Can they take my CPAP MACHINE AWAY???

[RandyJ]

You can buy a new water chamber for your S8 for around $36 and use your S8 until you work something out.

Just verify whether it is an H3i or H4i.

https://www.cpap.com/productSearch.php? ... er+chamber

[teachcsg]

The machines will differentiate between "therapy hours" and "Blower hours". Blower hours are when the machine is turned on but the mask is not on the patient OR its on (the patient) but there is such a large leak that no "real" therapy is taking place i.e. the pressure is escaping into the atmosphere and therefore not splinting the airway like it should.
Therapy hours are when the machine is turned on, mask is on correctly and the machine can sense someone is breathing on the machine.
The machines track this to ensure that patients do not try to "trick" the machine / MDCR into believing they are wearing when in reality they just turned it on and left it running beside their bed all night. We've had some patients try this.
With regards to the DME taking away your machine...trust me when I tell you that no DME "wants" to do this nor do they delight in taking away machines. But medicare will not pay unless the DME can prove the patient is compliant. If they are not then they don't pay-its very black and white with medicare. The post that someone here posted where the MD was willing to write a letter will not help with medicare-you are either compliant or you are not.
There is some leeway (with MDCR) on the higher end machines like the ASV, AVAPS etc.. why?? Not sure-maybe because many of these pts that receive these machines have ALS, central apneas and MDCR allows them more leeway? Who knows.
But put yourself in the DME shoes...MDCR only paid 3 months for this machine will not pay the remaining 10 months-the pts do not want to return the machine-well the DME just lost 10 months of revenue off that machine. A couple of those and business close, people lose their jobs etc..
Not the DME's fault-just following MDCR guidelines.
If the data on the card really was faulty-then that is the issue of the DME.

[LSAT]

Thanks for your reply.

I don't know what the doc meant. Maybe there was a leak in the hose since my DME sent me the hose for the S9 when I had the S8. I just got the S9 and used it successfully for 2 days. Nice machine! Now I have to learn how to look at the numbers. Doc set the pressure 5-8 which should cover it (I assume) based on my 5 year old sleep test. I'm going to post about frequency of sleep tests in a message when I get through the current posts.

The above is a quote from another post by OP.

So where is the S8 and why can't you go back to that in the mean time?

Thanks for the suggestion. The S8 had a water chamber that fell apart. That plus the doc said my S8 was operating at 40% efficiency so because it's over 5 years old he ordered a new one and that's where the problem started --- with my mother's health too. I did my best. If the powers that be don't allow me to work this out, then so be it. I don't have the energy to fight this anymore.

Sent you a PM

[archangle]

You can always lock your door and not answer the doorbell when they arrive until the issue is resolved. I highly doubt that they will get a warrant to gain acess to the machine.



my guess is that after one or two failed attempts,they will send you a bill for the machine.

Dave

If they bill you, they'll probably bill you the "uninsured patient" ripoff rate, which may be 2 to 3 times higher than the insurance patient rate, and 4 or more times higher than the online supplier rate.

[kaiasgram]

https://www.youtube.com/watch?v=WhWavua-1FI

LOL!!! I would totally do that!

Musica, in all seriousness I understand being too weary to fight this thing. Any way you can afford to buy the S9 or its PR counterpart (less expensive) -- not from this outfit that's confiscating your machine, but online from cpap.com or secondwindcpap.com? I couldn't afford it either but my insurance wouldn't cover any of my DME so I had to whip out my credit card. Depressing but there's no higher priority than our health so if I have to go into more debt that's what I'd do it for.

I just wouldn't refuse to give the machine back and wait for them to bill you because lord knows how much they would try to charge you, and then you'd have another fight on your hands.

Good luck, let us know what happens.

[Musica]

Thanks so much. AFTER MANY, MANY calls, I finally called the department that has the test results. I was 67% compliant and 70% compliance is required. They're giving me 30 days more. The privider also said they get phone calls like mine EVERY DAY.

Something's broken. Putting patients through h*ll like this is shameful. If they'd taken my CPAP away (which they tried yesterday by sending someone out to pick up the machine without notifying me) not only would I have to be dealing with my elderly mother's life and her E.R. docs (which has been a constant for many moths) but my own health, too -- and all because my data showed 3% lower than the required compliance rate without taking extenuating circumstances.

If this continues happening we'll see a lot of lives lost. My provider says the same thing happens EVERY SINGLE DAY with their other customers.

I do hope some of the authorities read these posts and do something about it.











Again, thanks!

I got a new Resmed S9 and the provider read the data. Despite trying very hard to comply, my numbers fell short (but not too short) of compliance numbers (they downloaded the data from my machine) and I got no warning. I've been struggling with the headgear, too, which the company knew about.

The provider is picking up the machine TOMORROW. My doc's office and medicare both said the same thing.

I was told by Medicare that if I want the machine I can buy it. Does anyone know of a rental company for CPAP machines I can get in the interim because this mess is going to take a while to resolve. Or maybe there's another solution?

Thanks

[chunkyfrog]

Whatever you do, get plenty of time on your machine every day.
Watching TV is a good plan. It's not really cheating, because not only are you getting used to it, but if you doze off, it's all good.
You have to be wearing it for the hours to count for compliance.

[lilly747]

teachcsg wrote:
The machines will differentiate between "therapy hours" and "Blower hours". Blower hours are when the machine is turned on but the mask is not on the patient OR its on (the patient) but there is such a large leak that no "real" therapy is taking place i.e. the pressure is escaping into the atmosphere and therefore not splinting the airway like it should.
Therapy hours are when the machine is turned on, mask is on correctly and the machine can sense someone is breathing on the machine.
The machines track this to ensure that patients do not try to "trick" the machine / MDCR into believing they are wearing when in reality they just turned it on and left it running beside their bed all night. We've had some patients try this.

I know this:
I used my machine as stated.
I had no idea there was a problem because I was using my machine way over the required usage for compliance.
The DME did not discuss the possible reasons for low treatment hours or what might be done to solve the problem.
If I was not getting treatment, them they let me go 75 days untreated and not breathing and I did not know it.
I did not fine out I was not in compliance until I was 75 days into my 90 day period.
They scared the shit out of me and cause me great stress because I thought I was going to have my machine taken with only 15 days left to qualify.
They gave me an Escape with NO data so I could not even fine out what was going on. I still don't know.
Great job DME........

[Janknitz]

Blower hours are when the machine is turned on but the mask is not on the patient OR its on (the patient) but there is such a large leak that no "real" therapy is taking place i.e. the pressure is escaping into the atmosphere and therefore not splinting the airway like it should.

This is one of the reasons an Escape and other machines lacking EFFICACY data are NOT appropriate machines to give anybody. Perhaps she was 100% compliant but there was a big leak issue? Under Medicare guidelines, many people would simply have to give up the machine and go untreated, instead of finding out what the problem is and SOLVING it.

Instead of showing up on her doorstep to confiscate, the DME should have been working with her to find out what the problem is and how to solve it. Terrible patient service, IMHO.

[greatunclebill]

Blower hours are when the machine is turned on but the mask is not on the patient OR its on (the patient) but there is such a large leak that no "real" therapy is taking place i.e. the pressure is escaping into the atmosphere and therefore not splinting the airway like it should.
..

to be clear, blower hours is the total time the blower is blowing air for whatever reason whether it is on your face or not on your face. blower hours has nothing to do with the therapy you are getting or not getting.

[archangle]

That plus the doc said my S8 was operating at 40% efficiency so because it's over 5 years.

Did the doctor somehow measure the machine, or was he just saying 5 year old machines are 40% efficient?

Neither one really makes a lot of sense. Unless something's broken, I wouldn't really expect any "efficiency" decrease.

[chunkyfrog]

If the original machine is a BRICK (escape, or 'plus'),
OP would probably be better off paying out of pocket for a full data machine. WAY BETTER.
Then correct data provided to THE doctor should (we hope) entitle her to masks and supplies from Medicare.
--at least that's what I was told.

[Bons]

Thanks so much. AFTER MANY, MANY calls, I finally called the department that has the test results. I was 67% compliant and 70% compliance is required. They're giving me 30 days more. The privider also said they get phone calls like mine EVERY DAY.

Something's broken. Putting patients through h*ll like this is shameful. If they'd taken my CPAP away (which they tried yesterday by sending someone out to pick up the machine without notifying me) not only would I have to be dealing with my elderly mother's life and her E.R. docs (which has been a constant for many moths) but my own health, too -- and all because my data showed 3% lower than the required compliance rate without taking extenuating circumstances.

If this continues happening we'll see a lot of lives lost. My provider says the same thing happens EVERY SINGLE DAY with their other customers.

I do hope some of the authorities read these posts and do something about it.



I hate insurance companies as much as the rest of the world, but the data shows you were not compliant. There has to be a cutoff figure somewhere. As many as 50% of all people who are prescribed cpaps (I remember seeing that on this site) end up giving up treatment. That is a HUGE usesless expense for insurance companies if they have to keep paying for machines that are not used.

I'm glad you got to keep the machine. I hope you keep using it.







Again, thanks!

I got a new Resmed S9 and the provider read the data. Despite trying very hard to comply, my numbers fell short (but not too short) of compliance numbers (they downloaded the data from my machine) and I got no warning. I've been struggling with the headgear, too, which the company knew about.

The provider is picking up the machine TOMORROW. My doc's office and medicare both said the same thing.

I was told by Medicare that if I want the machine I can buy it. Does anyone know of a rental company for CPAP machines I can get in the interim because this mess is going to take a while to resolve. Or maybe there's another solution?

Thanks

[mcdover]

.

I just wouldn't refuse to give the machine back and wait for them to bill you because lord knows how much they would try to charge you, and then you'd have another fight on your hands.

Good luck, let us know what happens.

And a lawsuit.

[The Choker]

mcdover

I did not post that which you just attributed to me. Please correct it.