General Discussion on any topic relating to CPAP and/or Sleep Apnea.
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ChicagoGranny
- Posts: 15295
- Joined: Sun Jan 29, 2012 1:43 pm
- Location: USA
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by ChicagoGranny » Sat Dec 31, 2016 8:14 am
2xRustler wrote:Imagine my surprise when the gentleman started talking about all the wonderful things these new machines can do. He unsealed a box that contained a Resmed Airsense 10 Elite. I was also prescribed heated tubing. The DME provider spent a reasonable amount of time showing me the relevant features of the machine, how to run mask leak tests, cleaning, and care, etc. He explained the auto climate functions and how to disable them and set my own humidity and tube temperature. He also showed me how to access the clinical menu (not that I couldn't have figured it out or asked here" so I could make adjustments to EPR which he said many people need to. He also gave me his personal phone number and stated I can call or text him at ANY TIME if I need anything.
This sounded so good, until I realized they gave you a straight CPAP (Resmed AirSense 10 Elite) instead of an Auto (Resmed AirSense 10 AutoSet).
It would have just cost them a few dollars more to supply an AutoSet -
https://www.cpap.com/cpap-machines/resmed.php#:::2::
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gregnga
- Posts: 149
- Joined: Sun Dec 24, 2006 8:04 am
- Location: Atlanta, GA
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by gregnga » Sat Dec 31, 2016 11:41 am
It is looking like I am going to have to get another sleep study if I want my insurance company to pay for my new CPAP machine. They will pay 80% of my new machine and supplies. I spoke to a number of DME's over the last several days and they all have told me that they want a recent prescription along with results from a recent sleep study plus the notes from the doctor that reviewed the S.S. test. So, after the sleep study, I should be able to get a new Airset 10 plus supplies for around $200 out of my pocket. Or, I could skip the sleep study and purchase the Airset 10 outright on cpap.com, who still has an older prescription on file that they will accept.
I am leaning toward biting the bullet and having another sleep study done.
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LSAT
- Posts: 13347
- Joined: Sun Nov 16, 2008 10:11 am
- Location: SE Wisconsin
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by LSAT » Sat Dec 31, 2016 12:36 pm
Ask about a home sleep study.....often DMEs will accept that. Check with your Insurance Company....
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ChicagoGranny
- Posts: 15295
- Joined: Sun Jan 29, 2012 1:43 pm
- Location: USA
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by ChicagoGranny » Sat Dec 31, 2016 3:11 pm
gregnga wrote:I spoke to a number of DME's over the last several days and they all have told me that they want a recent prescription along with results from a recent sleep study plus the notes from the doctor that reviewed the S.S. test.
Whoa! You are being fed a line of crap. All a DME is required to have in their possesion in order to supply a CPAP machine is a prescription which includes the machine settings. Any doc can write you that prescription.
Secondly, you need to talk to your insurance company about what they require to reimburse you for a new CPAP. Many only require a statement from your doctor that you require CPAP, that you are currently using CPAP and that you are compliant.
Every insurance company has their own policies and practices. You should talk to your insurance company before undergoing a sleep study that may not be necessary.
