Working Things out ....

[fredn]

Well yesterday afternoon I got a call from a DME that they had my prescription for my CPAP Machine. I had already made it clear that I wanted to be part of equipment selection ... and my Sleep Doctor said no problem ... well the sleep center bypassed that whole process. They had their Doctor interpret my titration AND they set me up with a DME Provider and picked out my machine .... a PR DS460S .... not my choice ... and I was not involved.

So I called my Insurance Company and they told me all I need to do is get together with MY Sleep Doctor .... figure out what machine I need/want .... go to any "In Network" DME Provider that has what I want and we're good ... I pay 20% and they pay the rest. So screw this whole "Buddy Buddy System" between the Sleep Center and
THEIR "PREFERRED DME" ..... so far so good ... I have a appointment with my Sleep Doctor on the 31st ... hopefully things will work out better.

Fred

[DoriC]

Good job Fred! Knowledge is power! Make sure Dr writes for the exact machine you want, no Escape and no Plus in the name. To get an auto my Dr had to prescribe a range of pressures because the DME gave me a hard time, not just straight pressure. Also, have him write "mask of patient's choice". Good luck and keep us posted.

[Not Fade]

You are doing the right thing, however understand

So screw this whole "Buddy Buddy System" between the Sleep Center and
THEIR "PREFERRED DME" .....

if the sleep doc told his patients to pick out a DME and pick out a machine, 99% of them would say, "WTH? That is your job doc. Prescribe for me."

You are in rarefied air.

[StuUnderPressure]

To make sure YOU control the process, do NOT walk out of the Doctor's office withOUT the original prescription in your hands.

Tell the Doctor, YOU will bring the prescription to the DME YOU decide you want to deal with. Also tell the Doctor NOT to fax it to the DME.

Then, don't give the prescription to the DME until AFTER you determine they can & will get the machine YOU want.

DMEs like to talk paperwork first (including the prescription) & then once all of the paperwork is done, they try to stick you with what THEY want to sell you.

Besides getting the machine you want, when you get it make sure it has zero machine hours on it (not zero usage hours which can be altered by the DME). Do NOT accept any machine that has any machine hours on it. Once you leave the DME with a machine, it is much harder to get it exchanged.

[Sheriff Buford]

I tell my doctor, "this is what I want... now start writing"... I guess I shouldn't expose my service revolver when I say this...

Sheriff

[fredn]

Thanks everyone with your advice .....we're gonna make this work .... for my part ... I'm not shy !!!!!

Fred

[fredn]

I think my 2 choices are

ResMed S9 VPAP™ Auto BiLevel Machine

PR System One REMStar 60 Series BiPAP Auto with Bi-Flex

What does everyone think?

Fred

[ChicagoGranny]

I think my 2 choices are

ResMed S9 VPAP™ Auto BiLevel Machine

PR System One REMStar 60 Series BiPAP Auto with Bi-Flex

What does everyone think?

Fred

What are your pressure settings currently?

What was your diagnosis?

[wildflowertx]

To make sure YOU control the process, do NOT walk out of the Doctor's office withOUT the original prescription in your hands.

Tell the Doctor, YOU will bring the prescription to the DME YOU decide you want to deal with. Also tell the Doctor NOT to fax it to the DME.

Then, don't give the prescription to the DME until AFTER you determine they can & will get the machine YOU want.

And make sure you keep a copy of the prescription for your records before you give it to the DME.

[fredn]

What are your pressure settings currently?

What was your diagnosis?

I didn't see the formal titration report yet. I do know that straight CPAP with a pressure of 13 made everything go away .... thats what the tech told me. My 1st study came back with and AHI of 59.9 ..... mostly all hypopneas .... there were Centrals too but when my Sleep Doctor saw them his comment was that "They were not the problem" .... also my blood oxygen went as low as 83% .....

The hardest part for me at my titration was dealing with exhale pressure .... my thoughts on getting a top of the line BiPAP is I will have the ability to make it as comfortable as I possibly can cause it have the most features and adjustments ... it I get a $1000 machine it costs me $200 .... if its a $2000 machine it costs me $400 .... so for an extra $2000 I have the best chance of getting used to it and using all the time .... WORKS FOR ME.

Both of my machine choices are top end .... they both will likely fit the bill. I do like the ResScan software .... I've used it for my wife in the past .... I'm also hearing that the ResMed is a little smoother for breathing BUT the Respironics has a more effective therapy ... that may be all subjective ...

I'll get as much info as I can before the Sleep Doctor appointment on the 31st ...

Again thanks ... Fred

[49er]

I tell my doctor, "this is what I want... now start writing"... I guess I shouldn't expose my service revolver when I say this...

Sheriff

I could have used you when I had the experience from h-ll with my first sleep doctor.



49er

[49er]

Thanks everyone with your advice .....we're gonna make this work .... for my part ... I'm not shy !!!!!

Fred

Awesome Fred.

Good luck to you.

49er

[fredn]

You are doing the right thing, however understand

if the sleep doc told his patients to pick out a DME and pick out a machine, 99% of them would say, "WTH? That is your job doc. Prescribe for me."

Hi ... I DO understand ... but at the same time "the system/process" should openly invite those that want to be part of the decision making ... and their input should be part of the decision making.

I have always been one that "listened" to what a doctor is saying ... but at the same time I made sure that I did enough reading and research to at least "validate" what I am being told. Fortunately all of my wifes doctors and my doctors welcome our involvement ... or we look for a new doctor.

BUT I DO KNOW WHAT YOU MEAN .... some people would rather leave it in their doctors hands ... which is fine

Fred

[chunkyfrog]

The funny thing is that diabetics are EXPECTED to be minutely involved in their treatment.
--diabetic management is the patient's responsibility--unless a caregiver steps in due to patient inability.
Who is supposed to micromanage our apnea?--as many can benefit from exactly that.
Sadly, the "system" seems to be tipped toward denying us that, even, make that especially,
when we are willing and able to do it ourselves.

[fredn]

The funny thing is that diabetics are EXPECTED to be minutely involved in their treatment.
--diabetic management is the patient's responsibility--unless a caregiver steps in due to patient inability.
Who is supposed to micromanage our apnea?--as many can benefit from exactly that.
Sadly, the "system" seems to be tipped toward denying us that, even, make that especially,
when we are willing and able to do it ourselves.

When my wife was dealing with "Mild Sleep Apnea" I had to order a special card reader from Australia .... I got my hands on ResScan .... and I looked at her "DETAILED" information every morning ... it was only me pushing to make changes that lead her to get used to using the machine. No one else was monitoring that closely ... all them seemed interested in was "making compliance" so they didn't have to take back the machine.

There is such a wealth of info on this board ... if you put in the time and try to understand as much as you can (and everyone is different) it can't do anything but help .... it may take some pushing but if you know what you're talking about eventually someone will listen.

I had to even push for a second "FULL SLEEP STUDY" about 1 1/2 years after the 1st one for my wife .... all they wanted to do was a titration. Turns out she no longer had Apnea.

So hang there .... Fred