Resmed S9 Question

[pittsbfan2000]

Hi all,
I'm new so I would like some help. I received a call from my DME to schedule an appoitment with a Nurse. I am scheduled for Thursday, I have been doing some research and it seems like one of the better cpap machines is the resmed s9. I asked them what brands they offer, they said they do offer RESMED. So I asked about the Resmed S9 autoset, she said that my insurance would not cover the AUTO. I don't know if I agree with that, i talked with Carefirst and they said that I am covered 100% of what the DR. writtes on the perscription( i guess the dr wrote cpap with heated humidity). The equipment just has to come from a perferred provider.

So I guess my question is, if I can't get the S9 Autoset, the next one I should ask for is the S9 Elite?

I currently don't have anything, i was just diagnosed wtih Severe Sleep Apnea.

Once I do get it, do they normally provide me with software to view my results?

Thanks for any help.

[jnk]

Hi all,
I'm new so I would like some help. I received a call from my DME to schedule an appoitment with a Nurse. I am scheduled for Thursday, I have been doing some research and it seems like one of the better cpap machines is the resmed s9. I asked them what brands they offer, they said they do offer RESMED. So I asked about the Resmed S9 autoset, she said that my insurance would not cover the AUTO. I don't know if I agree with that, i talked with Carefirst and they said that I am covered 100% of what the DR. writtes on the perscription( i guess the dr wrote cpap with heated humidity). The equipment just has to come from a perferred provider.

So I guess my question is, if I can't get the S9 Autoset, the next one I should ask for is the S9 Elite?

I currently don't have anything, i was just diagnosed wtih Severe Sleep Apnea.

Once I do get it, do they normally provide me with software to view my results?

Thanks for any help.

Since, according to my understanding, CPAP and APAP are the exact same insurance code, and the DME will get the same amount from insurance either way, what the DME is really saying is "we want to make more money off of you by giving you a cheaper machine unless we are forced to do otherwise."

What I would do is get a list of preferred providers and find one that will give me the machine I want and allow me to try masks for 30 days and exchange any mask that doesnt't work for me, at no cost to me or my insurance. I would get that settled before agreeing to any appointment. If they won't give you the machine you want and follow the 30-day-mask-trial rule, why meet with them at all?

If necessary, I would have my doc write on the Rx "Patient may use an auto." That way it is written on the Rx and the DME must provide it, if you insist.

Of course, the most important thing (as far as machines) is to get a machine that will show you leak and AHI information, whether it is an auto or not.

Hopefully you will find a DME with reasonable policies and that is not run by crooks and professional liars. With too many DMEs, their idea of a "good patient" is one that will let them rip him or her off and that will not insist on getting good care.

Look for a good DME somewhere in your state. Drive a distance if you have to. I hear there are some good ones out there.

[XSnorer]

I have the S9 Autoset. It's a fantastic machine. This is not to say that other choices wouldn't also be fantastic.

I wouldn't trust the comment from a DME as being fact. It might be correct but it's worth getting a bit of validation. Insurance coverages vary. I'd suggest getting a script for the auto and then filing a pre-authorization or pre-processing of the claim. This will then provide information on what is covered and not covered. I'd also suggest that you call your insurance provider and asking then what are the requirements for CPAP vs APAP.

In my case the APAP and CPAP were as jnk noted - same insurance code.

[Uncle_Bob]

If i were you I would insist on the S9 autoset, which can be set to run in cpap mode aswell.
They are billed on the same insurance code. It sounds to me like they are trying to make a bit more profit on the deal.

You could also check with your insurance and see if you can purchase from an on line DME like cpap.com, then you can purchase the S9 Autoset yourself and submit the claim to your insurance. That way you don't have to deal with people giving you a load of BS in order to make a few bucks.

[jabman]

As far as I understand if you can get the S9 cpap then you can get the S9 AUTO, they have the same Insurance code. I checked into this when choosing a machine for myself. I got lucky and did not have to fight for my S( AUTO because that is the machine MY DME was currently handing out.

[sleepylady]

Have your dr. rewrite the prescription for an autoadjusting CPAP. Call your insurance company to verify that they do in fact cover for an auto CPAP. That way if the DME tries to tell you no, you can let them know you've already talked to your insurance company. Also, as long as your dr. prescription says an auto CPAP, they need to fill it. DON'T accept the regular CPAP during the appointment. They are a supplier and not your dr. Also, it's your LIFE and if you feel an auto would work better for you, then you should get it.

[msla]

It is a good idea to have the Dr. put "mask of patient's choice" on the perscription. That will make it easier to get a mask that works for you!!

Rolf

[Breathe Jimbo]

FWIW, I love my S9 Elite.