Insurance changed my CPAP equipment (presumably without notifying my doctor)

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
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jtravel
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Re: Insurance changed my CPAP equipment (presumably without notifying my doctor)

Post by jtravel » Fri Jan 20, 2023 6:31 am

Considering the Autoset 11 is more expensive than the older 10 I would think the DME would love to give you the 10 if they had them in stock and would meet insurance compliance requirements.
Cpap.com was selling the Autoset 10 for as low as $399 during the Holidays and they are out of stock now.

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chunkyfrog
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Re: Insurance changed my CPAP equipment (presumably without notifying my doctor)

Post by chunkyfrog » Fri Jan 20, 2023 6:42 am

LizardBBQ wrote:
Fri Jan 20, 2023 1:46 am
I do have another question now. I don’t remember where I saw this, but someone advised that a certain number of hours logged into a brand new machine is acceptable because it could be the provider turning it on and testing its functionality. But I don’t remember the specifics.

So my question is, what are the “acceptable” number of hours in usage for a brand new machine from a DME?
My last two machines had ZERO hours; so ANY hours says "something".
Anything over a couple hours tells me it has been "somewhere."

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Dog Slobber
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Re: Insurance changed my CPAP equipment (presumably without notifying my doctor)

Post by Dog Slobber » Fri Jan 20, 2023 7:56 am

LizardBBQ wrote:
Fri Jan 20, 2023 1:46 am
I do have another question now. I don’t remember where I saw this, but someone advised that a certain number of hours logged into a brand new machine is acceptable because it could be the provider turning it on and testing its functionality. But I don’t remember the specifics.

So my question is, what are the “acceptable” number of hours in usage for a brand new machine from a DME?
If you are looking for a number of hours in a legal or consumer protection context, I don't think there is one. Though some might argue that a non-new item has to be identified as refurbished or something to indicate it isn't absolutely new. So in that context, the number or run-hours would be zero (maybe 1 or 2).

If you're asking what the run-hours should be in a general sense of acceptability, there is no consensus. Some expect and insist on 0 run-hours for a new device. Other's are OK with a very small number. CPAP devices are not like cars though. Cars will have a few clicks on the odometer for test-drives and movement from factory to dealer.

I can't think of any reason why a brand new, unused CPAP, would have a a value greater than 0. I have had two new AirSense 10s, both came completely wrapped, with no signs of opening and run-hours of 0. Some DME's will open them to for initial configuration, and casual working observation. But I can't see this being being an hour of blower use.

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loggerhead12
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Re: Insurance changed my CPAP equipment (presumably without notifying my doctor)

Post by loggerhead12 » Fri Jan 20, 2023 8:50 am

LizardBBQ wrote:
Fri Jan 20, 2023 1:46 am
So my question is, what are the “acceptable” number of hours in usage for a brand new machine from a DME?
The tech at my DME opened the box right in front of me, took off the plastic, plugged it in and turned it on and showed me zero hours right on the menu. She configured it while I watched and we tested it together.

They were actually a pretty good DME before going out of business. Maybe it isn't profitable to be good.

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Re: Insurance changed my CPAP equipment (presumably without notifying my doctor)

Post by Janknitz » Fri Jan 20, 2023 1:20 pm

I don’t trust the DME companies either. Sometimes when I find myself in the situation where the DME and insurance company tell me different stories (blame game), I say, well, let’s do a 3-way call to come to a correct understanding of the facts.
GREAT strategy!
What you need to know before you meet your DME http://tinyurl.com/2arffqx
Taming the Mirage Quattro http://tinyurl.com/2ft3lh8
Swift FX Fitting Guide http://tinyurl.com/22ur9ts
Don't Pay that Upcharge! http://tinyurl.com/2ck48rm

LizardBBQ
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Re: Insurance changed my CPAP equipment (presumably without notifying my doctor)

Post by LizardBBQ » Mon Jan 23, 2023 7:50 pm

chunkyfrog wrote:
Fri Jan 20, 2023 6:42 am
My last two machines had ZERO hours; so ANY hours says "something".
Anything over a couple hours tells me it has been "somewhere."
Dog Slobber wrote:
Fri Jan 20, 2023 7:56 am

If you are looking for a number of hours in a legal or consumer protection context, I don't think there is one. Though some might argue that a non-new item has to be identified as refurbished or something to indicate it isn't absolutely new. So in that context, the number or run-hours would be zero (maybe 1 or 2).

If you're asking what the run-hours should be in a general sense of acceptability, there is no consensus. Some expect and insist on 0 run-hours for a new device. Other's are OK with a very small number. CPAP devices are not like cars though. Cars will have a few clicks on the odometer for test-drives and movement from factory to dealer.

I can't think of any reason why a brand new, unused CPAP, would have a a value greater than 0. I have had two new AirSense 10s, both came completely wrapped, with no signs of opening and run-hours of 0. Some DME's will open them to for initial configuration, and casual working observation. But I can't see this being being an hour of blower use.
Thanks for the input. I checked and it seems to have 0 hours, so I'm good in that department. The DME has mostly good reviews, so now I just wait to see if they pull anything in the future.

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chunkyfrog
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Re: Insurance changed my CPAP equipment (presumably without notifying my doctor)

Post by chunkyfrog » Mon Jan 23, 2023 8:37 pm

Yeah, always good to keep an eye on things.
There are a few stinkers out there; and we never know where . . .

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Re: Insurance changed my CPAP equipment (presumably without notifying my doctor)

Post by SDBud » Tue Jan 24, 2023 1:56 am

LizardBBQ wrote:
Mon Jan 16, 2023 5:34 pm

When I went to the doctor, I specifically asked for a ResMed Airsense 10 because I got the impression the 11 wasn’t that big of an upgrade, and also I wanted the swivel on the back of the machine to make sleeping a bit more flexible.
I have a 10, and I NEVER use that swivel at all. The one on the mask gets used a lot, but the other end of the hose never moves, unless I'm removing it to clean or replace.
Airsense 10 Autoset
AirTouch and AirFit F10 masks
:roll:

jas32
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Re: Insurance changed my CPAP equipment (presumably without notifying my doctor)

Post by jas32 » Wed Jan 25, 2023 4:17 pm

I wonder the reason why they changed it to the AS11 is for the convenience of having the modem. From my understanding, while there are some AS10s with 4G modems, it appears all AS10s being sold now are Card-to-Cloud units. With the current chip shortage, ResMed is saving their modems for the AS11 and since it is a newer unit, they can charge more for those.

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Dog Slobber
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Re: Insurance changed my CPAP equipment (presumably without notifying my doctor)

Post by Dog Slobber » Wed Jan 25, 2023 4:51 pm

The 4G modem on the Air10 is very different than the Air11.

On the Air11 it's soldered onto the motherboard, on the Air10 it's removable. The Air10s can't be saved for the Air11s.

I think the ResMed's Air10 4G modem inventory is exhausted, and they're just not entering into a manufacturing contract to resupply a model line that has a limited lifespan.