DME ordering Respironics PR One - is this a good machine?

[Zzzer]

So I called the DME today and verified that they received my order (I.e. prescription) for my CPAP. They said they did and that they are in the process of filing with my insurance Co. They are supposed to call me back next week for me to come in and get set up.

Based on Janknitz's blog and advice, I asked which model they have for me. I was told it would be the Respironics PR One. I then asked if this was as good as the ResMed Auto S9 (mentioned in Jan's blog). The DME said that they had "problems" with that machine and that the Respironics PR One is one of the "latest" machines. I was also told I could not get my own data download from the PR One and that I would have to go thru them or my Dr. anytime I wanted to see my data.

Question, are they being straight with me on both the machine and the data availability? If not, do I have any options next week when they call me in to get "hooked up"?

Thanks!

[khauser]

Hi,
The PR System One is the latest LINE of machines, but they go from entry through ASV, and only some of the machines have data capability.

If it were me, I would ask for an APAP like the model 560. You may have to get the prescription re-written though. I think all of the straight CPAP machines do not record data (aside from compliance data), but I am not positive.

BTW, depending on your insurance, it may make much more sense to use an online provider, including our host (https://www.cpap.com). For instance, my insurance includes a $5000 deductible. The DME charges $1600 for a CPAP or APAP (has to do with weird insurance math). That would be $1600 out of pocket for me. The SAME MACHINE can be bought, new, for far, far less. For example my machines LISTS on their site for $640, but if you call or email even that cost will be significantly reduced.

So if this is out of pocket in any way, be careful. The only down side to going online is that your insurance won't cover it, so it won't count towards your deductible. How often do you get to your deductible, if you have one?

[nanwilson]

That DME is full of pure BS Make sure its a PR system one AUTO WITH full data capability not just compliance data. You ARE permitted to gather your own data... we have the software available here. There are NO cpap police, and its a big lie that ONLY the DME or doc can get your data. Make sure the System one they are giving you is data capable..... including ahi and leak... there are several system ones, just like there are several S9s. Some one will chime in shortly and give you the exact model numbers to get. Some patients will swear by the S9 and others by the Pr system, there is some differences but each difference out weights the other in my opinion.
Cheers and welcome to the land of hoseheads.
Nan

[Pugsy]

Confirm exactly which model number they are planning to give you.
Not all models will give you the data you want on that SD card.
You need model 450 or higher.

That "you can't get your own data" thing is a bunch of BS. SleepyHead software works with the PR System One machines but the DMEs aren't going to be familiar with that software at all. They are thinking ENcore software from Respironics and even that is available to the patient. Encore Viewer 2.1 is available for purchase by the patient and there are other Encore software products for free if you know who to ask.
Don't tell them you know about Encore though...it will just muddy the waters and they might play hardball just because they can.

The S9 has been problematic excuse is also a load of BS. More likely they have to pay more for the ResMed machines and that's why they chose not to supply it. They make more money off the PR S1 machines which BTW just because they are less expensive in the general market doesn't mean it is inferior.
I have used both brands and it's a toss up. Minor pros and cons with either machine brand but none are deal breakers.

The latest models in the PR System One line are the 60 series machines which have the heated hose option...it's an option that is worth having especially this winter. You may not need it now or ever but better to have it and not need it than need it and not have it.

In the 60 series models...full efficacy data
The 460 is the PR System One Pro CPAP....fixed cpap with limited apap trial days.....Similar machine in ResMed would be the S9 Elite except the Elite doesn't even have any apap mode at all.
The 560 is the PR System One Auto CPAP...has both fixed cpap mode and unlimited apap mode available....Similar machine in ResMed would be the S9 AutoSet.

So with the PR S1 machines....model number is very important and is easily seen on a sticker on the bottom of the blow unit.
With the S9 machine the model names are clearly stated on the top of the machine...avoid anything with Escape in the model name.

[Zzzer]

Thanks for the replies, so far. I will call the DME back and ask for the full model number.

So one more question ... Does the DME pick which xPAP machine a patient receives, or is the machine specified by the prescribing doctor?

Thanks

[chunkyfrog]

If the doctor does not specify, the DME is at their leisure to choose the machine for you,
which invariably is done with far more consideration to their bottom line than to your health.

[Pugsy]

Most of the time the doctor just writes a script for "cpap machine at so and so pressure with heated humidity" and the DME then provides whatever they have that barely meets the requirements of the RX. A brick non data machine would meet what is stated in the RX.

Most doctors don't care about brand name or model...but some do. So it all depends on what the wording is on what your DME received.
Now if the RX plainly states brand and model name then the DME either has to supply that exact machine or if they can't/won't then you need to go somewhere else.
We can't force a DME to supply a brand if they don't want to for whatever reason they want to give which is usually the "we have had trouble with that brand" when in reality they simply don't want to because they make more money on a different brand. Typically they buy in bulk so they will stock whichever brand they got the better deal on. They also will tend to push the brand of masks that they also stock machines because usually mask and machine deals go hand in hand.

My first DME 4 years ago refused to get me a Respironics machine because "they had had trouble with them"
Bunch of BS...they were pushing the cheap F & P models at the time.
They simply refused to do it for me so I elected not to use their services and found someone else who was happy to do whatever I wanted and at that time they didn't normally stock Respironics (now they do because they got a better deal ) .

[old dude]

I guess I just got lucky with my DME. I didn't know you could pick or request one. I knew nothing about anything, including that my prescription was for BiPAP. They just called and showed up with at my house with my machine and set me up two days after my sleep study. My doc may have told them to hurry given that my AHI at titration was 131, I don't know. They could have easily brought me a brick, but I got a new PRS1 760P machine and they brought me two different masks to try. I'm almost ashamed at how many masks they have ordered for me to try since I started in April, but suffice it to say I don't think there are many left that I haven't tried. I'm still struggling but they're hanging with me. And I know my insurance isn't paying for all these masks.

They just couldn't have been better to work with or nicer folks.

[Zzzer]

Just got off the phone with the DME. She told me the Respironics Model they are ordering for me is:

PR 60 Series SE

Of course when I looked it up on CPAP.com, it is the lowest priced Respironics PR machine listed. She also said I could "request" the Pro Series which provides more data, such as AHIs. She said I could request this, since it is the same price ... which it is NOT on cpap.com. She also said I have to bring the SD card into them to get my data

So at this point, I'm more than a little confused, to say the least.

[Pugsy]

Yep, they are trying to dispense the "Brick" machine which only collects hours of use used to satisfy any insurance requirements.

Have you read this blog?
http://maskarrayed.wordpress.com/what-y ... me-part-i/

What is your insurance???
What is your deductible? Have you met it? Does your insurance do the rent to own thing?
Have you contacted them to see exactly how they pay and want to handle things? Best to do it directly...don't rely on what the DME says because they don't always tell the truth.

She also said I could "request" the Pro Series which provides more data, such as AHIs. She said I could request this, since it is the same price ... which it is NOT on cpap.com. She also said I have to bring the ad card into them to get my data

It's the same price to them because they get the same price from your insurance company no matter which machine they dispense.

The Pro Series would I assume be the 460 machine...it's a good machine and it's only drawback is the limited time available for apap (auto adjusting pressures) mode.
Call them back and tell them you want the 560 and see what they say....

About taking the SD card into them to get the data...just smile and say that's okay...and we will get you hooked up with the software so you don't have to and they don't have to even know about it.
Besides...there's also data available on the machine's LCD menu..it's a bit limited but it's there.

When you check with your insurance company ask them if there are other DME suppliers in your area that you could use that are still within their provider network. You do have a choice in all this and what DMEs count on is that you won't know about your choices.

[oak]

zzzer, do you have a choice on what DME provider you use? I called my insurance and I had a choice of 5 providers within network within 25 miles of my house. i am getting a bad feeling about this provider.....maybe just me. have you read this?:

http://maskarrayed.wordpress.com/what-y ... me-part-i/

[khauser]

Fire that DME now. That's the worse possible machine you could be given.

Understand this: With the large (very large) majority of insurers, the DME gets a set price (the $1600 I mentioned) no matter WHICH machine they dispense as long as it is a CPAP or APAP machine. So if they get $1600 and give you a machine that costs them $200, well its off to the bank!

They are not making this decision with you in mind, are they? So fire their ass and either try another local DME (asking them first what machine they would give you) or go online for a machine.

BTW, you were brilliant to look in to this BEFORE you got the machine.

[Zzzer]

Thanks again for the feedback.

Yep, I read that blog which is why I was skeptical going into all of this. I'm not trying to bad mouth the DME, because I am new to all of this and maybe they're just doing their job and not really trying to take advantage of me. But I must say all of your responses have definitely provided me with more info going into this and I greatly appreciate that.

I do know that my Sleep MD and this DME are part of the same hospital organization. So if I have to go back to my doctor and tell them to send my Rx to a different DME, I may face some resistance. I may just avoid the DME altogether and buy the machine online. I assume I need my doctor to send my Rx in that case.

I will call my insurance next and see what my DME options are.

Wish me luck.

[oak]

you could call your doctors office and ask for a prescription that you pick up yourself. tell the nurse very specifically what to say on the prescription:

"brandname, model number and name"

"mask of users choice"

if they ask why you need the prescription, tell them you need it 1. to pick an in network provider that works with your insurance 2. to carry with you for travel 3. because if your insurance changes in the future, you will need a copy. (all true)

[Zzzer]

So glad I came here first.

I just called my Insurer and found 3 other DMEs in my network. I just got off the line with Apria and they told me that they would provide either the ResMed S9 OR the Respironics 460. Now I just have to have my Doc fax over my Rx and 2 sleep studies to get the process started. The person at Apria did mention the full data availability of these 2 machines, so I feel pretty good about following all the advice provided on this board.

Now ... ResMed S9 or Respironics 460 ??? It sounds like this board is split pretty 50/50 on either machine, but I'll take any more advice you're willing to share.

Thank you all so much!