Therapist set up vs non professional set up

I would love to hear storys about initial cpap/bipap set ups. Recent changes in insurance coverage , mostly medicare changes, have initiated drastic changes in how the dme's set up equipment. Several companies now use delivery drivers to set up cpaps and the only access to rt's is through cpap clinics once a month. Please weigh in!

I am in the "who cares about set up" camp. People every day buy new vcr's, fancy tvs, even bread makers are harder to set up and use than CPAP.

Get the CPAP machine at the cheapest place with the least hassle and follow the directions and in 10 minutes it is ready to go.

I don't really see a problem with that. I have been on CPAP for about 14 years and have been inside a DME's office exactly twice.

The first time was when I had the pressure on my first CPAP checked (that was in the days of using a manometer and a small screwdriver to adjust CPAP pressure), the other time was when I picked up my second CPAP. I don't intend to ever go to a DME again.

I met the driver in a hospital parking lot half way between his office and mine. Have the RT's cell phone number in case there are any problems. Everything works fine. Have not seen any medicare changes posted, and they seem to be as good as most insurance places. Self study online and order online seem to be the best options if you really want good therapy. None of the DME's seem interested in the software or data capable cpap or auto cpap machines that people really need if they are interested in getting things right. I have heard that over 90% of the population really don't know or even want to know how to get their therapy any better, so it seems like a bad fit for most people.

What do you really want to know?

You can set your own machine pressure(s) and analyze your own sleep data (if you have a data recording machine). What is needed and how to do that (info/help) is mostly available here and other places on the web.

If you don't have a data card machine (and the software to read it) you will have to make adjustments based on how you feel about your sleep.
It can be done but it's not the best way.

For you to do that properly will require an advanced capability machine. One with a data recording card and preferably one with automatic pressure controls. Insurance companies are less and less likely to pay for this type of machine. However, once you have a Rx, you can buy whatever you need online.

The only thing I needed from the DME (LinCare) Was the paper work from my Remstar Pro 2, they had stolen the manuel, when they stold the providers manuel, it took the 30 minutes to steal another user manuel. EBay must have been offline. Jim

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Since you are an RT, maybe you can tell us what some of these changes are and how your industry is affected. My RT has been the only bright light in the entire operation being willing to talk to me at any time and even to meet me at a sleep clinic to exchange and do some mask fittings for me. She is also much smarter than most of the other people I have met in this business, so RT's must be in short supply.

ww... it's not that RT's are in short supply... it's that the GOOD RT's are in short supply. There are plenty of dud's around.

Got that right, CFlame!!! Starting w/the DipChit RT at my first local DME's. I never did bother to figure out how much was ignorance and how much was "less than truthful" 'cause she wasn't worth the effort to figure it out. Nor was the DME supplier outfit itself. I was thrilled when I completed my capped rental w/those jerks.

They didn't deliver or mail anything. You had to drive over to the high rent district of town for any little thing you might need. And you HAD to make an appointment to do or get anything.

My current local DME I don't see the RT much since I haven't needed to. But he's EASILY only a phone call away and IF you don't reach him he's johnny on the spot w/returning calls. They do deliver but they are a lot closer to me than the other DME and directly on my way into town so I just drop in for a lot of stuff to drop off, pick up or exchange. They do have a young fellow who's very good at mask fitting who delivers the masks and/or makes the mask fittings. They've been very generous and lenient w/mask exchanges.

Most of the changes that medicare has made are indirect to the cpap crowd. Medicare has been slowly cutting reinbursement for oxygen patients and for most dme's the foundation of the business is o2 rentals. We are at a point now where o2 is a capped rental and a new wave of reinbursement cuts is due to hit in the third quarter. The result is less rt in the field my company just cut its clinical staff nation wide by fifty percent. The effect on cpap is cracking down on masks, and trying to force the sale of cheap cpap's. My cpap program was built around pt complaints from forums like this one. I only use high end equipment, auto's for both bipap and cpap, trained the whole staff to do downloads so people dont have to wait a week to get an appiontment with me, and keep a large inventory of masks from several different companies.
I definately understand coments about a shortage of good therapists, espically in dme's. I have heard far to often for my own comfort the phrase "they didnt tell me anything". I dont get this behavior. I dont like getting calls day after day mr soandso cant find the on button or took his pap apart for cleaning and now cant get it back together. Someone once told me that this creates the illusion of job security, afterall who else but the rt to answer all those calls. Personally I think it creats the reality that someone isnt doing their job.
Interestingly I have noticed a difference among cpap pt's. I have a store in the city and a store way out in the country. In the city most of the cpap setup's I have done have entered around mask fiting as the pt has been online lookin at everything and has a pretty good handle on the function rational and even cleaning of the equipment. Out in the countryside this is less true, the majority of the patients dont go online, dont seem to have any idea of the disease proces and so and so forth. Now I realize that this is a somewhat brazen statement and will most definatly piss someone off. I'm fairly certain this has more to do with accesability to both medical systems and computers. Also it a money issue the difference between rich and poor.
Well I believe thats enough pissing and moaning for a morning

RTKeat, thank you again for your comments and info. As a guest can you PM me or not?

I am also on 02 as well as a bi-level. Since starting the bi-level in late March my sleep pulmo took me off the 2L of 02 supplementation w/CPAP but I still am scripted 02 during the day.

I have some questions about the current cuts and the expected or proposed cuts anticipated this fall. And especially the capped rental for 02 concentrators, etc.

I have both the Helios and a DeVilBiss 5L concentrator. Plus B and E tanks as needed. I had the concentrator about a year before also being scripted the Helios.