Newbie DME questions

I was recently diagnosed with severe sleep apnea (AHI 35 and 39 over two nights) by an at home sleep study test (man it was tough to actually sleep with that thing, but that's a different story). I got the call from the DME, but haven't had a chance to call back yet, likely to schedule the in-home visit with equipment and whatnot (at least that's how my doctor explained it would be). I've done a fair amount of reading on this site, and others, and it's a ton of information to absorb and very overwhelming to process it all while dealing with the change, but I'm doing my best. My first question is whether anyone has any experience with Dynamic Healthcare Services out of Hackensack, NJ (or I think their parent company out of Harrisburg, PA)? Second, what is most important to know about dealing with the DME's to make sure I get the best/proper equipment when they're here? I've read a fair amount about DME's taking advantage or just giving you what's best for them, not the patient, and don't want to end up stuck with something I'll find out I don't like in few months. I'm sure after a while I'll ask my doctor for a written prescription so I can use the online retailers and do my own research, but in the meantime I'll have to live with what they give me.

Any advice? Thanks in advance.

You may have already seen this but just in case you haven't.

https://maskarrayed.wordpress.com/what- ... me-part-i/

and this one

http://adventures-in-hosehead-land.blog ... -with.html

You are under no obligation to get anything from the DME that contacted you if you don't want to. Check with your insurance company to see who else in your area they have a contract with.
You are under no obligation to accept a machine that isn't what you want. You can refuse and take your business elsewhere.

Know your machine models...and if they bring you one that you don't want make them take it back.

Some DMEs will dispense full data top of the line machines right from the start but some will give you the cheapest they can get by with because insurance pays the same for either a full data apap/cpap or the no data brick cpap.
Call them up and ask "what machine do you usually dispense". They should be able to tell you.

xxyzx wrote:if you had trouble with an in home test wait till you get a cpap strapped on

you got lucky
most make you waste money on a titration before they prescribe a device and tell you the settings

DMEs only care about compliance so they can charge medicrap or your insurance
you have to look out for you

get a machine with full data you can access via the SD card
and that reports automatically via cell phone so you dont have to take the card to them every month

try to get one that is auto not fixed
the more options the better so you can adjust it to work with you better
heated hose, ramp, humidifier, yada yada
read the links noted below

make sure you try several masks and get one that fits right and works right before you accept it

you need to get your Rx now first before anybody gives you anything

my sleep lab sent the Rx to a DME and i got screwed
do not set up any appointments until you get your results and the Rx in your hand

read the info at the top of this web site
7 links
2 3 and 6 are most useful
read the info there
drill down to read it all

Do you really think a newbie will get anything out of this stream-of-unconsciousness, no-caps, no-punctuation, ridiculous-paragraphing, shorthand dribble?

Compujas, I hope you skipped right over to Pugsy's post. She is taking care of you.

The post wasn't that bad. I've read enough about these things that I was able to parse most of it. The sleep test equipment was tough to sleep with mostly because there were so many wires that I was getting tangled up in, plus the pulse-ox on my finger, and the nose piece was kind of sharp so it was stabbing the underside of my nose, and it would occasionally move out of position and the thing would start yelling at me. Then there's the anxiety of making sure I'm doing it right and knowing that I need to fall asleep, so of course I can't fall asleep.

As for Pugsy's post, I did read the first link previously, which is what caused me to ask (also I couldn't find that page again). The second one I had never seen though, so thank you for that. Any suggestions on some of the suggested models to look for? Or should I just take the key features (like open settings, full data, heated hose, humidifier, etc.) and request them? I've seen a lot of people seem to have the ResMed 10? From what my doctor (who by the way is my general physician, not a specialty sleep doc) told me, he was putting in paperwork for an APAP and then the DME would come to the house and bring everything to get me setup. Unfortunately when they called the entire message was "This is so-and-so. Please call me back at this phone number." No mention of what the steps are, or what needs to be done, just "call us back".

The hard part that I can see is that they'll be coming out to my house (I'm assuming) which makes it a little more difficult to just walk away if I'm not happy like I could at a store.

It seems like what I should start with is calling my insurance company and asking what the coverage is, how it works, and who they work with. I know I have out of network coverage also, so I could probably get (less) reimbursement for the internet retailers.

With so much information to learn about so many different machines and accessories, it must take years, how does anyone end up getting set up properly straight out of the gate?

Call the DME up and ask what brand they usually dispense.
That will get you started on knowing which model will do what you want.
Since your doctor is going to specify APAP (that's where the pressure will auto adjust and make it easier to find your optimal pressure since you probably aren't going to have an in lab titration sleep test where they attempt to find the optimal setting) most of the apaps are full data.
Unfortunately ResMed has released an el cheapo model apap that is a brick...it's the AirStart model line.
So don't confuse it with the AirSense model line.

2 most commonly dispensed brands...ResMed and Respironics.

Since the doctor will specify the model as APAP the DME has to fulfilled the RX as written...can't give you a machine that doesn't have apap mode available.
APAPs are nothing more than cpaps with an additional auto adjusting mode...they have both fixed cpap and auto adjusting modes available..2 machines in one.

ResMed....the AirSense 10 AutoSet or the AirSense 10 AutoSet for Her....both will do what you want and are full data.
Respironics...the DreamStation Auto CPAP is their model that has both modes and full data.

There are a couple of other brands but chances are the brand dispensed will be either ResMed or Respironics.
Most DMEs will dispense a brand that they currently have the best contract price with. I have been on CPAP for 8 years now and when I first started my DME was selling ResMed brand...then they got a better price and changed to Respironics and then a year or so ago I was in there and saw ResMed again.
I just laughed and said "got a better wholesale price, huh?" and he just laughed and said that's how it works.
Now any DME can order any brand or model...if they would just do it but if they do that it's a special order and it usually costs them more...cuts into that profit margin so a lot of DMEs will tell you they can't or won't or the one I love is "your insurance will only pay for this brand" which is nothing but a blatant out right like. Insurance companies could care less about brands or models for that matter. They pay by HCPCS billing code alone...not features and not brands.

compujas wrote:I've read enough about these things that I was able to parse most of it.

Now we know that your IQ is much higher than average and you are not SO sleep deprived.

What is a DME?

Cowboyup wrote:What is a DME?

Hi Cowboyup

A DME is a Durable Medical Equipment provider i.e. the people who are going to fill the doctors prescription for a xpap device, and the supplies you might need.

-Bill

Cowboyup wrote:What is a DME?

It's a shortened form of DME Supplier or Durable Medical Equipment Supplier.

The Medicare and Medicaid definition is:

The term "durable medical equipment" - DME - includes, but is not limited to, wheelchairs (manual and electric), hospital beds, traction equipment, canes, crutches, walkers, kidney machines, ventilators, oxygen, monitors, pressure mattresses, lifts, nebulizers, bili blankets and bili lights.

DME Suppliers provide CPAP machines and related equipment.

wm_hess wrote:

Cowboyup wrote:What is a DME?

Hi Cowboyup

A DME is a Durable Medical Equipment provider i.e. the people who are going to fill the doctors prescription for a xpap device, and the supplies you might need.

-Bill

Thank you Bill! Appreciate the information.

ChicagoGranny wrote:

Cowboyup wrote:What is a DME?

It's a shortened form of DME Supplier or Durable Medical Equipment Supplier.

The Medicare and Medicaid definition is:

The term "durable medical equipment" - DME - includes, but is not limited to, wheelchairs (manual and electric), hospital beds, traction equipment, canes, crutches, walkers, kidney machines, ventilators, oxygen, monitors, pressure mattresses, lifts, nebulizers, bili blankets and bili lights.

DME Suppliers provide CPAP machines and related equipment.

Thank you ChicagoGranny!

I appreciate the info! Always wondered what that meant!

Cowboyup wrote:Always wondered what that meant!

I know the feeling.

So I finally got around to calling the DME back (had a bout of diverticulitis last week so I didn't want to add more to the mix). They said the machine they provide is the Dreamstation, so it looks like that's good (no Air Starts for me). I asked about mask trials and what happens if I find out that I don't like one and they said I can do one exchange within 30 days. Not sure if that's normal, but it sounds reasonable. I suppose if I really still have trouble I can always just get the paper rx from my doc so I can order several online to try instead. It's like test driving a car, it's so tough to figure out what you'll like for long term daily use from just a 5 minute test drive. I guess on the other hand the mask replacement schedule is 3 months, right? So I can get a new one after 3 months.

Next step I'm told is that I'll hear from the scheduler who I guess will schedule an appointment to have someone come to the house for fittings. Any tips for picking masks? I know I should try them on and lay in bed how I would sleep to make sure it fits and stays in place. Any particular things to look for or areas to focus on for fit/comfort?

I should probably also remember to ask them about cost and whether it's a rental or purchase and how getting equipment refills works.

I should probably also remember to ask them about cost and whether it's a rental or purchase

Don't ask your DME! Call your insurance company and ask:
Purchase or rental?
Rental period?
Out of pocket costs.

NEVER, never, never, ever, ever, ever trust the DME. Know the facts before they lie to your face.

Janknitz wrote:

I should probably also remember to ask them about cost and whether it's a rental or purchase

Don't ask your DME! Call your insurance company and ask:
Purchase or rental?
Rental period?
Out of pocket costs.

NEVER, never, never, ever, ever, ever trust the DME. Know the facts before they lie to your face.

I did ask my insurance company. They said it could be either a purchase or rental depending on the DME. My out of pocket cost is a co-insurance, so it's 15% of the allowed rate.