Dr gave me CPAP instead of APAP

[gtalexad2001]

Hello everyone from a Newbie in Atlanta

My appologies if this is a topic that has been discussed to death before.

I recrntly finished my second sleep study, was prescribed a CPAP machine and went back to the sleep center today to pick it up. Since I had no idea what brand & model CPAP machine the sleep center would provide, I sent them an email last week expressing that I would be interested in an "S9 Elite Autoset" machine.

Since I did not get a response from them when I went in today, I didn't have high expectations, but to my surprice the techinician did produce an S9 Elite machine (non-autoset). I noticed that it was an Elite, not an Autoset when I checked the device later in my car.

During the quick test at the Dr's office when I picked the machine up S9 Elite was quiet and comfortable to breathe with, much better than the machine that used during the second night of my sleep study.

So now I wonder if it is worth the hassle to bring this machine back and to demand an auto-set version. Since i did ask for an autoset model and they didnt provide it, I am not even sure if the Dr at that lab would prescibe it in the first place.

Also - and an FYI - Since I havent met the deductible on my insuarnce for the year, I assume that I will end up paying for the machine out of pocket.

[cflame1]

They probably did that as there is no 'S9 Elite Autoset'. There is however a 'S9 Elite' and there is an 'S9 Autoset'.

[Janknitz]

You asked for the S9 Elite and that's what you got. Unfortunately, the Elite is a CPAP, not an autoset. The doctor's office did exactly what you asked--you didn't understand what you were asking for.

If you want the auto instead, call the doctor's office and ask if they will change the RX to S9 autoset (not Elite) and help you work with the DME to get it changed.

If the doctor's office is not cooperative, you can try the DME, but don't hold your breath. It's cheaper for them (not for you or your insurance company) to give you the Elite rather than the Autoset (in other words, they make a higher profit off the Elite), and they will state that they are only doing exactly what the prescription called for.

If you do make headway with the DME, watch out for this bait and switch technique: Resmed now makes an S9 Escape Auto. You do NOT want that--it has very limited data, but some DME's are providing that when the prescription calls for an auto. You need to be very specific--the S9 autoset.

Or you could stick with the Elite and save yourself a lot of hassle if it's not imperative for you to get an auto machine. You got a Lincoln instead of a Cadillac--still a very good machine.

[chunkyfrog]

what janknitz said.

[Slinky]

Yep, you were asking for two models and you got one of the two models you asked for. But, hey, that Elite is a great CPAP and fully data capable so you didn't make out so bad at all.

On the other hand, since you have a high deductable ... how high is high and how much do you still have to meet?? It would be a wise idea for you to shop for both the S9 Elite and the S9 AutoSet online and get some prices (and notice that the online prices include the filters and hose which the local DME providers will charge extra for). How do those prices stack up against what you still have to meet for your high deductable? Armed w/that information ask your current provider if they can "meet" those costs to you for the CPAP model and hose and filter. Ask how lenient their mask exchange policy is.

Don't forget about the humidifier! Most online DME suppliers have an optional package price for CPAP and humidifier. AND most online DME supplies sell the mask AND headgear as one unit whereas most local DME providers price mask and headgear as separate units.

Also call your insurance and ask them for a list of local DME CPAP providers. Hopefully you will have the option of more than this one. Shop your local DME CPAP provider options to see if any of them would be willing to meet your online costs. Ask how lenient their mask exchange policy is.

If your high deductable makes it most comfortable and practical for you to purchase your CPAP online, still be willing to purchase your first few masks, etc. from a local supplier simply for their mask exchange policy.

[gtalexad2001]

Duplicate post - please remove

[gtalexad2001]

They probably did that as there is no 'S9 Elite Autoset'. There is however a 'S9 Elite' and there is an 'S9 Autoset'.

Yes - I realized the typo when I re-read last weeks email today.

[gtalexad2001]

...Or you could stick with the Elite and save yourself a lot of hassle if it's not imperative for you to get an auto machine. You got a Lincoln instead of a Cadillac--still a very good machine. ...

That's what I have been wondering about. Obviously I am new to this and from what I read the S9 Elite is a very good machine. Im sure I will be just fine with the regular CPAP version for now. Just want to avoid that I find myself 12 month down the road wishing that I had the AutoSet version instead.

...
On the other hand, since you have a high deductable ... how high is high and how much do you still have to meet?? It would be a wise idea for you to shop for both the S9 Elite and the S9 AutoSet online and get some prices (and notice that the online prices include the filters and hose which the local DME providers will charge extra for). How do those prices stack up against what you still have to meet for your high deductable? Armed w/that information ask your current provider if they can "meet" those costs to you for the CPAP model and hose and filter. Ask how lenient their mask exchange policy is....

The remaining deductible for 2010 is around $2000. After the deductible is met the insurance would pay 70%.

The higher end CPAP machines are expensive but probably not more than $2000. So I expect that I will be billed for the full cost of the machine & humidifier, mask, hose etc.

At this point I don't even know what the DMA that works with the local sleep center will charge me -the sleep center tech that gave me the machine and set it up didnt know. Presumably the hospital runs its own DMA. Its a fairly large local hospital group (Northside Atlanta).

Thanks for everyones feedback so far

[DoriC]

I agree an auto is not as imperative, not as important as having a data-capable machine. There might be a problem if you have some positional apneas, sleeping supine for part of the night where you might need higher pressure and not so high when sleeping on side. That's where an auto is good as you can sleep with a lower pressure most of the night. It's also good if you lose/gain weight or other health factors change. Your sleep study report will give you some important information so you should have a copy for your records along with an RX. Keep us posted.

[Janknitz]

Unless the money really doesn't matter to you, you need to call the DME and find out exactly what you are going to be paying. Someone already pointed out that a favorite DME trick is to charge out each and every component seperately--the machine, the humidifier, the chamber, the filters, the hose, and at a HUGE markup. Your insurance may limit what they can charge you, but it's still likely to be more (perhaps $1000 or more) than you can get the same thing on a package deal online--even for the autoset. So, if you have to pay out of pocket anyway, why let them gouge you like that?

You may be stuck with the humidifier or at least the chamber--they often won't take those back. But you can probably get the rest online for a fraction of what you'd pay out of pocket with these guys.

[gtalexad2001]

Unless the money really doesn't matter to you, you need to call the DME and find out exactly what you are going to be paying. Someone already pointed out that a favorite DME trick is to charge out each and every component seperately--the machine, the humidifier, the chamber, the filters, the hose, and at a HUGE markup. Your insurance may limit what they can charge you, but it's still likely to be more (perhaps $1000 or more) than you can get the same thing on a package deal online--even for the autoset. So, if you have to pay out of pocket anyway, why let them gouge you like that?

You may be stuck with the humidifier or at least the chamber--they often won't take those back. But you can probably get the rest online for a fraction of what you'd pay out of pocket with these guys.

Thats somewhat what I am afraid off - The machine is unused as of yet (just picked it up this morning). I'll see if I can find out what it will cost me before I start to use it.

[Slinky]

Well, the S9 Elite and S9 AutoSet use the same integrated humidifier so that's no big deal. Its not like you or your insurance paid for the humidifier and then you couldn't use it if you bought an AutoSet instead of keeping the Elite.

[Janknitz]

Slinky's right, if they won't take the humidifier back then you can use it with the Autoset. But BEFORE you open that package you need to find out the facts--how much to get it all online, how much out of pocket from the DME.

Remember, you probably have to meet that deductible every calendar year, so there's no sense in spending the money this late in the year when you can save a bundle online.

[gtalexad2001]

Slinky's right, if they won't take the humidifier back then you can use it with the Autoset. But BEFORE you open that package you need to find out the facts--how much to get it all online, how much out of pocket from the DME.

Remember, you probably have to meet that deductible every calendar year, so there's no sense in spending the money this late in the year when you can save a bundle online.

Well, since the tech at the local sleep center set the pressure etc. on it, the device is unboxed already, but it is unused. I left a VM with the company/office that provided the machine and and handles the billing and inquired about the cost to me ( I verified with the insurance that I will pay for it out of pocket)

Looks like a similiar setup will cost around $1150 on CPAP.com, incl shipping, so hopefully the price thru the local provider that works with the sleep center is in the same balpark. I won't bother returning it to save $50, but if the difference is several hundret dollars I certainly will.

[Laurie1041]

Everyone is certainly different, but I tried a straight CPAP machiine after using a "loaner" APAP and the diference was night and day. Since you will be tied to your PAP machine every single night, I recommend that you get the S9 Autoset whether it saves you $50.00 or not. The S9 autoset can be run in either mode - CPAP or APAP. I went through the trouble of returning my equipment and am very pleased that I did. Think about this carefully - if you were to find that the straight CPAP was in some way uncomfortable to you, then you are stuck with a machine that you may find to be uncomfortable. At least the S9 Autoset gives you an option to change maode. This is only one of the many features that the S9 Autoset offers. If you have not already done so, you can check out the differences between the S9 Elite and the S9 Autoset at http://www.resmed.com. In any event, please keep us posted as to how you are doing. Laurie