Ok, so I am going to the Doc to get my test results from my sleep study tomorrow, and I am kind of wondering what I should expect.
Should the doc want me to be on a machine, will they give me a perscription for a specific machine?
Will i have any say on what type of machine I get?
I should be able to get a copy of the results right??
What should I get information wise from the doc??
Test Results Tomorrow - couple of questions
8 posts
• Page 1 of 1
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communilink
- Posts: 46
- Joined: Wed May 24, 2006 7:20 pm
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Sleepy-in-AL
- Posts: 131
- Joined: Thu May 04, 2006 7:09 pm
- Location: Alabama
Communilink, if you need treatment the Dr. may offer to send your prescription directly to a DME. You certainly have the right to request that he provide you a copy of the prespcription instead of or in addition. If you are familiar with the offerings and want a specific machine, you will definately want to discuss this with the DME prior to them setting up your billing.
If you want to use your insurance, once your DME starts billing, you will likely be stuck with that DME for the duration as far as insurance is concerned. So if they don't / can't /won't offer the particular equipment you want, figure this out now The Dr. will probably provide a prescription for a class of machine CPAP/BiPAP/BiPAP S/T without specifics regarding auto or other options. Many DMEs only offer one brand of machine, so if you are stuck with a specific DME because of insurance, you may not get much say in specifics. You can certainly make request though. You may be able to request a specific machine through http://www.billmyinsurance.com which is a sister site to https://www.cpap.com, depending on your insurance.
If you are willing to pay out of pocket or self file your insurance you can take your prescription to https://www.cpap.com and order whichever machine you want within the class of your prescription. See the faqs on https://www.cpap.com for specifics regarding what is required to be on the prescription for each class of machine.
You will likely have to request a copy of the sleep study from your Dr. However, they should have no problem giving it to you and you do have the right to it.
Did you have a split study where they observe you sleeping part of the night and then put CPAP/BiPAP on to titrate? How long ago was your sleep study?[/quote]
If you want to use your insurance, once your DME starts billing, you will likely be stuck with that DME for the duration as far as insurance is concerned. So if they don't / can't /won't offer the particular equipment you want, figure this out now The Dr. will probably provide a prescription for a class of machine CPAP/BiPAP/BiPAP S/T without specifics regarding auto or other options. Many DMEs only offer one brand of machine, so if you are stuck with a specific DME because of insurance, you may not get much say in specifics. You can certainly make request though. You may be able to request a specific machine through http://www.billmyinsurance.com which is a sister site to https://www.cpap.com, depending on your insurance.
If you are willing to pay out of pocket or self file your insurance you can take your prescription to https://www.cpap.com and order whichever machine you want within the class of your prescription. See the faqs on https://www.cpap.com for specifics regarding what is required to be on the prescription for each class of machine.
You will likely have to request a copy of the sleep study from your Dr. However, they should have no problem giving it to you and you do have the right to it.
The Dr. should explain the results of your sleep study and what if any therapy is needed and why. Beyond this, he should listen to and answer your questions. The more you read and educate yourself and prepare to ask intelligent questions, the better.What should I get information wise from the doc??
Did you have a split study where they observe you sleeping part of the night and then put CPAP/BiPAP on to titrate? How long ago was your sleep study?[/quote]
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| Additional Comments: Pressure MinE 11 MaxI 17.5 | ||||
[Should the doc want me to be on a machine, will they give me a perscription for a specific machine?]
If you know what you want one why not? Easier to get a DME to give you something if it is on the prescription. Consider Cflex or EPR and humidifier. Get them on the prescription if you want them.
[Will i have any say on what type of machine I get?]
Why not? But you had better know what you want if you want to have a say.
Read this forum and the host's listing and description of machines.
[I should be able to get a copy of the results right??]
They are your medical records. I can't see why not. But don't expect them to be offered to you on a platter. Get a copy in case you might want to deal with a different DME than the dr sets you up with. New DME might require them and you won't have to get the dr to fax later.
[What should I get information wise from the doc??]
I am sure that there is plenty I will leave out, but you should know your titrated pressure. And if your pressure is appropriate for CPAP or BiPap. If you have any feeling about APAP figure that out now but be warned insurance may not want to pay for that).
You should understand all your data (events) I am not as good at listing those someone else may be able to help.
You should leave with a hardcopy of your presciption in case you want to use a different vendor for your machine than the doc's office or insurance sets you up with. In my opinion this is one of the most important things to leave with. Not just the "the DME will call you" line.
What DME will the dr call? Who chooses (may be more than one acceptable one for your insurance, who chooses then?) Copy of your sleep study since if you choose to use a different DME you will probably need this. I have yet to figure out why since the prescription states pressure or for APAP pressure range etc.
You need info from your insurance company too. How much they cover, what they will cover, what the total cost is (and your copay) so you can make sure that the total that YOU pay isn't more than buying outright with no insurance from a website like this. Is it rent or rent to buy? How long before insurance will buy, is the rental $ paid included in the total price. Is there a compliance period? What determines compliance. What happens if you don't meet compliance (do you get another shot and of course you are paying rental for that period, so what happens to that rental money...
All this stuff is very good to know prior to going to see the doctor and getting a prescription. Most likely the doc will write you a prescription and tell you he will fax it to the DME. GET a HARDCOPY incase you don't like what happens next. Given the way you asked this question in this thread, I think you have no idea if you will like what happens next. Best to have what you need so you can make choices later without more dr appointments and waiting.
Good luck.
If you know what you want one why not? Easier to get a DME to give you something if it is on the prescription. Consider Cflex or EPR and humidifier. Get them on the prescription if you want them.
[Will i have any say on what type of machine I get?]
Why not? But you had better know what you want if you want to have a say.
Read this forum and the host's listing and description of machines.
[I should be able to get a copy of the results right??]
They are your medical records. I can't see why not. But don't expect them to be offered to you on a platter. Get a copy in case you might want to deal with a different DME than the dr sets you up with. New DME might require them and you won't have to get the dr to fax later.
[What should I get information wise from the doc??]
I am sure that there is plenty I will leave out, but you should know your titrated pressure. And if your pressure is appropriate for CPAP or BiPap. If you have any feeling about APAP figure that out now but be warned insurance may not want to pay for that).
You should understand all your data (events) I am not as good at listing those someone else may be able to help.
You should leave with a hardcopy of your presciption in case you want to use a different vendor for your machine than the doc's office or insurance sets you up with. In my opinion this is one of the most important things to leave with. Not just the "the DME will call you" line.
What DME will the dr call? Who chooses (may be more than one acceptable one for your insurance, who chooses then?) Copy of your sleep study since if you choose to use a different DME you will probably need this. I have yet to figure out why since the prescription states pressure or for APAP pressure range etc.
You need info from your insurance company too. How much they cover, what they will cover, what the total cost is (and your copay) so you can make sure that the total that YOU pay isn't more than buying outright with no insurance from a website like this. Is it rent or rent to buy? How long before insurance will buy, is the rental $ paid included in the total price. Is there a compliance period? What determines compliance. What happens if you don't meet compliance (do you get another shot and of course you are paying rental for that period, so what happens to that rental money...
All this stuff is very good to know prior to going to see the doctor and getting a prescription. Most likely the doc will write you a prescription and tell you he will fax it to the DME. GET a HARDCOPY incase you don't like what happens next. Given the way you asked this question in this thread, I think you have no idea if you will like what happens next. Best to have what you need so you can make choices later without more dr appointments and waiting.
Good luck.
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communilink
- Posts: 46
- Joined: Wed May 24, 2006 7:20 pm
I am mostly wondering what has happened to others. I had my test two weeks ago. Part of the test was off the machine, and part was on. Since the test, I have gotten no information at all other then what I have read and learned here for the week before the test and the two weeks after. I read the messages here everyday and have some ideas on how I want to proceed based on knowledge I have gained here, but I am unsure what the "medical community" will allow when trying to deal with this issue.
At this point, I guess I will find out in the morning what the test results are and how she wants to proceed versus how I want to proceed.
It is not my desire to "rent" a machine, as I would like more control over the situation. I don't kn ow what the insurance will say, and in some ways don't care, as I can afford to purchase the equipment outright regardless of the insurance.
I am mainly trying to glean more information on how different people moved forward after learning about their test results, and how fast they got on a machine, how they choose their specific machine and mask.
Everyone is talking about how they are doing now, and I have learned alot, but what about right after getting your results. what did you do next.
I will become more active on the forums when I get the results and feel that i have more to share and discuss.
Don
At this point, I guess I will find out in the morning what the test results are and how she wants to proceed versus how I want to proceed.
It is not my desire to "rent" a machine, as I would like more control over the situation. I don't kn ow what the insurance will say, and in some ways don't care, as I can afford to purchase the equipment outright regardless of the insurance.
I am mainly trying to glean more information on how different people moved forward after learning about their test results, and how fast they got on a machine, how they choose their specific machine and mask.
Everyone is talking about how they are doing now, and I have learned alot, but what about right after getting your results. what did you do next.
I will become more active on the forums when I get the results and feel that i have more to share and discuss.
Don
I don't know about anybody else. I had to call the DO that had set me up for the test in order to get the results, and get the ball rolling. There had been no appointment scheduled with her or anything after the test. I've never seen the sleep doc that read the study. His bill came in from out of state.
It was kind of frustrating to me. I had this DME calling me, didn't know them for anything... she just sent them the script and I didn't even know what it was for. Only thing that I knew because I'd asked when I called her was that there was going to be a heated humidifier with it... I'd read on here that it would be good... I don't always use it heated... but it always has water in it every night.
Originally I didn't even ask for a copy of the study or the script... I finally got up the nerve to ask a couple of weeks ago... I've been on CPAP since the end of March. I had no idea what any of it meant. Nobody explained it to me or anything.
Just clueless me.
The DME came to my place and set me up with the only machine that he brought... he'd brought 3 masks, and I definately was having none of two of them. I ended up with a Swift.
The DME doesn't usually return my calls... though through modern inventions... I now have his cell phone number and instead of leaving him a message at work... I call him there.
It was kind of frustrating to me. I had this DME calling me, didn't know them for anything... she just sent them the script and I didn't even know what it was for. Only thing that I knew because I'd asked when I called her was that there was going to be a heated humidifier with it... I'd read on here that it would be good... I don't always use it heated... but it always has water in it every night.
Originally I didn't even ask for a copy of the study or the script... I finally got up the nerve to ask a couple of weeks ago... I've been on CPAP since the end of March. I had no idea what any of it meant. Nobody explained it to me or anything.
Just clueless me.
The DME came to my place and set me up with the only machine that he brought... he'd brought 3 masks, and I definately was having none of two of them. I ended up with a Swift.
The DME doesn't usually return my calls... though through modern inventions... I now have his cell phone number and instead of leaving him a message at work... I call him there.
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NightHawkeye
- Posts: 2431
- Joined: Thu Dec 29, 2005 11:55 am
- Location: Iowa - The Hawkeye State
Don,
Individual circumstances seem to be all over the place. Some folks (very few) get a machine that day. Some folks (again very few) wait months to get a machine. They all claim no control over the situation. They are always at the mercy of their health care providers.
The vast majority are offered a basic CPAP, and are not offered any selection. A few, usually the ones needing pressures close to 20 cm, will be prescribed a BiPAP, often the BiPAP-auto from Respironics.
If you want to monitor your therapy, or want an APAP, and want insurance to pay for it, then you may have a battle with your physician, DME and insurance. A lot of bad stories have been told about these situations. If, on the other hand, you are willing to take matters into your own hands, and not as reliant on insurance, then the situation gets much easier regarding choosing a particular machine. All you need is a CPAP prescription and CPAP.com will sell you any CPAP/APAP machine they carry. Same goes for BiPAP. Masks need no prescription.
Hope this helps.
Regards,
Bill
Individual circumstances seem to be all over the place. Some folks (very few) get a machine that day. Some folks (again very few) wait months to get a machine. They all claim no control over the situation. They are always at the mercy of their health care providers.
The vast majority are offered a basic CPAP, and are not offered any selection. A few, usually the ones needing pressures close to 20 cm, will be prescribed a BiPAP, often the BiPAP-auto from Respironics.
If you want to monitor your therapy, or want an APAP, and want insurance to pay for it, then you may have a battle with your physician, DME and insurance. A lot of bad stories have been told about these situations. If, on the other hand, you are willing to take matters into your own hands, and not as reliant on insurance, then the situation gets much easier regarding choosing a particular machine. All you need is a CPAP prescription and CPAP.com will sell you any CPAP/APAP machine they carry. Same goes for BiPAP. Masks need no prescription.
Hope this helps.
Regards,
Bill
Ok I will tell you my situation.
2 weeks from the time of sleep study until results are available seem fairly normal for a lot of people. Mine was similar.
Mine proceeded to "the DME will call you" I had not gotten as far as you with this forum but I had started making phone calls to my insurance. I found out that there were 6 brick and mortar DMEs that I could use and use my insurance.
I found out that my doc's office chose one themselves (seems like they always send to Apria, no one could tell me why) and take it upon themselves to send my stuff there.
I was not offered my prescription, or sleep study (had to ask) nor was I told that there might be other places I might want to buy. It was assumed that I would just wait for the call. It was also assumed that I would want the CPAP that my insurance paid for. Remstar Pro2 (which is a fine machine, except I had some issues for which I believed an auto was better for).
These issues were weight flux, multiple sleeping positions, reasonably high pressure (13) and ears that plug with pressure. Therefore it was a two step process to go back to the Dr and indicate why I wanted an Auto. Got a new prescription (this time I was smarter and held it myself and faxed it myself to the DME).
Denied by DME (apria), appealed insurance ruling 3 times (lost) during the third go round with the Insurance (that wouldn't work with Bill my insurance and wouldn't provide decent benefits if I bought from Cpap.com for cash) DME called me and once again told me "we need to set up your appt for you to pick up your CPAP". I once again asked "My APAP that my doctor prescribed or a CPAP"
This time after a bit of discussion I was able to get the APAP but.... I needed a pressure range or they wouldn't give it to me on the prescription. The sleep specialist who read my sleep studies wouldn't give my doc a pressure range since he claimed that the study was for CPAP only. I gave data from here to my doc who wrote a range for me.
Then I got my APAP (in the mean time I had bought a used CPAP on Ebay so I could fight and get therapy while I fought). APAP was set up wrong by Apria (split night mode. A couple other settings I was not consulted on at all even though I told the guy I had another machine and was familiar with it)
I too was all but ready to buy with my own cash but luckily got what I wanted for what should come out to just under $300 as opposed to $725 cash from CPAP.com.
I am not through compliance yet (3 months for me) so I still have a ways to go to see it all work out. Crossing fingers. When I had spoken to insurance numerous times before getting the machine from the DME, they could or would not tell me what the contract price was with any of their vendors (DMEs) for my machine. Not for the Pro2 either. I needed this to make sure that the fight was worth it. That I wouldn't pay more for the DME machine than the cash CPAP.com machine in the long run.
My question was "How do you pay the bills from the DME if you don't know what the contract price is?" Never did get a decent answer on that one. In making multiple phone calls to Insurance and a couple DME's I manged to figure out that I was pretty sure that I was money ahead if I kept at it to use the insurance. EVEN figuring in the cost of the used machine I bought.
So that is what I did. But I came very close to losing and giving up and buying outright.
Depends on how much it is worth to you to save a few hundred dollars. I am a cheapskate, and although I also can afford to pay out of pocket, I pay for insurance and darn it I should get something from it. Maybe they make it so hard so we give up and they make more money. I don't know.
That is the best way I can answer your latest question.
Least hassle way is take hardcopy of whatever script your doctor wants to hand you and you can buy what you want. See section on this website for requirements for a prescription.
_________________
CPAPopedia Keywords Contained In This Post (Click For Definition): cpap.com, CPAP, DME, Prescription, auto, APAP
2 weeks from the time of sleep study until results are available seem fairly normal for a lot of people. Mine was similar.
Mine proceeded to "the DME will call you" I had not gotten as far as you with this forum but I had started making phone calls to my insurance. I found out that there were 6 brick and mortar DMEs that I could use and use my insurance.
I found out that my doc's office chose one themselves (seems like they always send to Apria, no one could tell me why) and take it upon themselves to send my stuff there.
I was not offered my prescription, or sleep study (had to ask) nor was I told that there might be other places I might want to buy. It was assumed that I would just wait for the call. It was also assumed that I would want the CPAP that my insurance paid for. Remstar Pro2 (which is a fine machine, except I had some issues for which I believed an auto was better for).
These issues were weight flux, multiple sleeping positions, reasonably high pressure (13) and ears that plug with pressure. Therefore it was a two step process to go back to the Dr and indicate why I wanted an Auto. Got a new prescription (this time I was smarter and held it myself and faxed it myself to the DME).
Denied by DME (apria), appealed insurance ruling 3 times (lost) during the third go round with the Insurance (that wouldn't work with Bill my insurance and wouldn't provide decent benefits if I bought from Cpap.com for cash) DME called me and once again told me "we need to set up your appt for you to pick up your CPAP". I once again asked "My APAP that my doctor prescribed or a CPAP"
This time after a bit of discussion I was able to get the APAP but.... I needed a pressure range or they wouldn't give it to me on the prescription. The sleep specialist who read my sleep studies wouldn't give my doc a pressure range since he claimed that the study was for CPAP only. I gave data from here to my doc who wrote a range for me.
Then I got my APAP (in the mean time I had bought a used CPAP on Ebay so I could fight and get therapy while I fought). APAP was set up wrong by Apria (split night mode. A couple other settings I was not consulted on at all even though I told the guy I had another machine and was familiar with it)
I too was all but ready to buy with my own cash but luckily got what I wanted for what should come out to just under $300 as opposed to $725 cash from CPAP.com.
I am not through compliance yet (3 months for me) so I still have a ways to go to see it all work out. Crossing fingers. When I had spoken to insurance numerous times before getting the machine from the DME, they could or would not tell me what the contract price was with any of their vendors (DMEs) for my machine. Not for the Pro2 either. I needed this to make sure that the fight was worth it. That I wouldn't pay more for the DME machine than the cash CPAP.com machine in the long run.
My question was "How do you pay the bills from the DME if you don't know what the contract price is?" Never did get a decent answer on that one. In making multiple phone calls to Insurance and a couple DME's I manged to figure out that I was pretty sure that I was money ahead if I kept at it to use the insurance. EVEN figuring in the cost of the used machine I bought.
So that is what I did. But I came very close to losing and giving up and buying outright.
Depends on how much it is worth to you to save a few hundred dollars. I am a cheapskate, and although I also can afford to pay out of pocket, I pay for insurance and darn it I should get something from it. Maybe they make it so hard so we give up and they make more money. I don't know.
That is the best way I can answer your latest question.
Least hassle way is take hardcopy of whatever script your doctor wants to hand you and you can buy what you want. See section on this website for requirements for a prescription.
_________________
CPAPopedia Keywords Contained In This Post (Click For Definition): cpap.com, CPAP, DME, Prescription, auto, APAP
i don't remember how long it was before i got my machine and mask, but it was a reasonable period of time--like maybe a week or even less. i also don't remember whether they volunteered to give me a copy of my test results or i had to ask, but it was not a hassle. they also gave me a copy of a summation letter for my regular doctor.
this was a long time ago, but...
i didn't realize that home use would feel different than in the sleep lab. i told the dme i didn't think the machine was working properly so he gave me a different one. it worked the same. i told him the pressure wasn't enough, so after much bellyaching on my part they got the sleep doc to agree to go up 1 cm. they gave me a heated humidifier, which really did stop working after about a week. the dme said i must have spilled water all over it. i did not, and they reluctantly gave me a new one, which has worked fine for five years, even if i do spill water on it.
they titrated me on one mask, size small. i complained it was too small. the sleep lab said they didn't understand why, but they gave me a spare medium they had. i complained the mask sprayed air in my eye (not leaks) and i couldn't get it to stop. so the dme gave me another type of nasal mask, size small. i complained it was too big, so they gave me a shallow one. then i complained i was mouthbreathing, so they gave me a full face mask, regular small and shallow small. they gave me extra containers for my humidifier, a travel bag, and extra parts for my masks.
then they told me they were done with giving me masks for at least the time being.
it sounds like i got a lot of stuff, which i did. but there were many phone calls back and forth, (mostly me calling him and him not returning the calls), the dme didn't show up for appointments at least twice that i remember. the sleep lab said they would check my pressure and i drove the half hour there, only to find out someone made a mistake and they couldn't (it's in a hospital, and there was some hospital conflict. one time the dme actually got to my house but he brought the wrong mask, so i had to make many phone phone calls to get someone to bring the right mask. i remember one of the times i agreed to meet the dme at his office and they said he was at the sleep clinic, so i remember chasing him all over the sleep clinic.
i commented to the dme that some manufacturer should learn how to make a proper mask, and i remember him laughing and saying there were many masks.
i got a lot of stuff, but communication was terrible between me and the sleep lab, between me and the dme, and maybe between the sleep lab and the dme, i don't remember. it was a big hassle. i didn't choose--they just gave.
i think this may have been before apap and swift and a lot of things we take for granted now. most of the equipment was high quality, and they said they would not even think of not giving me a heated humidifier.
thing was, i was exhausted. i had been on many meds, which i had to get off of for the sleep tests, and getting off some of the meds was tough and took a long time. i had to wait a long time for the sleep test and the results appointment. i had a great titration night, best sleep i ever had, and i just wanted to get on with it. so i was cranky, and it was difficult for me to deal
with all the stuff going wrong.
if you have no problem paying without going through insurance, and don't feel you should get your insurance dollar's worth, i'd listen to what the dme has to say (some sleep lab techs and dme's can be helpful.) but if the hassles start, i'd split soon.
good luck.
caroline
this was a long time ago, but...
i didn't realize that home use would feel different than in the sleep lab. i told the dme i didn't think the machine was working properly so he gave me a different one. it worked the same. i told him the pressure wasn't enough, so after much bellyaching on my part they got the sleep doc to agree to go up 1 cm. they gave me a heated humidifier, which really did stop working after about a week. the dme said i must have spilled water all over it. i did not, and they reluctantly gave me a new one, which has worked fine for five years, even if i do spill water on it.
they titrated me on one mask, size small. i complained it was too small. the sleep lab said they didn't understand why, but they gave me a spare medium they had. i complained the mask sprayed air in my eye (not leaks) and i couldn't get it to stop. so the dme gave me another type of nasal mask, size small. i complained it was too big, so they gave me a shallow one. then i complained i was mouthbreathing, so they gave me a full face mask, regular small and shallow small. they gave me extra containers for my humidifier, a travel bag, and extra parts for my masks.
then they told me they were done with giving me masks for at least the time being.
it sounds like i got a lot of stuff, which i did. but there were many phone calls back and forth, (mostly me calling him and him not returning the calls), the dme didn't show up for appointments at least twice that i remember. the sleep lab said they would check my pressure and i drove the half hour there, only to find out someone made a mistake and they couldn't (it's in a hospital, and there was some hospital conflict. one time the dme actually got to my house but he brought the wrong mask, so i had to make many phone phone calls to get someone to bring the right mask. i remember one of the times i agreed to meet the dme at his office and they said he was at the sleep clinic, so i remember chasing him all over the sleep clinic.
i commented to the dme that some manufacturer should learn how to make a proper mask, and i remember him laughing and saying there were many masks.
i got a lot of stuff, but communication was terrible between me and the sleep lab, between me and the dme, and maybe between the sleep lab and the dme, i don't remember. it was a big hassle. i didn't choose--they just gave.
i think this may have been before apap and swift and a lot of things we take for granted now. most of the equipment was high quality, and they said they would not even think of not giving me a heated humidifier.
thing was, i was exhausted. i had been on many meds, which i had to get off of for the sleep tests, and getting off some of the meds was tough and took a long time. i had to wait a long time for the sleep test and the results appointment. i had a great titration night, best sleep i ever had, and i just wanted to get on with it. so i was cranky, and it was difficult for me to deal
with all the stuff going wrong.
if you have no problem paying without going through insurance, and don't feel you should get your insurance dollar's worth, i'd listen to what the dme has to say (some sleep lab techs and dme's can be helpful.) but if the hassles start, i'd split soon.
good luck.
caroline
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| Additional Comments: Large mask collection | ||||
caroline
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