Hey NyNurse!!!!!

it is all to simple, people on autopaps have fewer visits to the doctor. She needs someone to make her Mercedes payment.

She will stall you off on Nancy as long as she can, your best bet is getting a copy of your script. It is as I said before doctors know very little about cpap machines all they know is they don't want you to have a autopap.

Here's how you handle that situation:

Wait a few days, if don't hear from "Nancy" as promised call your doctors office and leave a message with the receptionist for the doctor... say returning cpap machine to DME due to aerophagia, rental running out, will seek alternative threatments with ENT unless I hear from you or Nancy (bet she calls you back in 10 minutes guaranteed).

_________________

CPAPopedia Keywords Contained In This Post (Click For Definition): CPAP

Thanks guys for all your inputs....we should run and manage our own sleep lab and therapy...we would make so many people happy.

Just to clear up some things: This MD is the ENT and Nancy is the RPsgT @ the sleep lab right down the hall from the ENT/Allergy office. The ENT is who my primary MD referred me to. Nancy "prescribed" my machine and sent the script right to the DME which is not in the same building. The medical directors are my ENT's partners in her office. So definitely some affiliation going on.

I will be pursing this further with Nancy, the RPsgT and manager of the sleep disorder center, who seems to have all the power, even over my ENT who ordered the darn test. I think it may go well, if I just keep telling her the key benefits of apap over cpap.

Interesting enough, when my MD asked me yesterday which DME I use and I told her, she seemed to not even know who they were. She said that they usually use _________. So I'm wondering if she is innocent in this part, maybe there is no financial kickback. The DME I'm using is the only one near where I live, so maybe that's why it was chosen. But then again, it was chosen by Nancy, not me.

At this point I don't think I can get my script and go there here, b/c I have already entered into an agreement with my local DME. At least that's the impression I got from billmyinsurance.com. I also don't think I can get my original script which says cpap and take it to another DME and have them fill it as apap. Even though I know the billing code is the same and apap is still a cpap. Correct me if I'm wrong on this. Maybe I should call some local DMEs and ask them that question. Then I wonder what my insurance will do. I am still in the rental period.

Melissa,
No matter what you do with it... you still should be allowed to get your script. Just ask for it.

I certainly don't see any reason to suspect your doctor is commiting a felony and haven't seen any reason to suspect so in any of your other posts, so that seems a rather funny road to be going down. Without some pretty hefty proof I would be really leery of even broaching a subject like that - you are talking about serious jail time and ruining peoples lives even hinting at such allegations.

I wouldn't expect the doctor to know all about the different coverage needs for the different machines. It's kind of unfair to expect her to. Check with the person when she comes back. It sounds like that is her job - to deal with the various companies and equipment. Certainly, going so far as to accuse people of having some sinister conspiricy just to get people back into the office is rather ridiculous as well. I've never understood why people think the doctors are supposed to be experts in all the various machines and all the various insurance companies and all the various policies and all the various requirements. That's a pretty far fetched thing to expect. Myself, I'd rather them just focus on medicine thank you very much!

It's great to hear that your doctor is so open to trying all these different things you are interested in. It seems so many people here post about the doctors not being willing to discuss options it's great when you see someone posting about one who is so flexible.

I also have the problem with the pressure in my ears. I wouldn't expect anything to change that. It's going to be a side effect of cramming all this air directly into our nasal passages! I think switching to a machine with cflex would certainly help alleviate the aerophagia problems.

Certainly an autopap would not really be very applicible to your situation. Most people here have found that insurance companies will cover an auto unit for people who are experiencing significant aerophagia. I would hope that none of us here would want to be suggesting insurance fraud just to get a fancier machine! I think we are all above that sort of thing!

"GUEST"

I don't see anywhere in my postings, where I stated that I would be accusing anyone of anything illegal. I was merely stating that here as a form of thinking out loud. Which I thought was appropriate in this forum. If we couldn't vent here, that we might get ourselves in some trouble in the real world.

I didn't expect my MD to understand what my insurance covers and doesn't, but I do and if I'm the one paying my premium and are aware of what they will cover, then she has no business telling me she can't write a script because of that reason.

Telling me that apap is not applicable in my situation is not for you to decide. There are many other factors to consider, other than my lack of severe aerophagia. I want to participate in the management of my therapy and having an apap with available data allows that to happen. Am I supposed to stay on # 10 forever? People change, pressures need to change. And I don't have the desire or time to keep going back to the lab for titration studies. That, my friend, in my opinion is a way they keep you coming back. Again, this is my opinion, which I am entitled to. If apap didn't help people succeed in these areas, then they wouldn't of invented one. And who suggested insurance fraud? No one that I could tell. Not like we are asking for something we don't need. I'm not someone who doesn't have OSA and is looking for a machine. But its my $$, my insurance and as long as there is no medical contraindication for me not having apap, why the heck not?

When you're brave enough to sign in under your real name and not "guest", get back to me.

YES MELISSA !!!!!!!!!! YOU GO GIRL!!!!!

Brenda

...and furthermore, an APAP can be setup to work as a straight CPAP.

The doctor can explain why it shouldn't be used on automatic, if she thinks it shouldn't, and the patient can decide trust the doctor and run it on CPAP, but doctors can have no medical grounds for refusing the APAP as an option.

People come out of doctors offices with many chemical that if not used according to instructions will do them grave harm. An APAP, used in auto mode is less dagerous than an overdose of many run of the mill medications, or insulin.

And it bears repeating that you don't need "automatic" on your script to get an automatic machine from cpap.com.

O.

You tell that guest!!!! Way to go.

I want to participate in the management of my therapy and having an apap with available data allows that to happen. Am I supposed to stay on # 10 forever? People change, pressures need to change. And I don't have the desire or time to keep going back to the lab for titration studies.

Hi Melissa, I totally agree with you. I am a RN and went through similar detours until I got what I want. I spoke with the office manager at my sleep doctors office and they got me the prescription I wanted with the Doctor.
I have always believed that we have the right to direct our own care. It is every patient's right to question any part of their treatment and make informed decisions. When a patient takes charge of their therapy you ususally see much better results because they are compliant.
You also have the expertise as a registered professional nurse to monitor your own therapy in a clinical manner. I would stress that with Nancy in an assertive, firm manner.
Unfortunately, too many times things get screwed up because someone doesn't care, or they are incompetent. I do believe you will get what you want if you remain consistent.
Seena

NyNurse33 wrote:I don't see anywhere in my postings, where I stated that I would be accusing anyone of anything illegal. I was merely stating that here as a form of thinking out loud.

I was also just making a general statement, rather than specifically directing something to a specific person and crying 'Slander!'. However, what prompted that were quotes like this:

"they have a vested interest in the DME!!! "
"I would get out of that sleep center monopoly"
"They want me to keep coming in to get titrated"
" definitely some affiliation going on."
"She needs someone to make her Mercedes payment."

We all know what an insanely litigious society we live in now. It's a sad commentary but statements like those above can wind up getting used against excellent and poor doctors alike. Most of the things either directly referenced or alluded to in those quotes are felonies and even the accusation of such can and does completely ruin peoples lives. That's all I was commenting on. I wasn't accusing anyone of anything, just pointing it out.

NyNurse33 wrote:Telling me that apap is not applicable in my situation is not for you to decide. There are many other factors to consider, other than my lack of severe aerophagia.

You are damn right it isn't for me to decide! I was only putting forth an opinion, just like you! Really. It's all good.
And honestly, what I basing my opinion on are these statements you made:
"its not like my current machine isn't working @ all. I want what I want."
"Of course there is truth in what I'm telling her, except the fact I have only had occasional aerophagia "

I know we all want the best that money can buy, but at what point do we have to take responsibility for these never ending increases in costs and start accepting what solves the problem without all the bells and whistles? A data card that can be taken every couple of months to a provider to be read will accomplish everything that is needed - helping to tweak pressures should things chage. And honestly - how many of us are on the same pressures we were 6 months ago? I bet most of us are. How about a year? I bet most of us are within a couple points. Sure there will be people who are on a significantly different pressure. I bet a lotta them post here too. But I'd be willing to bet the majority of us are on the same pressure.

NyNurse33 wrote:Again, this is my opinion, which I am entitled to.

You are damn right you are. I don't think I came across as implying you weren't, but if I did I honestly apologize - it weren't intended.

NyNurse33 wrote:But its my $$, my insurance and as long as there is no medical contraindication for me not having apap, why the heck not?

This is what I was getting at above, but in a nutshell my response would be:
If there is a cheaper alternative that does essentially the same thing - why not?

NyNurse33 wrote:When you're brave enough to sign in under your real name and not "guest", get back to me.

"Bravery" has nothing to do with it, and I would hope it doesn't for anyone else. It's just a name. Who really cares? I could log in as Bill Clinton and none of you would know the difference. I could log in as Rested Gal and realistically you'd have to admit that you wounln't know the difference unless I made dramatic spelling/grammer errors or started badmouthing folks. I just honestly don't see the big deal behind names. I'm not doing it to hide or cause trouble - really. Again it's all good!

I thought we had seen the end of "Guest" postings on this board. I know that I don't have to read these threads, but I have never read one and not learned something new. I'm really tired of reading mean-spirited posts in reply to normal every-day postings. I think if people want to argue with someone, they should start a blog of their own, and be done with it. I, for one, am looking for support and friendship on this board, and I would dare to think others feel the same way.

Guest, get a life! And maybe an antidepressant...

Missy wrote:I'm really tired of reading mean-spirited posts in reply to normal every-day postings.

I apologized in my previous post if I came across as implying that others weren't entitled to an opinion and I'll do it again! I'm really genuinely sorry if I came across that way. I didn't think I did but apparently I was mistaken!

Missy wrote:I, for one, am looking for support and friendship on this board, and I would dare to think others feel the same way.

Myself as well. I am!

Melissa-
Vitriol aside, in answer to your questions:

Yes you can get your script and take it to another DME. Its your RIGHT by law.

Yes, another DME will be glad to fill whatever script you bring them for durable medical equipment. They may NOT provide an APAP for financial reasons that have been well discussed here. However, they would HAVE to if you doctor (one of them) ordered an APAP or an "auto-titrating" machine on the script. If you pay out of pocket, they'll give you whatever CPAP/APAP that you are willing to pay for.

Billmyinsurance is VERY conservative because of the hassle factor of dealing with strange insurance carriers from around the nation, instead of the carriers in Texas only, with whom they have relationships and/or contracts.

Your insurance carrier probably will be reluctant to allow you to switch DMEs because they will have already paid set-up and rental fees to them,, and they won't want to pay that again. I don't know whether you'll prevail with them, but BE STEADFAST! Its your health, fer chrissakes!

Chuck

Anonymous wrote: This is what I was getting at above, but in a nutshell my response would be:
If there is a cheaper alternative that does essentially the same thing - why not?

Cheaper for whom? DME? Do you work for one?. And if you think my model of cpap does "essentially" the same thing as an apap with Data I can download, then you are sadly mistaken and uneducated.

I will not continue this, for the simple fact that I am not a negative person by nature, and will not allow you to make me into one. But thanks for your accusations, negative remarks, and other comments that you must pull out of your ---. It reminds me of the person, I don't want to ever become. To all the rest of you out there, who are going through the trials and errors of cpap therapy....we only get stronger, smarter, and healthier. And each day since I have found this outlet, I am forever grateful!!

Guest wrote: A data card that can be taken every couple of months to a provider to be read will accomplish everything that is needed - helping to tweak pressures should things chage

You could login as "Provider".


O.