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A few more questions:

1) What do the acronymns GERD, LES and PSG stand for?
2) Do Dr's ever prescribe the Smart Card and Software?
3a) Are masks sold the same way machines are (DME gets flat rate)?
3b) If so, would the Swift be a high-profit item (the DME was REALLY pushing it this morning)?

GERD = Acid Reflux Disease
LES = Lower Esophageal Sphincter valve, keeps stomach acid from refluxing back up into the Esophagus. When it is damaged from GERD it can leak allowing CPAP pressure to enter the stomach (called aerophagia) which can be painful.
PSG = Polysomnography (name of your Sleep Study).

SmartCard & Software; no prescription is required, you can purchase it from cpap.com.

Are masks flat-rate like machines? yes, they have bill codes for the various replacement parts, full face masks have different codes than nasal.

I have no idea why they push the Swift, I guess because it takes less time to fit and resolve problems? I really don't know, but if you look at the patients that post here, Swift users are NOT in the majority. You would have to research it, but most report higher AHI scores using that interface so treatment doesn't appear to be any better. Search for Swift and any other interface you are interested in and you should find the good, bad and ugly about it. I think the Swift is a good "summertime" mask.

Hi folks,

I just got back from the titration study and feel great from what would normally be a very short night's sleep. The tech said I slept like a baby for most of the night - can't wait until I can sleep that well at home!

Thanks Matt for the scoop on the Swift. Glad to know puppies aren't doomed when a DME comes down the street!

For my first mask I'll probably go with a FF due to wintertime colds and stuffiness which may negate benefits if I can't breathe through my nose. Maybe I'll pick up a nasal mask in the spring.

And thanks Snoredog for the definitions. I appreciate the patience y'all are showing as I learn the ropes around OSA.

I was wondering about prescription for smart card software in the hopes that insurance would pay for this item. Anyone know this?

What about getting insurance to pay for a battery pack?

Thanks again!

--Andy

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CPAPopedia Keywords Contained In This Post (Click For Definition): swift, Titration, DME, Prescription, Smart Card

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CPAPopedia Keywords Contained In This Post (Click For Definition): swift, Titration, DME, Prescription, Smart Card

ColoZZZ wrote:I was wondering about prescription for smart card software in the hopes that insurance would pay for this item. Anyone know this?

What about getting insurance to pay for a battery pack?

It's not unheard of for an insurance to pay for a smart cart/reader but it's very rare. I've only managed 1 case out of several hundred where we got insurance to pay for a battery backup and that was a very serious exception.

Basically, with insurance companies they don't care about comfort or ease of use. What they care about, and therefore the threshold you have to meet, is Medical Neccessity. The second word being the key: neccessity.
They look at it in the same way I couched my first answer to you (Which is also why I couched it that way).
Do you NEED a card reader/software? Is is Medically Neccessary?
Well, not really. Statistically, most patients don't have a statistically relevant variance in pressure needs over a statistically relevant period of time. Yes that's an obnoxious statement but this is how insurance companies look at this stuff.
Additionally, for the patients who MAY have changing indicators, you can take a smart card (If you have one) to a DME provider and get it read at no charge.
So, they (The insurance company) has now been able to prove that for the majority of cases there is no BENEFIT to authorizing the money for a smart card/software. It's stupid, but that's how THEY are looking at it and what WE have to overcome to try and get it covered.

It's even worse for a battery backup. Honestly, the response from payors is usually just something along the lines of "Go somewhere where there is power".

mattman

Heh, forgot to sign in again. Blargh.

Just a comment on your asking if a swift is a high-profit item.

Without being involved in a DME, one has no way to know what incentives are given to any one DME to push a particular product.

If a company can sell you on their mask or equipment they are likely to get a repeat customer. Called increasing market share. Sometimes it is beneficial to sell at lower cost to increase market share for later profit.

I am quite sure that is why drug reps visit doctors and leave samples. How can it be different for CPAP manufacturers?

That being said, I am sure which items are high profit most likely depends on the particular dme and their business relationship (and sales volume) with certain manufacturers.

I not bashing Swift masks (I use one), but just logically looking at how the business game may well be played.

The only time one truly knows what is a high profit item is, is when they are pushing hard the low end of any line. Resprionics Plus is a good example vs. giving the Pro2 (or m series pro).

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