need advice.

[tony72]

how do you know if you have a modern cpap machine?

[Emilia]

You want a machine that is quiet and, most importantly, is fully data capable. That means it gives out full data on your therapy, not just compliance data of # of hrs. used in a month. Our host's site has this interesting page on consumer trends in buying cpap machines of all kinds. In another thread you said you were considering the IntelliPAP. You should consider their AutoAdjust with Smartflex (newest model that is available as of Aug.) since you can use their SmartLink software to monitor your therapy. Other brands to consider are the PR One RemStar and the ResMed S9 series. I have the IntelliPAP and have been using it for a week now. I am very happy with its performance and data. Others can speak to the other brands.

https://www.cpap.com/cpap-user-preference.php

[tony72]

can i convince the dme to give me the one you have?insurance will pay.

[Emilia]

I have no idea...you will need to ask assertively! Don't let them tell you that 'you don't need to know' about your therapy. I had a heck of a time with my HMO, and I finally decided to buy my own machine out of pocket. But many folks on here have no problem getting their insurance to provide them with great machines. I guess the best thing to do is call the insurance company and ask what machines they allow, what is their normal allowance toward a machine, and then find a DME they work with that supplies the machine you want. It is a process, to be sure, and you will need to be on your game and assertive with all parties.

[elena88]

I dont think you want to be in a position to "convince" a dme to give you something you need for your well being.

Your doctor should be able to get you what you want.. and have him write the prescription for the machine you want..

probably an auto adjust machine full therapy data easy to download.. something with exahation relief too..

Look at all the top auto machines on this website or others..

If your doctor will not give you what you want, find another doctor who will. The dme follows THEIR instructions, and the doctor
should be looking out what is best for you..

I have a resmed autoset s9 it is auto adjusting, meaning it will automatically follow you breath by breath and stop an obstruction with
whatever pressure it needs. that is called an AUTOPAP, or autoset or auto adjusting machine.

a cpap is a machine which will be set at ONE pressure, lets say pressure ten, and lets say you use ten when youre on your back, but when you
on your side you only need seven... so you are getting more pressure than you need all the time you are on your side..

Get an auto adjusting machine, get one with downloadable (TO YOUR computer) therapy capabilities, NOT just usage data.. those are useless.

the rest you can figure out later.. just fight for a good machine, or you will be in the dark. Dont let anybody pawn something off on you you dont want..
YOU have might have thirty days to return a machine if you dont like it.. the dme gets the same price from insurance for an auto or cpap, but they pay more for an auto, so they want to give you the cheap machine, so they can m ake more money.. dont get in that position, read all you can as fast
as you can so you can be informed.. Dont sign anything the dme hands you without reading it, have a list a questions.. ask them the cost
of each and everything you sign for, have them put it in writing.. Be a critical thinker, research everything, and you should be okay..

[tony72]

but my sleep dr has faxed it already.

[Emilia]

Do you have a copy of what he faxed to know what he Rx'd? If not, get a copy...and also a full copy of your sleep study results. You are entitled to have these for your own file. It is important to have the Rx's so if you are traveling and need to get a replacement of something, you can show that copy. Also, just because he faxed over a Rx already, doesn't mean it can't be retracted and a new one sent. What insurance do you have? Is it a good policy or is it an HMO or a policy with a very high deductible or copay? All these things will factor into your decisions. Some insurance provide the machine on a rent to own basis...meaning you get the machine and they insurance company pays a rental amount on it for usually 13 months after which it is yours to keep. If you have a copay on that rental fee, you need to determine if that copay x 13 months is more than what you could buy your own machine for online. Lots to think about and calculate!

[tony72]

southern health is my insurance.

[rested gal]

My list of machines that record "full data" (AHI and leak info) and those that don't -- updated through March 2010:
viewtopic.php?p=307168#p307168

[elena88]

dont worry, its not too late to change it.. just call the doctor's office and ask what they faxed over..
also tell the doctors office you would like a copy of your five to eight page summary of your sleep study..


if its a crappy machine, then ask the doc to change it to what you want..

YOU are not obligated to take a machine from any dme if you dont want it! They cant bill the insurance company
until you accept it.. Many times patients will change their minds on treatment options before the machine gets picked up..
so dont worry, you dont have it, you have signed nothing with the dme.. youre okay right now..

You can even change doctors and get one who will help you get a good machine, if the currant one does not..

do you have a ppo or an hmo?

[Emilia]

I am not familiar with that insurance company.... is it a PPO or a HMO? Do you have a high deductible? Copays? Does it allow for out of network providers besides their in network ones? All of these things will influence the insurance company's stance on your therapy and what they will allow. HMO's are very hard to deal with, and they can override a doctor's wishes/Rx easily. This is what happened to me.... totally denied me what the doctor explicitly wrote on the RX... twice! They only wanted to give me a basic non-data capable piece of crap machine. So.... I told them thanks, but no thanks.... got my own and I am very happy.

I hope you have great insurance that will provide you with what the doctor Rx's for you..... according to your wishes!

Keep us posted!!

[brazospearl]

tony, honey, welcome to the forum and good for you for taking such a big step to improve your health & your life! There are several things you need to do now.

The first is read, read, read on this board because there's lots to learn and the learning curve is steep.

The second thing is talk to your doctor and GET THE PRESCRIPTION IN YOUR HAND. Even if it's been sent to a DME already it can be sent to you as well. If you're in the United States it is your legal right to have this document. You also need to ask for a copy of your sleep study at this time. Again, in the US it's your legal right to have this.

Next, you need to visit the DME and have a discussion about what products they stock, how they handle mask purchases/exchanges, and just to get a general sense of how they treat their customers. There are excellent brick-and-mortar DMES around, but many forum members have had difficult experiences; one good way to tell is how things will go is to visit them and chat. If they're morons, or if they try to tell you that you don't need data capability or an auto machine, TAKE YOUR MONEY ELSEWHERE.

Once you have the information about what they can supply, you need to compare that with your list of machines that are acceptable to you (Rested Gal's list is handy for this!)

Then, you need to get in touch with your insurance company and find out what they pay and under what circumstances. This varies with each policy, so don't go by what somebody else says happened for them.

Next, do the math. Seriously. Even with my "good" insurance, it was cheaper for me to purchase my equipment online, and pay for it all out of pocket, than to go through the DME.

When choosing your machine the 3 things you must insist on are FULL DATA CAPABILITY, autotitrating feature, and exhalation relief. Although many experienced users don't need the auto and exhale features, they are really important for new users while you adjust to therapy as they offer the most options.

Ask us anything, we're here to help!

[tony72]

i sure will ask.

[tony72]

no deductible or copay.mine is care pos

[Emilia]

It sounds like you have great coverage, but you'll need to find out about their DME's and what type of machines they offer. Just be assertive and fight for what you want... have your doctor write the Rx for exactly the machine you want with the mask you want. Then be sure the Rx has DAW (dispense as written) and/or "Medically necessary" on it.

Good luck! Let us know how it works out for you.