New Machine, Is it a downgrade?

I'm confused.......

They gave you a straight CPAP but you have THIS in your forum profile....... "S8 VPAP Auto 25 BiLevel Machine"

Which machine do you have and/or have a prescription for?


Den

Thanks for the advice guys. Well, I can afford to be nice to my primary doc because I have an excellent relationship with him. I usually use him as my gatekeeper to the medical world, a role he is confortable with.

I had to Google DME but I think that is Durable Medical Equipment?

My plan is to contact my DME on Monday and tell them that I want the better machine. As suggested I am going to say that require it and will do whatever it takes to get it. I will offer to get them a script from my primary doc if necessary. Plan A is to be professional. Plan B is to work through my primary doc who has a good working relationship with this DME.

rbrown3rd wrote:On Monday, tomorrow, I am going to call my homecare provider and find out if they are going to be able to provide me with the machine I want without sending the letter. If that does not prevail then this is a draft of the letter I will send to my primary MD. Any feedback is greatly appreciated.

That's a very good letter. I would leave out every reference to having bought software and a card reader to do your own downloads. I'd erase these specific sentences:

"In anticipation of having the machine after my Medicare compliance period had been satisfied I purchased software and a card reader to help me chart my progress and to further enhance the feedback loop."

"I had taken steps to enjoy the fullest advantage of having the sleep data available by purchasing software and a card reader. "

It's fine to talk about the usefulness of the data that can be seen in the LCD display of the Elite II. But I'd not say a single word about using software.

You might be able to shorten the letter more -- the shorter the better, so a busy doctor will be more likely to read the whole thing.

rbrown3rd wrote:I will offer to get them a script from my primary doc if necessary.

If you need to get a new script, I'd ask that the doctor write it this way so there is no wiggle room or confusion about the exact brand/model machine the DME is to give you:

ResMed S8 Elite II CPAP with H4i humidifier
Pressure: __ cm H2O
EPR 2 fulltime
Mask(s) of patient's choice.

Fill in the blank for whatever single pressure the Rx is for....if no Rx yet, I'd use 10 as a pressure number.

That's all that the prescription needs to have on it to specify that particular machine/humidifier, to have EPR turned on, and to let you request the mask you want.

There are a lot of other settings/features you'll probably want to enable and/or adjust that the DME might not turn on when setting up the machine. You can go into the clinical menu and take care of all those things yourself after you get the machine.

rested gal wrote:

rbrown3rd wrote:On Monday, tomorrow, I am going to call my homecare provider and find out if they are going to be able to provide me with the machine I want without sending the letter. If that does not prevail then this is a draft of the letter I will send to my primary MD. Any feedback is greatly appreciated.

That's a very good letter. I would leave out every reference to having bought software and a card reader to do your own downloads. I'd erase these specific sentences:

"In anticipation of having the machine after my Medicare compliance period had been satisfied I purchased software and a card reader to help me chart my progress and to further enhance the feedback loop."

"I had taken steps to enjoy the fullest advantage of having the sleep data available by purchasing software and a card reader. "

It's fine to talk about the usefulness of the data that can be seen in the LCD display of the Elite II. But I'd not say a single word about using software.

You might be able to shorten the letter more -- the shorter the better, so a busy doctor will be more likely to read the whole thing.

rbrown3rd wrote:I will offer to get them a script from my primary doc if necessary.

If you need to get a new script, I'd ask that the doctor write it this way so there is no wiggle room or confusion about the exact brand/model machine the DME is to give you:

ResMed S8 Elite II CPAP with H4i humidifier
Pressure: __ cm H2O
EPR 2 fulltime
Mask(s) of patient's choice.

Fill in the blank for whatever single pressure the Rx is for....if no Rx yet, I'd use 10 as a pressure number.

That's all that the prescription needs to have on it to specify that particular machine/humidifier, to have EPR turned on, and to let you request the mask you want.

There are a lot of other settings/features you'll probably want to enable and/or adjust that the DME might not turn on when setting up the machine. You can go into the clinical menu and take care of all those things yourself after you get the machine.

Thanks very much Rested Gal. That is very helpful advice. Tomorrow will tell the tale. Thanks for the RX.

Wulfman wrote:I'm confused.......

They gave you a straight CPAP but you have THIS in your forum profile....... "S8 VPAP Auto 25 BiLevel Machine"

Which machine do you have and/or have a prescription for?


Den

I have not seen my prescription Den. That is something I have to get a copy of. I also have to edit my signature because I entered that when I got my machine for the trial period thinking that would be my machine.

FYI - Medicare implemented a new rule last November. The basics are this: Patient must meet certain criteria to have a sleep study, have a face to face appointment with the ordering physician, and then begins a 90 day trial period on xPAP. If compliance is not reached within that 90 day trial period the xPAP is no longer covered. A Medicare patient if non-compliant can either switch to BiPAP Auto in that period or return to another sleep study.

Congratulations on becoming compliant because many patients struggle with this!

Now, if having a data capable machine assists your compliance by all means request to have this machine returned to you. Or, if the DME argues with you just have your physician write an Rx for the data capable machine to be returned. Technically the machine is still under rental until the 13 months are met and Medicare purchases the equipment for you.

The rental is no longer "capped" in the old terms meaning the DME retained ownership. Now, after you've met compliance then rented for 13 months the equipment converts to a purchase and you own it. So, by all means get a machine that you are comfortable with and compliant on because it will be yours!

Called my doctor's office this morning and had a long talk with one of his nurses whom I know well. I also sent the email containing the draft letter I posted here minus the references to software and card readers focusing mostly on the ability to fine tune my compliance. They said they would discuss it with my DME. I know that they will but will follow up. Thanks for all the help and advice. I will keep you posted.

Well, apparently I am blessed with a great DME. Turns out they ordered my S8 Elite last week when I asked them to. They said it should arrive later this week. I did contact my doctor's office who in turn contacted the DME provider but as I said it turned out that they had already ordered my machine. I am totally happy about this. Thanks to all of you for your support.

That's very good news, rbrown.

Glad to hear your DME is being cooperative.

rested gal wrote:That's very good news, rbrown.

Glad to hear your DME is being cooperative.

Thanks "rested." I have to say I am impressed. Also, my doctor's office all give high praise for them. Looking back over the last six weeks in dealing with them I have had nothing but good experiences. From reading this forum I think they must be the exception rather than the rule.

Good news. My DME provider called today and asked if they could deliver my new machine. I was away and took the call on my cell phone so I had to defer delivery until tomorrow morning. They are really good. Don't know if I can post names here but I could post their name I would brag about them.

Just to close this thread out I am reporting that my DME happily delivered my new machine the next day and it is the correct one as indicated in my signature. I am very happy with them. The company is named Lincare.

Congratulations. You've got a goooood bi-level auto. I have its forerunner, the VPAP Auto. I'm glad to hear too, that your provider has done well by your. May they continue to do so.