They don't have the masks I want to try

dieselgal · Post by **dieselgal** » Wed May 30, 2007 3:19 pm

I live in a small town in the hill country of Texas and with a list in hand of the DME's my insurance works with I started calling today to make sure they were going to have the masks I was interested in trying. Well so far I have called 4 of the 6 and the only mask they carry (not necessarily in stock) but can get is the Mirage Activa. This is one I want to try but I would want to compare it to the Somnotech Soyala and none of them know of that mask! They also haven't even heard of the Bravo.
It sure gets depressing to know that I know more about their equipment than they do, and it means that I will be lucky to ever be able to get anything new or something out of the norm with them.
Instead of calling myself Dieselgal I should have called myself
"PODUNK PATTIE"

Babette · Post by **Babette** » Wed May 30, 2007 3:29 pm

Sorry Buddy! Well, it's back to playing Mask Roulette for you. Didn't I see a Bravo for sale/trade here recently?

See if your local sleep center has a support group. Maybe they can arrange a meet up with other patients, maybe have a vendor fair....

Or you could holler out HERE for some folks nearby who might want to play "Face Tupperware Party" with you.

I got some players to do that in Seattle. I'm sure Texans can't be that stand-offish. Offer them barbecue!

Good luck!!!
Barbara

tillymarigold · Post by **tillymarigold** » Wed May 30, 2007 3:31 pm

Define "Hill Country of Texas." If you're out near Midland or Lubbock, it might be worth coming here to New Mexico if you're really keen?

Craig-Tx · Post by **Craig-Tx** » Wed May 30, 2007 3:32 pm

I'm in Fort Worth Tx myself. I'm stuck with Apria, until I can convince my insurance company otherwise. (Or next year I'll get a new ins company.)

I've been on xPAP since January and I'm often asking them about masks they have never heard of. Right now they are special ordering an Aura (Took them a week to figure out what it was and 7 weeks and counting to get it.)

Every person I have talked to from corporate down hasn't heard of the Aura. It's sad that they don't take the time to keep up on the latest equipment. They basically only know what the manufacturers are pushing.

dieselgal · Post by **dieselgal** » Wed May 30, 2007 3:54 pm

tillymarigold wrote:Define "Hill Country of Texas." If you're out near Midland or Lubbock, it might be worth coming here to New Mexico if you're really keen?

No by Hill Country I mean Kerrville Texas, I am about an hour from San Antonio which is a big city but I would almost rather be whipped with an old CPAP hose than go there and it is impossible to go during the week and around here the DME's are closed on weekends. What's up with that?
Also I have to keep in mind that just because someone is a DME if they aren't in plan with my insurance then I would pay a lot more out of pocket.

Mile High Sleeper · Post by **Mile High Sleeper** » Wed May 30, 2007 4:24 pm

Dieselgal, the way I work with Apria is like this:

After I research masks on cpap.com and cpaptalk.com, I work with an excellent local hospital sleep center. If they can get in the masks I want to try, I try on several masks and sizes, using their expert fitting advice. They fill out a form with my mask choice, which I take to my doctor. My doctor writes the prescription for that mask (for insurance billing purposes).

I take the prescription to Apria. With luck, they will reluctantly "special order" the mask, giving dire warnings about no refunds if it doesn't work. If they can't order the mask, I get it from cpap.com and ask my insurance to reimburse me.

At least two hospital sleep labs in the Denver metro area offer mask fittings; one free, one for a charge for the first fitting, then free. Thankfully, these hospital sleep labs are providing good patient services which many local DMEs don't seem able to deliver. I hope there are similar hospital sleep labs in your area.

atruvirgo · Post by **atruvirgo** » Thu May 31, 2007 10:24 pm

dieselgal wrote:I live in a small town in the hill country of Texas and with a list in hand of the DME's my insurance works with I started calling today to make sure they were going to have the masks I was interested in trying. Well so far I have called 4 of the 6 and the only mask they carry (not necessarily in stock) but can get is the Mirage Activa. This is one I want to try but I would want to compare it to the Somnotech Soyala and none of them know of that mask! They also haven't even heard of the Bravo.
It sure gets depressing to know that I know more about their equipment than they do, and it means that I will be lucky to ever be able to get anything new or something out of the norm with them.
Instead of calling myself Dieselgal I should have called myself
"PODUNK PATTIE"

Dear Podunk

I have APRIA as many people also seem to have. I spoke with them today because my doctor wrote on the prescription for them to fit me with a nasal pillow mask. I called to tell them I want to try the Bravo and they told me the pillow masks that are available to me. I am going to call my insurance tomorrow to ask if that is APRIA not wanting to help me or if that is a clause in my policy. Perhaps the insurance company will run interference. I noticed that you show you are currently using the 407 nasal mask. How did that work for you? I just got the 406 (the petite version of 407) and so far it has worked the best for me. Good luck with your DME. I was told I can only use APRIA as my DME.

Debbie
________________

CPAPopedia Keywords Contained In This Post (Click For Definition): mirage, activa, DME

Craig-Tx · Post by **Craig-Tx** » Fri Jun 01, 2007 10:43 am

atruvirgo wrote: I have APRIA as many people also seem to have. I spoke with them today because my doctor wrote on the prescription for them to fit me with a nasal pillow mask. I called to tell them I want to try the Bravo and they told me the pillow masks that are available to me. I am going to call my insurance tomorrow to ask if that is APRIA not wanting to help me or if that is a clause in my policy. Perhaps the insurance company will run interference. I noticed that you show you are currently using the 407 nasal mask. How did that work for you? I just got the 406 (the petite version of 407) and so far it has worked the best for me. Good luck with your DME. I was told I can only use APRIA as my DME.

Debbie

Debbie,

Please keep us informed of your progress on dealing with (I assume) Cigna. I too am planning on talking to them about going to someone other than APRIA.

Babette · Post by **Babette** » Fri Jun 01, 2007 11:08 am

When I complained to my insurance (Premera in WA State) about my DME, they said they don't have any problems with who I want to go to. I was referred to that DME by the sleep center, and the insurance told me to call the sleep center. I did that, and found out that the sleep center was told to use that DME by the hospital, and I should complain to the hospital. I had already called the hospital a week before to complain about other parts of this process, so instead, I put it in writing and emailed it to them. Since I haven't heard anything BACK from the hospital, I'm pretty sure they either didn't get the email, it was "junk mailed" by their computer, or they just don't care.

But I found out if I pressure my doctor to write me the prescription I want, and a letter of medical necessity, I can probably just do this all on my own with Premera. I still need to call them and find out HOW I go about doing this on my own, since I'd rather manage that part myself than go through BillMyInsurance. I just feel like if I'm going to do this, I'm going to do it right the first time.

I'm already tired of having to constantly correct mistakes made by the staff at the DME, the sleep center, my primary, and the sleep docs office.

Cheers,
B.

neverbetter · Post by **neverbetter** » Fri Jun 01, 2007 12:22 pm

Heck, try the activa. It's a pretty good mask.

Craig-Tx · Post by **Craig-Tx** » Fri Jun 01, 2007 2:50 pm

Babette wrote:When I complained to my insurance (Premera in WA State) about my DME, they said they don't have any problems with who I want to go to.

Unfortunately Cigna has negotiated a sole source DME provider through Apria. From my understanding, if you want Cigna to pay anything for CPAP related DME, you MUST use Apria.

-craig

skjansen · Post by **skjansen** » Fri Jun 01, 2007 4:28 pm

[quote="dieselgal"]I live in a small town in the hill country of Texas and with a list in hand of the DME's my insurance works with I started calling today to make sure they were going to have the masks I was interested in trying. Well so far I have called 4 of the 6 and the only mask they carry (not necessarily in stock) but can get is the Mirage Activa. This is one I want to try but I would want to compare it to the Somnotech Soyala and none of them know of that mask! They also haven't even heard of the Bravo.
It sure gets depressing to know that I know more about their equipment than they do, and it means that I will be lucky to ever be able to get anything new or something out of the norm with them.
Instead of calling myself Dieselgal I should have called myself
"PODUNK PATTIE"

skjansen · Post by **skjansen** » Fri Jun 01, 2007 4:31 pm

tillymarigold wrote:Define "Hill Country of Texas." If you're out near Midland or Lubbock, it might be worth coming here to New Mexico if you're really keen?

Tilly....I just HAD to LOL. I just got back from dropping my son at Texas Tech in Lubbock and there is NO WAY that could be construed as the "Hill Country!!!

Just giving you a hard time...it is all in fun. I actually can have fun now that I feel much better to successful use of my CPAP.

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CPAPopedia Keywords Contained In This Post (Click For Definition): CPAP

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CPAPopedia Keywords Contained In This Post (Click For Definition): CPAP

motherall · Post by **motherall** » Fri Jun 01, 2007 6:17 pm

I guess I just lucked out...when it was time for a new mask, my DME coordinator (Homelink) asked what I wanted and I told them. The actual DME supplier then called me to ask what a Bravo was and how did I hear about it. I gave him the web address, he looked it up,ordered it and I know I've tired all of you with how happy I am with this mask, so I won't bore you with that.

atruvirgo · Post by **atruvirgo** » Fri Jun 01, 2007 10:10 pm

Debbie,

Please keep us informed of your progress on dealing with (I assume) Cigna. I too am planning on talking to them about going to someone other than APRIA.

_________________
Actually I have Blue Cross but I hear what you're saying.

Debbie

CPAPopedia Keywords Contained In This Post (Click For Definition): nasal pillow, DME, Prescription[/quote]

They don't have the masks I want to try

They don't have the masks I want to try

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Re: They don't have the masks I want to try

Re: They don't have the masks I want to try

Re: They don't have the masks I want to try

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