DME

bairdbeth · Post by **bairdbeth** » Mon Sep 25, 2006 5:27 pm

Wow! I saw the pulmo on Friday. I called his office today to ask about getting a copy of test results. They were faxing the script over to the DME as we spoke ( 1:00) They gave me the number to call tomorrow so I could call and check my costs.The Rt at the pulmo told me she ordered me the Respironice M Series and it had c-flex. I looked online and it didn't so I called the DME (4:00) to see what in fact they called in. She told me it was the Respironics M Series Plus with heated humidifier and that their RT would call me tomorrow afternoon. I got home(6:00)and already had a message from the RT. So 2 questions... Does this mean I may actually have a good DME (American Home Care)? Is the machine I am getting a good one? I had thought about the Pro 2 or an APAP, but my pulmo Rt suggested this machine and the Activa mask based on how well I did at the sleep study ( AHI 0.6!) My insurance will cover this at 100% of contracted fee. I'm not sure how much I want to haggle as I want to start therapy ASAP!

snoregirl · Post by **snoregirl** » Mon Sep 25, 2006 5:39 pm

Your insurance covering it 100% is good. Chances are they may also cover a Pro 100% and chances are an APAP would be a hassle. Maybe not undoable but not easy (probably not certain).

I am not sure how much data you can get with the plus. Maybe someone else will chime in here.

The Plus is the cheapest model of Respironics machine in the M series.

The Plus makes the DME the most money since they get reimbursed the same for any CPAP.

Do you have a good DME.

I doubt they are better than a lot.

They didn't give you any more than they had to.

I would ask for the Pro.

Worst case you can't get it and you still have a decent machine at no cost to you.

Just make sure it is new and set up properly.

Make sure you get that prescription and sleep study. Sounds like you asked for it and didn't get it. You will want to file that away for any future need.

SelfSeeker · Post by **SelfSeeker** » Mon Sep 25, 2006 5:43 pm

bairdbeth

Here is the site to learn more about the CPAPs.

http://mseries.respironics.com/Family.asp

The fact that you did not get your prescription and that the DME and DR decided which CPAP model to get raises a flag to me.

Unless maybe that you are in such bad shape and it is endangering your life. Even then maybe you can be given a choice of machines.

NyNurse33 · Post by **NyNurse33** » Mon Sep 25, 2006 5:57 pm

People keep telling me that this machine has LCD data, but I can't find where that's listed anywhere.

REMstar® Auto M Series with C-Flex™

The REMstar Auto M Series with C-Flex is an ideal flow-based Smart CPAP for use in the lab or home. Its Proactive Algorithm looks for and adjusts to the patient’s need based on optimal and critical pressure levels. When combined with Encore Pro Software, you can track events like snoring, elevated leak levels and apnea/hypopnea. Add that to a host of other great patient features, and it’s easy to see why REMstar Auto with C-Flex is the smartest Smart CPAP we’ve ever made.

The new platform design is convenient for travel with and without the integrated humidifier. The standard travel carry case has been updated with a new sleeker look. Optional travel accessories are also available for packing the device in a suitcase and for use when traveling internationally or when a portable battery or DC adapter is required

NyNurse33 · Post by **NyNurse33** » Mon Sep 25, 2006 6:02 pm

I'm talking more than usage hours, reminders, etc. Does it have AHI data?

rested gal · Post by **rested gal** » Mon Sep 25, 2006 6:05 pm

bairdbeth, personally, I would insist (and hold out for) a Respironics machine that can give you more data than the Plus machine can. The "Plus" model, whether it's the older larger machine or the small "M" series, can record only "compliance" -- the number of hours you use the machine. It is not capable of recording what we think of as "full data" -- info about AHI, apneas, hypopneas, limited flows, snores, leaks.

I'd want a machine that records full data. I'd want one of the machines I'll list below, starting with the ones you're most likely to be able to get the DME to give you with the least hassle.

You would be able to see some of the data info in the LCD window on the M series machines without having software, but not in the "non-M".

With either (M or non-M) it is extremely helpful to get the Encore Pro software and card reader so you can see full details about your overnight treatment. Any of these machines record full overnight data:

Respironics REMstar Pro with C-Flex "M" series
Straight cpap, small machine.

Respironics REMstar Pro 2 with C-Flex
Straight cpap, not as small as the "M".

Respironics REMstar Auto with C-Flex "M" series
Autopap, small machine.

Respironics REMstar Auto with C-Flex
Autopap, not as small as the "M".

Respironics BiPAP Auto with Bi-Flex
Combination bipap/autopap, not as small as the "M"

Respironics BiPAP Auto with Bi-Flex "M" series
Combination bipap/autopap, small machine.

The current version of Encore Pro software, version 1.6, works with all those machines.

I'm not a doctor, do not work in the healthcare field, have no connection to any cpap manufacturer. Just a well treated, well rested autopap user.

bairdbeth · Post by **bairdbeth** » Mon Sep 25, 2006 6:23 pm

Thanks! That is what I needed to know. I want the most data I can get. I will ask for the M Series Pro c-flex. Will I have to get another script? I really think my pulmo is used to people who do not do research, ask questions, or have a clue about CPAP machines available.I wouldn't have known anything if I hadn't come here. He had told me to tell the DME what I wanted, but then his RT picked one ( with all the options I wanted except good data) She also picked the masks based on what I used with little leaks or problems during titration. She actually picked the 2 I wanted to try. I will be calling the DME starting at 8:00 tomorrow and then in between our parent teacher conferences if I can't get them.

birdshell · Post by **birdshell** » Mon Sep 25, 2006 7:05 pm

rested gal wrote:
I'm not a doctor, do not work in the healthcare field, have no connection to any cpap manufacturer. Just a well treated, well rested autopap user.

ROTFL, RG!!!

Maybe it is just me, but I thought you must be some kind of professional when I first became one of the Forum Folk. Thus, your paraphrased disclaimer cracked me up.

But wait a while: You DO seem to know more than some of the pros!

Ta,
Karen aka birdshell

rested gal · Post by **rested gal** » Mon Sep 25, 2006 10:52 pm

LOL, birdshell. I just like to dig into this stuff. I can get it wrong same as anyone else. All we can do is try to learn.

Speaking of digging... I wanted to see what Respironics says the user can see on the LCD of the REMstar Auto M series machine, without using software.

The M Auto LCD can show 90% Pressure Used, Leak rate, and AHI as 7 day and 30 day averages.

"90% Pressure", by the way, means the machine had to use THAT pressure OR pressures BELOW it, 90% of the time while treating the person. Doesn't mean the autopap spent 90% of the time using just that pressure.

So, if a person were given a REMstar Auto to use for a trial period with the aim of putting the person on straight cpap after the trial, the "90%" pressure (or perhaps a cm or two above it) is likely to be what the doctor would prescribe for a straight cpap pressure. In other words, a straight cpap would be set at a single pressure high enough to take care of "worst case scenario" whether you really needed that single pressure very often at all during the night.

http://global.respironics.com/UserGuide ... esAuto.pdf

excerpts from:

REMstar Auto M series USER MANUAL

4.4 CHANGING THE DEVICE SETTINGS

You can view the set pressure on the Active Display screen, and you can view the following settings on the Patient Data screens:

• Therapy usage hours
• Number of sessions greater than 4 hours
• 90% therapy pressure averages – only appears if in Auto-CPAP therapy
• System leak (if enabled by your home care provider)
• Apnea/Hypopnea Index (if enabled by your home care provider)
{I added bold emphasis of three points}

Additionally, you can view and modify the following settings on the Patient Setup screens:

• C-Flex (if enabled by your home care provider)
• Ramp starting pressure (if enabled by your home care provider)
• Mask alert (enable/disable)
• Auto off (enable/disable)
• FOSQ questionnaire

4.4.1.1 VIEWING DATA ON THE PATIENT DATA SCREENS

4. 90% Therapy Pressure Screen

This screen displays a 7-day and 30-day average of the 90% pressure that you have used. The 90% pressure is the pressure at which you spent 90% of the session time at or below. For example, if you have the device on (with airflow) for 10 hours, and spend 9 hours at or below 11 cm H2O, and 1 hour above 11 cm H2O, then the 90% pressure is 11 cm H2O. The maximum value for both averages is 20.0 cmH2O.

Note: This screen is only for reference. Your home care provider may periodically ask you for this information.
Note: This screen only displays if you are in Auto-CPAP therapy.

{A graphic on the page shows how the screen would display 90% Pressure data:}

90% Pressure cmH2O
7 Day Avg: 10.0
30 Day Avg: 12.0

5. System Leak Screen

This screen displays a 7-day and 30-day average of the leak history for the device in liters per minute (LPM). System leak is a combination of intentional and unintentional air leak. Intentional leak is the expected leak at the exhalation port. Some leak is required to minimize CO2 rebreathing.
Unintentional leak occurs around the patient interface. If you see a large increase in the amount of leak indicated here, contact your home care provider for assistance.

Note: This screen only displays if your home care provider has enabled it. It is only for reference. Your home care provider may periodically ask you for this information.

{A graphic on the page shows how the screen would display Leak data:}

System Leak L/min
7 Day Avg: 0.0
30 Day Avg: 0.0

6. Apnea/Hypopnea Index Screen

This screen displays your Apnea/Hypopnea index (AHI) for the last 7 and 30 days.

Note: This screen only displays if your home care provider has enabled it. It is only for reference. Your home care provider may periodically ask you for this information.

{A graphic on the page shows how the screen would display AHI data:}

Apn-Hyp Index
7 Day Avg: AHI = 0.0
30 Day Avg: AHI = 0.0

Guest · Post by **Guest** » Tue Sep 26, 2006 7:33 am

You know, I just have to say this at this point. Some of the people here freaking kill me.

The person who started this thread called the DME company within just a couple hours of the doc faxing the prescription to them and they already have everything worked out and are able to answer all the questions. The person has a call from an RT wanting to setup the machine within 5 hours.
And people are saying they see "red flags" and that "I doubt they are better".
Holy crap what do some people freaking expect?!
Look, I have no ties to anyone. Frankly, I really couldn't care where someone gets treatment from if it makes them happy - but come on for crying out loud. This is better treatment than most of us have a right to expect and people are still slagging on them??

To the person who started this thread: If you are getting answers to your questions, if you are getting equipment than will treat your OSA and if feel comfortable with the people you are dealing with then I would say you are absolutely in the right place.

Guest · Post by **Guest** » Tue Sep 26, 2006 7:43 am

Anonymous wrote:This is better treatment than most of us have a right to expect

snoregirl · Post by **snoregirl** » Tue Sep 26, 2006 12:52 pm

Guest.

My comment that -- I doubt that they are better than most others -- I stand by.

I don't see any reason to jump up and down just yet and say "what a great DME I have" when they give you no choice of machine and in fact are handing you the low end without even consulting you. That is what MOST DME's do. That was all I was saying. Especially since the poster hadn't seen the costs yet or actually received the machine and verified it was new.....and gotten filters and had them put in correctly, and been fitted for a mask. Too little had happened yet to get excited, and what had happened wasn't exceptional.

Yes, nice they called, nice they gave a number for costs but are they wonderful? I would reserve judgement on that until you see how the rest pans out and by the way the machine is the base Respironics machine. Nothing to get excited about at the same price they could give you a machine that shows data for given what they are most likely charging the insurance company.

bairdbeth · Post by **bairdbeth** » Tue Sep 26, 2006 2:10 pm

I called the DME this morning. They have been very helpful. They will not bring me or order a machine that I do not approve first. They have the M Series Pro with c-flex in stock, but they have another lady looking to see if there is a better one with more/easier data information. I will have to pay an upgrade as my insurance doesn't have that as a contracted model, but I can handle the upgrade fee as I do not have a co-pay or deductible for this. They are calling me back in a few minutes with the name of the other machine so I can look it up and see if I like it better. I already have the RT cell phone number and I am to call her as soon as we decide on a machine so she can come and get me set up.

snoregirl · Post by **snoregirl** » Tue Sep 26, 2006 2:16 pm

How much is the upgrade fee if you don't mind me asking. Just curious. The difference in cost on CPAP.com is $75 between the Plus and the Pro2 and $117 between the M series plus and pro.

And have you called your insurance co yourself to check if the info you are getting from the DME on upgrade cost (machine not covered) is correct?

My experience is that one CPAP is the same as another to the insurance company E0601 is the billing code. Reimbursement is the same no matter what you pick so I would make sure you should really be paying anything.

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bairdbeth · Post by **bairdbeth** » Tue Sep 26, 2006 2:32 pm

It's $100 for a M Series Pro instead of M Series Plus. I had looked up the same numbers before I called them, so I knew the difference was a little over $100. I have not called my insurance as I can never get anyone who can tell me a straight answer. I had called about a sleep study and they didn't know anything at first and then told me wrong info. From their website it doesn't look like they pay very much for the contracted rate. Billmyinsurance couldn't cover with my insurance at least at this time. I really don't want to wait any longer as I have a 20 year plus sleep debt and it is getting worse. I fell asleep at the computer today while my students were at PE! If it only costs me $100 to get the machine I want, not what my insurance will cover, then it's all good.