How is everyone getting an S9 Autoset? - I can't

[sampt]

I am stressed & frustrated with my DME. My Dr. wrote a script for an S9 Auto and the DME gave me an S9 Escape Auto. I told them the Dr. wrote the script for full data capability. They said they only issue the S9 Escape (basic model), and the S9 Autoset was too expensive & I didn't need the "bells & whistles". How is everyone else acquiring the S9 Auto? Purchasing out of pocket? I'm going through insurance with a "rent to own". Went back to the DME today with another script in hand for an Enhanced S9 with full data capability & they told me they don't carry & to check elsewhere. I checked with another DME & they don't carry either. They all carry the basic model. I was told because of profit reasons. Since 2/11, I have been using the S9 Escape Auto/with Humidifier, slimline hose, Swift FX nasal pillows.

My scalp has been burning & I'm wondering if it's a reaction to the silicon strap that fits on the top of my head? Originally I was wearing a bandana to prevent hair breakage & didn't notice until I stopped using the bandana. (My hair was still breaking & getting dry so so much for that idea) Any suggestions regarding the silicon strap? Right now I'm wrapping it with a silk scarf but my scalp still burns in that vicinity. I haven't introduced any new products (soap, shampoo, etc). Sorry for the long post but I'm beside myself right now regarding the model of CPAP I was given & the DME's attitude, and now the scalp burning. I'm claustrophibic so the FX is the best "mask" for me. Thank you for your time.

[Janknitz]

Since 2/11, I have been using the S9 Escape Auto/with Humidifier, slimline hose, Swift FX nasal pillows.

I'm afraid you are probably stuck because you accepted the Escape Auto in the first place and you've been using it now for 4 months. Why should ANY DME be willing to swap this cheap brick out for a brand new and expensive autoset, when they'd lose 4 months of rental income by doing so???

If you'd stuck to your guns at the beginning in refusing to accept the Escape Auto in the first place and finding a DME (even if you had to travel some distance) who could provide what your doctor ordered, you'd probably have succeeded. I'm not blaming you--in the beginning you are so sleep-deprived and unsure of what is going on that you (like almost everyone else) walk into a DME's business place with a great big fat SUCKER sign plastered on your forehead. And DME's are happy to take advantage of it.

The DME did NOT fill your equpipment prescription as ordered (the Escape Auto is not the same as the Autoset, (you can make a big deal about the lack of leak data and the fact that there is no differentiation of types of events), so you MIGHT have a complaint to make with the appropriate state agency that regulates DME's, but the 4 month lag is probably not going to help you succeed with such a complaint. At the very least I'd write a complaint letter to the presribing doctor, stating that they did not fill his prescription as ordered and you hope that he will think twice about referring any more patients there. Make sure you send a copy of such a letter to the DME.

You can look for an Autoset online with regular CPAP vendors like our hosts, or maybe you can score one on Craigslist or Secondwind.com for a reasonable price. You don't need to buy the humidifer portion again, so you may be able to have an autoset for just a few hundred dollars, if that's a financial possibility for you.

[Otter]

I'm not sure on the burning. Sounds like you might be allergic to the straps or something on them.

The local DME's don't want to sell you an S9 Auto because your insurance will pay them the same no matter what machine you get. Hence, they want to get you out the door with the cheapest machine they can foist off on you.

If you can't get anyone there to sell you what you want, go around them and buy from an online DME. They'll be glad to take your insurance money too, but their business model relies on bringing in freely roving customers from the internet instead of wringing every last dollar out of the ones referred to them by local doctors. Hence, an online DME will have no problem giving you what you ask for.

Jan may be right about being stuck. Having paid out of pocket myself, I don't know all the details of insurance billing. But it certainly wouldn't hurt to try.

I've dealt with both CPAP.com and 1800cpap.com, and while I wouldn't count on either one for advice, I'd recommend them if you already know exactly what you want. You may still want to buy your masks from the locals if you've found them helpful with the fit.

For used machines and advice, secondwindcpap.com is the place to go. They also sell some new machines, but I think all the S9's they have are used. OTOH, they've got an "open box" S9 auto that will probably set your insurance company back less than the balance on the elite you're currently renting. In insurance, sanity is far from a given, but if you find someone with both common sense and the authority to act, they ought to go for it. It would be a win win.
http://www.secondwindcpap.com/Used_CPAP.html

[kempo]

If the doc wrote a prescription for a s9 auto set and your DME gave you a different model it sounds like your DME is playing Doctor. What would you do if your Doctor gave you a prescription for a drug and the Pharmacist gave you a different drug? Say oh ok I'll take it.

Your DME is a piece of sh..

[sampt]

I want to thank everyone for your response. I think you all hit the nail on the head and maybe that's why I'm so stressed as I'm angry for letting myself be "taken" by the DME. Janknitz was correct, I had "sucker" written on my forehead as I was so sleep deprived I couldn't think straight and was just desparate for help hoping it would improve my sleep issues. I just took what they gave me. They said they got me an S9 Auto, but it was the "Escape" Auto. I kept telling them it was suppose to be the one with the full data capability but they won out. The 2nd DME I spoke with today brought up the insurance aspect also as I've had the unit since 2/11. They doubted the insurance company would approve the new script for the S9 Autoset. They also told me, as did Resmed, that I wouldn't be able to get information from the display, only the clinician can obtain. That's why I was wondering how so many of you were able to get the S9 Auto and how you get all your information & software. You must have better DME's than I. I was hoping there would be software for the S9 Escape Auto so I wouldn't have to keep relying on the DME. The DME told me they're still giving out the S8's and haven't been dealing with S9's except for the Escape. They said I wouldn't be able to get the S9 Elite either. So I have this script that isn't worth the paper it's written. Again, thank you for your time. I apologize for venting....

[Otter]

If the doc wrote a prescription for a s9 auto set and your DME gave you a different model it sounds like your DME is playing Doctor.

Kempo has a point. But unfortunately, DME's aren't regulated the same way pharmacies are. The way it should work is you call the FDA and the shaken DME calls you back an hour later to tell you the S9 Auto you back ordered will be in Thursday, and they're very sorry if there was any confusion. I doubt this would happen, but that's worth trying too.

What might work is to ask your doctor to put the fear into the DME that altered his prescription. I read a post a while back from someone who did that and got results. However, if your sleep doc owns a share of the DME, he's probably just going to call and ask if they''re still on for golf tomorrow. If your doc is on board, though, I would think the DME is between a rock and a hard place. I gather that, at least in most states, DMEs are allowed to refuse your prescription, but I strongly doubt they have license to freely interpret it for their own profit.

[Otter]

There's no need to apologize, sampt. You have every right to be upset, and this is a good place to vent.

As for how we get the data that is only available to clinicians, it's actually available to anyone who holds down the dial and the info key for three seconds. Also, you can download the clinicians' version of the software from Resmed for free. They even have a form for end-users to register it. All they ask is that you say you will be "properly supervised" by your sleep doc.

[Janknitz]

Most DME's either don't know that there is software available to patients to use to access data, or they don't want to admit it because they think terrible things will happen (like you won't pay THEM to access your data) if you do have access. With the ResMed Software you may be able to print out charts of your AHI and usage, but I think the Escape Auto doesn't collect any other info like leak data or breakdown of the AHI, centrals, and flow data. At least it's something.

I can't for the life of me imagine why they gave SOME data with the Escape Auto but not leak info. It's certainly not dangerous to have leak info, and it's very useful to know if leaks or mouth breathing are interfering with your therapy. I surmise the purpose of the Escape Auto is specifically to play the "bait and switch" game on unsuspecting newbies like you--you go away thinking you got an auto machine (wow!) and most people never realize that they got an auto machine with limited capabilities. DME's are thrilled because their profit margin is increased.

[sampt]

Otter, I can download free software from Resmed? Then do I just insert the SD card into my PC slot and I get the same info as the clinician? Would you happen to know the website? The new prescription I have in hand is from a Pulmonary Dr. who my Primary Care referred me, who my ENT referred me to a Sleep specialist who .... it goes on & on. I don't know if I'm coming or going but I do know I didn't get what I wanted and upsets me that I "fell" for the DME. I thought they would be looking out for my best interest, guess not... just their profits. Too trusting of a soul here...I think I'm more angry with myself. I'm so exhausted I can't think straight (memory issues) when I'm talking to the DME so they just talk over me and out the door I go. Thank you for your input. Greatly appreciated.

[Janknitz]

The DME told me they're still giving out the S8's and haven't been dealing with S9's except for the Escape.

Not to add fuel to the fire, but this is baloney. They could have and should have ordered the Autoset if that's the machine you wanted.

Now, quit kicking yourself. You are right to be angry at THEM, not yourself. My suggestion of a complaint letter to the physician probably won't accomplish much (other than ticking the DME off), but it might make you feel better.

[sampt]

Janknitz, funny you mention profit. That subject came up with my current DME today, as well as a second one I called to see if they had the S9 Autoset (They did not). They both indicated they sell the Escape as it is more profitable. It's my own fault as I was just naive and not well informed about the "process" of obtaining a CPAP. Lesson learned. I just hope in 5 years if the insurance lets me upgrade, I have the opportunity to get the piece of equipment that allows me to monitor my own medical issues, & not have to rely on the DME as a middleman between me & my doctor. Thank you for taking the time to respond.

[chunkyfrog]

We paid an additional $460 for my husband's Autoset over and above the $1500 paid by our insurance
for the blower and the humidifier. (The DME did 'kick in' a free mask.)
The Autoset was not out yet when I got my Elite; and after 9 months using it, I ordered my Autoset from CPAP.com.
All my own dime. I wish they carried hearing aids. . .

[Otter]

Otter, I can download free software from Resmed? Then do I just insert the SD card into my PC slot and I get the same info as the clinician? Would you happen to know the website?

I think this is the current version, but if not, just change "3.14" in the URL to whatever the newest is. Or look in UncleBob's signature. He keeps track of it.
http://www.resmed.com/int/assets/html/s ... c=patients

And here's the clinician's manual.
http://tinyurl.com/24x73ws

I'm so exhausted I can't think straight (memory issues) when I'm talking to the DME so they just talk over me and out the door I go. Thank you for your input. Greatly appreciated.

Brain fog has caused me to make quite a few errors too. Don't kick yourself. Under the circumstances, you did well. Everyone here understands what chronic sleep deprivation does to the brain. That's why this is a good place to vent. We've all been there. Some of us are still there.

The data is nice, but even without it, it's possible to fine tune your therapy. Whether or not you get the machine you wanted, you'll hopefully be thinking much more clearly soon.

I hope you can find some leverage to apply to the DME, but if you don't have the energy, that's very understandable. If you decide you like everything else about your S9 but decide you really need the data, watch secondwindcpap.com for a used S9 Autoset. They're out right now, but I'm sure they'll get more. It'll run you around $640, will be professionally cleaned and tested, and carries the same warranty as a new one. Still not cheap, but the mental errors and health problems you'll get with ineffective therapy won't be either.

[JDS74]

This thread finally brought to mind why my DME/RT started off angry at me.
It has taken me this long to figure it out.
I walked into the door with my scrip and the make and model I wanted.
I wasn't interested in discussing options -just give me this make and model.

I got it but things went downhill from there.

[ozij]

For getting detailed info safely, I prefer the "review' combination: that's a prolonged simultaneous holding down of the "Info" and "Setup" button. The screen hiccups, and then you get all the therapy details available in the second option from the top.

The "dial and setup" combination suggested by Otter puts you in the clinician's setup mode - I don't use that mode unless I want to change clinical setting - and then I do it very carefully. I prefer the review mode because it protects me from changing my settings unintentionally.