Musical DME's? & choice Airsense Autoset vs FP ICON Auto?

[FrayedTrain]

I have been waiting for the DME approval and selection process.

First... I called CareCentrix and they told me that they did receive the authorization from my Dr's office and it was being processed. They gave me a ref#. The DME wasn't selected at that time though.

Then... My Sleep Dr's office has someone dedicated to DME management, precerts, etc. I get a call from my Dr's office, he said that he was working with CareCentrix and they approved the authorization and were working with Persante DME (he also said that he had previously sent the information directly to Persante and he knew that Persante would be able to fulfill the Dr's prescription.) My Dr was happy to request Persante as the DME. The DME manager at the Dr office said that they've had good luck with Persante.

Then... I get a call from CareCentrix. They told me that they approved the prescription and completed the DME selection process. BUT.... they said the DME was Apria?!? Huh? I said something about the location not being convenient to me and asked if there was another DME provider in my area. I even mentioned Persante and they said that Persante wasn't 'in network' and 'they had already chosen Apria.' Sounded like it was a done deal. I get the feeling it was the end of the day and they didn't want to make any changes. All of this happened at the end of the day, so any calls I would make to Persante, my doctor, etc. after that would go to an 'after hours' machine.

So, I will call Persante DME directly tomorrow and ask if they are in network with CareCentrix. If Persante wants my business I'm sure they will help to get them 'selected' by CareCentrix. Then I will call my Dr's office and let the DME manager know about the 'bait and switch.' He can argue with CareCentrix to 'clear his reputation.' Nothing like having others fight your battles for you!

Worst case is that Persante isn't 'in network' and I'm stuck with Apria. I looked on their site and they only list two APAP's (APAP is listed on my prescription ) One is the Resmed Airsense Autoset (I want this one) and F&P ICON Auto. I just need to find enough information about the ICON that will eliminate it as a candidate for me. Then they should have only one choice left, the ResMed Airsense Autoset. (I suppose their website could be out of date and they have other APAP machines to choose from.)

Are there any APAP's that don't have full efficacy data? Machines that don't work well with SleepyHead?

[chunkyfrog]

Can you get your doctor to specify the Resmed?
Writing a new Rx should not be a big deal.

[TangledHose]

I have both the Icon and the Airsense (Autos).....both are good machines, but you were asking about data. In terms of data the Airsense has the edge, and this is why.....the ResMed uses FOT technology to differentiate between Obstructive and/or Central Apneas. So the ResMed data will let you know if your Apnea is Obstructive or Central, the machine also handles the two differently in terms of pressure response to the event (Centrals do not cause an increase in pressure because that would not help). The Icon does not differentiate between these two kinds of Apnea, it just lumps them together as an Apnea.

So on that score you'd have to give the nod to the ResMed. The ResMed is newer technology and has a few more bells and whistles such as Auto Ramp and a few other minor advantages.....EPR being another advantage to the ResMed.

I like my Icon Auto, it's a solid machine and works very well, but in terms of data and newer technology the Airsense definitely has the edge.

[FrayedTrain]

I have both the Icon and the Airsense (Autos).....both are good machines, but you were asking about data. In terms of data the Airsense has the edge, and this is why.....the ResMed uses FOT technology to differentiate between Obstructive and/or Central Apneas. So the ResMed data will let you know if your Apnea is Obstructive or Central, the machine also handles the two differently in terms of pressure response to the event (Centrals do not cause an increase in pressure because that would not help). The Icon does not differentiate between these two kinds of Apnea, it just lumps them together as an Apnea.

So on that score you'd have to give the nod to the ResMed. The ResMed is newer technology and has a few more bells and whistles such as Auto Ramp and a few other minor advantages.....EPR being another advantage to the ResMed.

I like my Icon Auto, it's a solid machine and works very well, but in terms of data and newer technology the Airsense definitely has the edge.

Thanks for the comparison. You bring up a good point regarding Central Apnea identification. My doctor didn't send me to a sleep lab for titration, just set me up with the machine after the first sleep study. I can try to spin this info as a good reason to get the Airsense.

[Krelvin]

When you saw your Dr, you should have received a copy of your RX. He should have discussed with you what that RX is and covers. With that, you can go to any DME your Insurance uses or if not supported your Pocket can afford.

If you never had titration, the RX better include AUTO in it and it should have full data so you can determine if it is working. Just checking the AHI and hours of use is not really therapy because a happy face can still mean you are not getting sufficient sleep. Compliance is an Insurance thing, not really a health thing.

You should already have:
o Sleep Study Report
o RX for the machine, mask and supplies.

[FrayedTrain]

I made some calls this morning. It turns out that CareCentrix couldn't find the Persante DME in their system. The correct name for the DME is Persante Continuing Care. CareCentrix had it listed as 'Continuing Care', didn't have 'Persante' in the database.

They were ok with switching to the new DME, did that while I was on the phone with them.

Now I'm getting closer to dealing with equipment and mask selection. Let's see how smoothly this part goes.

PS - My Dr wrote for an APAP, so I'm good there. For the supplies, it's written as 'Humidifier, heated, Fit for mask.....'. One thing that jumps out at me is it has the word 'heated' as a separate term. That could leave room for interpretation. Does it mean heated humidifier or heated hose, or both? Since it's open like that, I'm going to push for both. I'd rather have the heated hose and not need it, than to do without and wait for a 'period of time' before getting results. Does anyone know if the regular hose is provided along with a heated hose? In case I'd want to switch back to regular hose.

[Pugsy]

Does anyone know if the regular hose is provided along with a heated hose? In case I'd want to switch back to regular hose.

Not normally.
Usually a person gets one or the other.
Since insurance usually covers a new hose after 3 to 6 months (I forget which and insurance varies anyway) most people just wait and get that second hose later.
That said...if you get a heated hose and don't need the heated part there is no real need for a separate non heated hose because the heated hose function of the humidifier can be turned off and the heated hose then will be a non heated hose.

So you can make the heated hose into a non heated hose by changing some settings on the machine. Easy to do.

[OkyDoky]

Both hoses were provided in my original setup. I think the regular hose came with the unit and the heated hose was an add on.

[chunkyfrog]

On my request, my DME swapped the regular hose for the heated hose and the regular tub for the cleanable one.
Maybe I will keep them!

[palerider]

Does anyone know if the regular hose is provided along with a heated hose? In case I'd want to switch back to regular hose.

plain hoses can be had from most anywhere, amazon, ebay, cpap.com, they're very cheap.
(heated hoses too, but they're more spendy)

[FrayedTrain]

Both hoses were provided in my original setup. I think the regular hose came with the unit and the heated hose was an add on.

I was leading to this. Thinking that the standard hose was prepackaged with the unit, and the heated hose was an add-on. I'm sure the DME, in their greediness, takes the standard one out of the package and sells it to someone at the regular replacement schedule just to make a few bucks.

I know that the heated hose can be used without heat. I also have read that the heated hose can be 'less flexible.'

So I was curious if the machine came prepackaged with the standard hose. If that was the case, I'd think the hose was already paid for by me or my insurance and I'd be entitled to it. I'm sure my thriftiness won't bring my insurance rate down, but it may delay the the next increase if I can prevent ins. fraud.

[Tatooed Lady]

Does anyone know if the regular hose is provided along with a heated hose? In case I'd want to switch back to regular hose.

plain hoses can be had from most anywhere, amazon, ebay, cpap.com, they're very cheap.
(heated hoses too, but they're more spendy)

Yeah...but sometimes the heated hoses can be a real pain in the ass to actually get a hold of. I blame USPS a. And paranoid schizophrenia.

[Pugsy]

So I was curious if the machine came prepackaged with the standard hose. If that was the case, I'd think the hose was already paid for by me or my insurance and I'd be entitled to it

The machines aren't always packaged with the standard hose. Sometimes they are packaged with the heated hose. This is where the product model numbers come into play in terms of the box and contents the unit comes with

I don't know the exact numbers for each model but using the S9 as an example check out page 34 here
http://www.resmed.com/us/dam/documents/ ... st-usa.pdf

Product number 36005 is the S9 AutoSet but it is also 36015, 36075, 36025 depending on what is included in the package.
In other words it depends on which product number the DME order whether it comes with the slimline hose or the heated hose but they don't come with both hoses.
I am sure that the new AirSense machines follow the same way for product packaging. This has always been the way things have been done.
If someone was given both hoses...it was because the DME was a nice guy.

Also...even though the DME may purchase the entire setup in one package...they will still bill out everything individually to the insurance company....same as they do with masks...each part gets billed separately.

I have both the S9 slimline hose and the S9 ClimateLine hose...let me go see if I can tell any difference in flexibility. Will report back in a little bit.

[Pugsy]

Report on ClimateLine flexibility vs the ResMed Slimline hose (these are S9 since I don't have the new AirSense stuff).
My ClimateLine is actually more flexible than the Slimline hose....of course my ClimateLine has been used more than the SlimLine hose. In terms of just flexibility I believe it would be a non issue for most people. If there is a difference I can't feel it.

[chunkyfrog]

Hose management is always worth considering if your hose is not behaving.