor write an Rx for autopap since a pressure range instead of a single pressure has to be stated on the Rx. His DME let him have an autopap with no hesitation at all and no extra charge. The billing continued to Medicare just the same as if he were using a straight cpap. As far as Medicare is concerned, an autopap IS a cpap machine...same billing code whether it's a straight cpap machine or an "auto-titrating cpap" machine.

A woman here in town, whom I've been helping with her cpap treatment, is on Medicare. She started cpap treatment in June with an Ultra Mirage FF mask. After several months, when the time came for her to be able to get a new mask under the Medicare replacement schedule, I asked her DME to give her a Hybrid. They did that with no problem, no new Rx, no hesitation. If a person were not already using a FF mask, then the DME would probably want an Rx for "Full Face" mask. When billing Medicare, I think they have to dot all the i's and cross the T's.

At any rate, I think it really might depend very much on how cooperative the DME wants to be about your requests. But for them to tell you that Medicare won't cover an autopap (it's just another cpap when it comes to billing) or won't cover a Hybrid mask (it's just another FF mask)...I don't think the DME is being forthright with you.

John Galt · Post by **John Galt** » Fri Nov 17, 2006 6:31 am

As recommended by a couple of folks, I erased my smart card yesterday in hopes that it would now record data.

This morning when I inserted the card into the reader, it was recognized (again) and the light turned green. The software noted that the patient information did not match the information in my database and inquired if I wanted to proceed ... I said yes. Then it asked whether to erase data, and I said no. It then stopped. There was no apparent effort to process/download data.

The sql database is on.

So, I'm stumped. The card clearly records some data, as I can put my name and ID number on it and read it, so it's not defective. The database is activated and I can read old data, so the software appears to be working. The cpap recognizes the card (yes, the card icon was visible last night in the cpap display; and, it did beep once when inserted to acknowledge the card).

Is there a way that I can test the machine or do I have to return the entire package to cpap.com for assistance?

Ray · Post by **Ray** » Fri Nov 17, 2006 7:56 am

I've been experiencing the same problem. My card is properly inserted into my cpap, is acknowledged in the screen, but data hasn't been being recorded. I, too, would appreciate any other ideas on how to diagnosis/resolve this problem.

poopedknot · Post by **poopedknot** » Fri Nov 17, 2006 7:09 pm

The experiences dsm had would lead me to believe the cards have some minor glitches that could be causing sporadic data transfer problems. Even though the machine is recognizing the card there might be other firmware faults going on. Try calling your DME and see if they have an extra card you could borrow for a few nights. If the same problems occur it must be a machine problem somewhere. If it works OK the card is probably the culprit. After all, everything eventually wears out, as my old body constantly tells me.

Wulfman · Post by **Wulfman** » Fri Nov 17, 2006 7:45 pm

John,

I can't recall if this has been covered in this thread.....but do you have your cardreader plugged into a motherboard USB port? This has been an issue with some users that use a hub that may not be powered. Also, the reader likes to use the same port with which it was installed.

Den

John Galt · Post by **John Galt** » Fri Nov 17, 2006 8:07 pm

I have always kept the card reader plugged into the same port. I have never unplugged it. It is the same port that it was installed in. It is a direct plug in the front of my dell desktop.

John Galt · Post by **John Galt** » Sat Nov 18, 2006 8:12 am

Another night with no data. Card is still inserted correctly, etc.

If I were to request replacements, should I start with the card, the reader, or the cpap?

Guest · Post by **Guest** » Sat Nov 18, 2006 9:40 am

The card is only $10. That's the cheapest way to start.

dsm · Post by **dsm** » Sat Nov 18, 2006 9:16 pm

Re what works & what doesn't ...

1) If you can erase the card then that is good !
2) If you can do a set-up on the card, that is even better
3) If you can load a prescription on the card that is a good test.

If you set a prescription on the card with a value other than the existing machine cms (or range of cms settings depending if a cpap or an auto)
and when you put this card in the machine, the cms changes to that set in the prescription you created on the card then your machine and EncorePro/datacard reader, are in harmony as regards communicating with each other.

The card should be recording nightly data as the card was able to change the cms of the machine.

If a prescription won't change your machine's settings then there is no good reason to believe the machine can write on that card.

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Just for the heck of it. I took the faulty card I have & although I have gone back to my PB330, I did a 10 min test with the Remstar fitted with the 'faulty' card & the used EncorePro to download the data & it was fine - 10 mins of data. But when I put the card back in the Remstar it gave a C-1 error. I removed the card & re-inserted it & no error.

This just reaffirmed to me that this card is erratic when used in this Remstar.

DSM

John Galt · Post by **John Galt** » Sun Nov 19, 2006 3:01 pm

I followed your advice. I inserted the smart card into the reader, opened Encore Pro and changed the prescription. I inserted the card into the cpap and it did change the prescription. Then I ran the machine for a while ... put the card into my computer, downloaded and still found no data.

So, to summarize:
1. The card is correctly inserted into the machine and it communicating with the cpap as confirmed by the fact that I am able to change the prescription.

2. The card is recognized by my computer, as confirmed by my ability to erase it, add patient information to it, and even add a prescription to it which then adjusts the cpap.

3. Encore Pro is working as confirmed by the SQL Server being active, the ability to program a prescription onto the card, the ability to read the card while in Encore Pro.

But, still no new data for over a week. What do I try now? This is quite perplexing.

Smart Card Problem - No Data

gave up on hybrid mask