"Sleep Doctor" doesn't like autopaps

cpaplady · Post by **cpaplady** » Mon Feb 21, 2005 10:48 am

You know if your provider does not offer you a complete choice of products and inquire about your lifestyle then they are not interested in your well being. Not all DME's are out there to rape the public. Not all docs are interested enough in the treatment end to even research and find what is best for their patients, Make sure you educate yourself and insist on the best. All patients are suppose to be given a choice in their treatment. Sometimes it involves insisting on the best!

As for autopaps many in the medical community believe it is the wave of the future. We tend to put most every patient with a pressure above 12 onto auto for compliance purposes. We also do a one to one and a half hour educational session with each aptient at the time of set-up so that they know the choices available to them.

Also keep in mind most all insurances pay for the auotpap as a regular cpap, therefore there is no need for additional documentation. you just have to make your DME company aware that you know this and request it. It is still a cpap and they can not refuse your request for a particular model.

cpaplady (DME provider too!)

chrisp · Post by **chrisp** » Mon Feb 21, 2005 12:53 pm

Hello cpaplady,
Does this mean we should add you to the Good DME side. LOL..

The point many have made is this. We were never told about auto paps and were never given a choice. We were shown a few cpaps but they were all plain janes . Many were relics that you see on ebay.

So if you offer a auto to all your patients without them asking and you sell it at a fair price then you are a good DME. If not, well a lie of omission is still a lie. Then Go to the evil DME side.

Cheers,

Chris

chrisp · Post by **chrisp** » Mon Feb 21, 2005 12:56 pm

GTOJim · Post by **GTOJim** » Mon Feb 21, 2005 1:12 pm

The DME did not offer any choices for my machine or mask. The only CPAP I was shown was the one I was given, same goes for my mask.

They fitted me for a mask that was too large that kept leaking, and when I went to a full facemask I was fitted with a mask that was to small. They wouldn’t return any of my phone calls when I called and left phone messages about having problems with either mask.

I had to contact my medical group to get a call back from the DME.

This whole experience hasn’t been pleasant, but I’m finally getting good nights sleep with my new Auto C-Flex.

It’s easy to understand why a lot of people are not compliant.

SleepyGuy · Post by **SleepyGuy** » Mon Feb 21, 2005 4:01 pm

AutoPAPs absolutely do not wait for an apnea before adjusting. I'm still having trouble sleeping the entire night, but this morning my AutoPAP showed I had slept for 2:40 hours. My HI was 0.3 and my AI was ZERO. In Over 2-1/2 hours, I had had a total of ONE hypopnea and no apneas! The machine had adjusted itself up to 8.8. The limit is set for 9.0.

JudyAnn · Post by **JudyAnn** » Tue Feb 22, 2005 8:44 am

Hey Sleep Guy,

What brand of auto pap do you have? I have the RedMed Auto respond and I cannot see how I am doing. As soon as I get extra $$, I am having my doc write me a prescription for one that I can get the software for to at least see how I do during the night.

It makes me angry that we are not given these machines from the get go with the software to at least see how we are doing so that if we are not doing well, we can call the doctor/therapist so they can eventually get paid for adjusting our machines. The bottom line is the $$ when it comes to why they don't want us to be so aware of what is going on with our own bodies.

Thanks,
Judy

Liam1965 · Post by **Liam1965** » Tue Feb 22, 2005 9:34 am

Hey, someone pointed out to me that Yahoo auctions have had several Remstar Auto's for sale recently. They appear to pre-date CFLEX, which kinda sucks, but they're not terribly expensive and, being used, probably won't require the pain of getting a copy of your prescription.

There's one on there now that's running about $260 right now.

Liam, all over that one of these days.

wading thru the muck! · Post by **wading thru the muck!** » Tue Feb 22, 2005 10:01 am

Liam,

It looks like this seller has sold 5 other REMstar autos (without c-flex) in the recent past for between $195 and $220. My guess is these are rebuilt models. It says 65hrs on the blower and not 65hrs on the machine. This is the kind of tricky language that the online auctions are famous for. You can always ask him the question though. I wouldn't necessarily feel you have to jump on this one. Seems he sells a lot of them.

Janelle · Post by **Janelle** » Tue Feb 22, 2005 10:25 am

I guess I am very, very lucky to have one of the more progressive Sleep Drs. He actually prescribed an APAP from the get go, and I was only titrated at 8/9. My readouts on the APAPs have shown ranges between 5 and 11, with an average of 9. But it seems these averages are getting lower and lower the more I am on CPAP. I don't know why this is except maybe my body is healing itself and some of the central apneas are decreasing or perhaps my soft palate is becoming firmer and not falling so much. I am also one of those rarities that has more apneas on my side than on my back, possibly from my deviated septum.

What I do not understand when I find someone who has just started xPAP therapy is that they are always on straight CPAP, not even BiPAP at high levels like 18. When I ask why or suggest a different machine, like one with CFLex they say the insurance wouldn't pay for one and their co-pay would've been higher. Now if the allowable is the same regardless of machine, shouldn't the billing by the DME for the co-pay, also be the same? Perhaps another DME ripoff, Sorry good guys, but could you explain how this is billed.

Since the code is the same to the insurance, wouldn't the allowable and the amount the insured would be liable for be the same regardless of the type of machine. Yes, I can see you wouldn't get as large a profit, but it really shouldn't cost the consumer more, should it? You are still under a contracted price, and that should be passed on to the insured.

Mikesus · Post by **Mikesus** » Tue Feb 22, 2005 10:34 am

If the allowable is the same, then it would cost more. But instead of stating that, most dme's lie and say that it isn't covered at all. THERE IS NO SEPERATE CODE FOR AUTO!! Your insurance will only cover up to the MAXIMUM ALLOWABLE CHARGE for that billing code, REGARDLESS of the type (cpap, cpap w/cflex, auto, auto w/cflex). It would be NICE if the DME's would be honest about this instead of lying...

firemarshal · Post by **firemarshal** » Tue Feb 22, 2005 11:24 am

As most have said get as much knowledge about what ever you have been diagnosed with. My wife actually was able to prove a doctor wrong. After figuring out I had OSA I read as much as I could, posts and net. After my sleep study I researched machines and went to the DME and told them what I wanted, and they agreed! It is your life find as much out as you can and discuss with your doctor, they may get mad and they may listen and do the right thing.

Nenetx2004 · Post by **Nenetx2004** » Tue Feb 22, 2005 3:39 pm

Okay, I just posted the "Pray to the Autopap Gods" topic.....what arguments should I use if my doc won't write the order? I mean, I just have a measly Bachelor's degree as opposed to his years and years and years and years of education........

Jeanne

wading thru the muck! · Post by **wading thru the muck!** » Tue Feb 22, 2005 4:00 pm

Jeanne,

chrisp told you what to do! Follow his expert advice.

Guest · Post by **Guest** » Tue Feb 22, 2005 4:49 pm

Nenetx2004 wrote:Okay, I just posted the "Pray to the Autopap Gods" topic.....what arguments should I use if my doc won't write the order? I mean, I just have a measly Bachelor's degree as opposed to his years and years and years and years of education........

Jeanne

Also, you might call your insurance company and find out how much the reimbursement is if you pay out of pocket. For me I was going to pay $500 for a bottom end Cpap from Lin(dont)care, but for $200 more, I am have a remstar auto with cflex and the software...

Liam1965 · Post by **Liam1965** » Tue Feb 22, 2005 5:39 pm

Y'know, it's too bad more patients don't know what we all now know (thanks in large part to rested gal, wader and SWS), because really, going to a sleep doctor who doesn't like autopap is kind of like going to an allergist who doesn't like antihistamines.

Liam, who likes antihistamines. They make him a very cheap date.

(And for those who are keeping score, this is officially my 400th post to cpaptalk.com. Which means now I'll be picking confetti out of my 15 strands of hair all night.)

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