Changing from Bi-Pap to C-Pap with lower pressure

In June 2012, I got my first sleep apnea machine, Phillips Respironics Pro Bi-Flex System One. In August of this year, my mask broke-had to see the doctor to get a Rx in order to get a new mask. The doctor said the pressure on my Respironics was too high in light of my losing weight. The doctor issued orders to have the machine changed to C-Pap, which according to the Phillips Respironics manual, this can be done. And the orders include a lower pressure. It has been weeks since the doctor issued the orders to AeroCare and still my machine remains unchanged.

Being proactive in all my medical needs and activities, I asked the doctor's office what is the hold up in getting my machine changed. They told me that AeroCare is saying Medicare is not wanting to pay for the change. So I call AeroCare and they continue with the finger pointing and run-around with me by saying the orders from the doctor have been sent on November 16 to the AeroCare Review Office. I told AeroCare that I wanted to talk to that office. They said I could not talk to their review office:( I told AeroCare that I am not sleeping well. That during my visit to the doctor Thursday, November 19, the doctor asked how am I sleeping? I told the doctor "not good at all." AeroCare gave the impression to me that they could care less about me, the patient. They kept insisting that the orders are being reviewed and that Medicare Contractor in Tennessee is not wanting to pay for these changes. Some individual sitting in a cubical office making a decision against the skills, education and years of training of the doctor. I called Medicare, long time waiting on hold, and finally a Medicare representative told me that the doctor can call the Medicare Contractor in Tennessee and talk to them direct, by-pass AeroCare. But the Medicare representative did not have a phone number and when I told this to the doctor's office, they didn't have a number to call either.

So bottom line, I need my machine changed to help give me a better nights sleep---starting place for all good health, right?---but I am put on hold while the providers finger point, in particular AeroCare, while sitting in their non-medical expertise cubical offices:(

no1texan wrote:In June 2012, I got my first sleep apnea machine, Phillips Respironics Pro Bi-Flex System One. In August of this year, my mask broke-had to see the doctor to get a Rx in order to get a new mask. The doctor said the pressure on my Respironics was too high in light of my losing weight.

curious, how did the the doctor make this determination? Did he have you do another sleep study? Or is he using his new magic ball diagnosis?

If not I would be very suspicious, since weight loss may have no relation to the pressures needed for your therapy.

As for changing the settings in your machine, billing for that is a scam, it is trivial to do with that machine and even you could do it.

Your machine is a Philips Respironics System One model 650 or 660 BiPAP Pro. It is fixed bilevel, and does not auto-adjust pressure. It can be changed to CPAP mode in the clinical setup menu. All you need to do is turn the dial to Setup, then press the dial and ramp button at the same time to enter the clinical menus. Now you can go to setup and set the mode to CPAP and the pressure to your prescription.

Nothing will help your therapy like taking charge of it. Look at the data and decide if the changes you make are in your interest. Think about what your doctor is saying. First, you can keep BiPAP mode and reduce pressure if you find that the lower exhale pressure (EPAP) is more comfortable. Your doctor appears to be basing his recommendation on a hunch, assuming you need less pressure since you lost weight. This may, or may not be correct. It would be a lot better if you did the change yourself, and learned to understand whether the change improves your comfort and therapy, or if his recommendation turns out to be wrong, you can increase the pressure as needed or retain BiPAP mode.

no1texan wrote:Being proactive in all my medical needs and activities,

1. Get the clinical manual from here. http://www.apneaboard.com/adjust-cpap-p ... tup-manual Scroll to the bottom section three and they will tell you how to get one by email.
2. Get Sleepyhead and see your data to determine what setting controls apnea. https://sleep.tnet.com/resources/sleepyhead

no1texan wrote:In June 2012, I got my first sleep apnea machine, Phillips Respironics Pro Bi-Flex System One. In August of this year, my mask broke-had to see the doctor to get a Rx in order to get a new mask. The doctor said the pressure on my Respironics was too high in light of my losing weight. The doctor issued orders to have the machine changed to C-Pap, which according to the Phillips Respironics manual, this can be done. And the orders include a lower pressure. It has been weeks since the doctor issued the orders to AeroCare and still my machine remains unchanged.

Being proactive in all my medical needs and activities, I asked the doctor's office what is the hold up in getting my machine changed. They told me that AeroCare is saying Medicare is not wanting to pay for the change. So I call AeroCare and they continue with the finger pointing and run-around with me by saying the orders from the doctor have been sent on November 16 to the AeroCare Review Office. I told AeroCare that I wanted to talk to that office. They said I could not talk to their review office:( I told AeroCare that I am not sleeping well. That during my visit to the doctor Thursday, November 19, the doctor asked how am I sleeping? I told the doctor "not good at all." AeroCare gave the impression to me that they could care less about me, the patient. They kept insisting that the orders are being reviewed and that Medicare Contractor in Tennessee is not wanting to pay for these changes. Some individual sitting in a cubical office making a decision against the skills, education and years of training of the doctor. I called Medicare, long time waiting on hold, and finally a Medicare representative told me that the doctor can call the Medicare Contractor in Tennessee and talk to them direct, by-pass AeroCare. But the Medicare representative did not have a phone number and when I told this to the doctor's office, they didn't have a number to call either.

So bottom line, I need my machine changed to help give me a better nights sleep---starting place for all good health, right?---but I am put on hold while the providers finger point, in particular AeroCare, while sitting in their non-medical expertise cubical offices:(

It doesn't sound like you're using software.......like Sleepyhead. (Link is in Pugsy's first post in the Announcements section)
If you REALLY ARE proactive with your therapy, get it and use it.
Waiting on a bunch of doctors, DMEs, RTs, and others is going to be a wasted effort in frustration.

THEN.......you'll know WHAT you're changing and WHY.


Den

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