Venting

My very first post (I'm never awake long enough). I've had severe sleep apnea for years and my wife finally nagged me enough to go to the doctor. I went to the doc, he sent me to a sleep study where they awakened me half way through and put a CPAP machine on me. After using it ONE time, I wanted the machine right then. It was amazing. I felt great all day, didn't want to take a nap once which NEVER happens. The next week I called to have my follow up appointment moved up by 2 weeks because I didn't want to wait. The doc comes in and says "You have severe sleep apnea but the CPAP machine is able to correct it 100%". My gut reaction was to say, thanks for stating the obvious but I was polite and just asked for the machine or the prescription for the machine or whatever I need to do to get that baby plugged in. But NOOOOOOO - they notify a company that has the machines and they work with my insurance company. "If you don't hear from them by Friday call me" is what the doc told me so that means I already expect them to mess this up. So this rant is twofold. A - Why couldn't you just look at those results and tell me over the phone what the diagnosis is and how it can be corrected? Does an office visit generate that much revenue? AND 2 - Why do I have to wait to get this thing? It ammounts to making me suffer (that's really not overstating it). They know what the problem is, they know how to correct it, and I have to wait days to get the machine?

No need to point out the obvious like I coulda done this years ago so I have no one to blame but myself. I have read a good deal on this board and thank all who have contributed. My only question is how long does it typically take to get the prescribed unit delivered to the house? Say they do call on Friday (which I suspect they will not), is it something that gets delivered that day or in a week or what? I was under the impression that I would pick it up at the doctor's office but he told me they come out to the house, show you how to hook it up, etc. Appreciate any insight you may have!

My doc told me to wait for DME to call me to set it up. I ended up getting call that day and came into the DME the next day and took my equipment home that day. I guess it really depends on how long and what DME you are working with.

It took me about three weeks until I picked up the Rx at the Dr's office. Then I went straight to the DME and they came right out and set up the CPAP and showed me how to use it and the mask.

I started with a nasal mask (I think it is a comfort light-goes in the nostrils) which made my nose very sore. I went in and ask for another mask. They sent out an RT who fitted me with one that goes over the nose. From there on the results have been amazing.

Good luck to you. It will get better.

Ted in Texas

Hiya scherebh! Welcome to the forum.

A couple of things I'll comment on.

Typically you will find most DME providers will be able to set you up within 24-48 hours of receiving the information required by your insurance company. This is a crucial point. I work for a DME provider and I can't tell you the number of times we recieve either incomplete prescriptions (Such as CPAP but no pressure) or a prescription without any sleep study. Most of the orders come in complete but about 25% don't. So this can really delay things.

You can always ask them who they have sent the prescription to, and then call that company to check.

I have to say one thing, but only because I'm a hopeless optimist. Don't go into this expecting things to go wrong!! All too often we find exactly what we go looking for. If you go into a situation expecting it to be all screwed up I can almost guarantee you that's what you will find. I fully admit though that like I said, I'm a huge freakin optimist and it's just a big deal with me.

For most DME companies I am familiar with, they will be able to deliver the equipment to your home. Or, if you would prefer most will also be able to have you come by thier store and get setup there. I like that option since there will often be more of a selection of different masks and sizes you can try on.

Good Luck with this and welcome to the club! Please feel free to ask any questions you want and you are also welcome to send me a message if you need to.

mattman

I had 2 sleep studies in about a 8 day spa and had my equipment in 2 or 3 days later.If they don't call as promised do make a call to them immediately.It can be a bit of a struggle with the therapy once underway,but so worth it.Good luck !!!!!

Most of my patients are setup with CPAP the day they leave their CPAP titration study. It can be done. The major hang up is insurance companies requiring precertification. Sometimes that can take up to two weeks.

My question is: Weren't you given a CHOICE of DME's with which to do business? I know that some sleep labs may have their own 'supplier', but you have the right to pick whichever one you want. Check with your insurance company for a list of DME's that they work with, and try to get some feedback from them also.

I've never had a RT come to my home; I always went to their place of business. The better ones have a private room, stocked with most available equipment. You 'may' get to see a more complete line of masks that way, as they have to pack quite an assortment. Try on as many masks as you can!

I agree with previous poster, don't "expect" problems, but with education on your side, expect the best service you can get, and don't settle for less.

Good luck, and continued success. A good rapport with your DME/RT is worth a lot, so let them know of your awareness of certain things, and your willingness for them to teach you the rest.

Good to hear from you Offerocker! I was gonna start a post to see where you were! I looked foward to your posts everyday!

Brenda

Thanks to all of you!!!!! First (dumb) question - what's a DME? I assume that's the supplier of the equipment but I looked at FAQ's and Wisdom and couldn't find the acronym anywhere.

The doc didn't offer me a choice of DME's, just that one would be calling. For those who replied they were called quickly - I hope that's the case with me too! The people who did the sleep study showed me a couple different choices with respect to the mask. I used the nose pillow ones because they were lighter in combination with a chin strap to keep my mouth closed. It probably took 30 minutes for me to fall asleep (15 seconds is the norm, no exageration) but once I did I was comfortable and slept like a baby.

As for not expecting things to go wrong, I've reverted to the "Three Times Rule", which I invented anytime I deal with the DMV. You go the first time and don't bring something no one told you you had to bring, you go the 2nd time and the computers are down, you go the 3rd time and get what you need. When I get myself in this frame of mind my stress level definitely decreases. I just need to think - "Don't worry. It hasn't been 3 times yet!"

Appreciate all you help here - this is a great place to learn. I've become a CPAP evangalist since my sleep study.

Durable Medical Equipment

I hate the insurance companies. I have the worst insurance ever. $5000 deductable for durable medical equipment and then they cover 70% of the next $2500 and that is it!

So one less thing I have to worry about! I am just going to pay for it out of my own pocket anyway so I am not even going to deal with the insurance.

[quote="scherebh"]

1) - Why couldn't you just look at those results and tell me over the phone what the diagnosis is and how it can be corrected? Does an office visit generate that much revenue?

2 - Why do I have to wait to get this thing? It ammounts to making me suffer (that's really not overstating it).


My only question is how long does it typically take to get the prescribed unit delivered to the house?

Scherebh,

Maybe you know this by now but I thought it needed to be said based on your second post of this thread.

The doctor doesn't determine where you get your equipment, you do. The insurance company only has a say in it if you choose to received benefits from them.

SO, your doc MUST (in the US) give you your prescription and copies of your sleep studies if you ask.

Even if you do decide to keep what you now have from the DME where the doc faxed your information, go back to the doc's office and get that paperwork for your file.

You may want another machine down the road that either insurance won't pay for or it may be cheaper to buy cash. Then you have the paperwork to do so.

Or, in case you didn't do the math (and I didn't do a search on all your posts to see if you mentioned your copay and deductable) and it turns out a cash purchase is cheaper for you than what your are paying the DME you will have the paperwork to give them back their machine and purchase the machine of your choice online.

It is your health issue and your insurance and your money. Do as YOU will.

Dr. B,

Yes, very much so - especially the last two paragraphs. I guess my frustration is that the sleep study technician reviewed the results with me and could show me when I stopped breathing, when my leg kicked to get me started breathing again, etc. It was very easy to see and understand. She then showed me the results after the cpap and it was essentially a flat line. As I said, the doc came in and said "You have severe sleep apnea but the cpap machine corrected it 100%". That alone said it all and I feel could certainly have been said over the phone. Drive time, time waiting to get to see the doc, drive time back - probably 40 minutes. Time in the presence of the doctor - 4 minutes TOPS. I was able to tell him how great I felt after the machine and how disappointed I was that I wasn't leaving with one. Seems to me that if he had those results, he could have called the prescription in well before I came into the office and I could be getting used to it instead of still waiting.

I had a similar experience years ago. I was given an EEG and had to come back to discuss the results. That discussion was essentially "Everything looks good, nothing out of the ordinary", which could have very easily been done over the phone.

I admit I'm cynical when it comes to this stuff (healthcare and money) and think it's great that you schedule phone appointments. I hate going to the doctor not because I'm afraid of them, but because the follow ups never end and it's a huge hassle. I have NEVER been offered a phone appt. and it seems like it would often be best for both parties.

I could write more - you get the idea but if you ever move to Phoenix, I'd be happy to have you as my physician! Thanks again.[/quote]

[quote="snoregirl"]Scherebh,

Maybe you know this by now but I thought it needed to be said based on your second post of this thread.

The doctor doesn't determine where you get your equipment, you do. The insurance company only has a say in it if you choose to received benefits from them.

SO, your doc MUST (in the US) give you your prescription and copies of your sleep studies if you ask.

Even if you do decide to keep what you now have from the DME where the doc faxed your information, go back to the doc's office and get that paperwork for your file.

You may want another machine down the road that either insurance won't pay for or it may be cheaper to buy cash. Then you have the paperwork to do so.

Or, in case you didn't do the math (and I didn't do a search on all your posts to see if you mentioned your copay and deductable) and it turns out a cash purchase is cheaper for you than what your are paying the DME you will have the paperwork to give them back their machine and purchase the machine of your choice online.

It is your health issue and your insurance and your money. Do as YOU will.