Prescription Question

Since my sleep doc won't let return the machine that was prescribed and get one that I want, could I get a prescription from my PCP instead since she is much more open to patient input. Does it matter where the prescription comes from?

Thank you all! If it weren't for you posts, I would have had nothing to go one. This forum is golden!

Angelique

Do you currently have a copy/original of your prescription?

And, which machine do you now have?

Den

AmoRanas wrote:could I get a prescription from my PCP instead since she is much more open to patient input. Does it matter where the prescription comes from?

Angelique, yes, an Rx from your Primary Care Physician would be a legal prescription for any type of xpap machine. Doesn't matter at all where the Rx comes from as long as it's signed by a licensed MD. Doesn't have to be from a "sleep doctor."

Den's question, "Do you currently have a copy/original of your prescription?" is a good question. Because if your current prescription has the word "cpap" on it, and you want to buy an autopap from an online store like cpap.com, your "cpap" prescription will let you do that. No need for a new prescription. No need for a range of pressures to be stated. Just a copy of your prescription stating "cpap" will do to buy an autopap online....if an autopap is what you want.

If you want a bipap or the bipap auto, however, the prescription needs to state "bipap" (or bi-level.) For just a bipap, the IPAP/EPAP pressures need to be on the Rx. For the bipap auto, just the word "bipap" (or bi-level) is needed, as I understand it. I might be wrong about that.

oops

oops again

[quote="RosemaryB"]It's when you are getting the machine through your insurance that it gets tricky. I'm finding that out. I'm wrangling with my "in network" DME right now. They didn't want to give me an autopap. So they became fussy about the diagnostic code. Apparently there's an old one and a new one, so they called the doctor's office insisting on the new one and at the same time told the woman who runs the office there to tell the doctor not to use the word "auto" but to delete that and just put CPAP. I think she just used this as a pretext.

If you want an autopap from your DME, you will need to have the pressure range right on the prescription. Along with the new diagnostic code. Along with the exact machine you want from them. (although they may call the doctor and tell him to scratch that part out). So far they haven't mentioned my first born child, but then I still haven't gotten the machine from them so you never know. . .

If you are buyin it directly with cpap.com, it will be considerably easier.

(I have no connection with cpap.com)

Sorry about the triple post. I'm still dealing with untreated sleep apnea so kept hitting the wrong button . I do things like that all the time, but usually there's a way to delete posts.

One question I have for the original poster. You say your doc won't let you return the machine you have... I don't think that is any of his business if you return it. If it is a rental then it is very easy. Take it back and say I don't want it.

Double check your insurance benefits and see if it really makes all that much difference to go through insurance after copay and deductable etc.

Hi Snoregirl

I've spoken to the doctor about my issues with the plain cpap (remstar m series) with exhalation, but was told that I 'shouldn't have a problem with a pressure of 6. She said she would send in a prescription for a different mask though. Which she still hasn't done, it's been a week, plus I sent a fax requesting the machine I wanted remstar with c-flex with three brief descriptions of the product, how it works and why it's a good choice. No response.

When I call the DME they said that the machine is being rented, but the humidifier, mask and hose was sold to me therefore I couldn't return it without a new prescription from the doctor stating that I need a different machine and that I would have to pay for any upgrades. I have a $1000.00 benefit and from what I've gathered from my insurance they don't care what I get, they are only going to pay the $1000.00. Anything over that I pay. So I was overcharged for the machine and accessories that any changes will be my responsiblity.

It's amazing that the insurance company didn't care that 'we' are getting ripped off and that this company the only provider I can go to. So I got the address to send a complaint to about this DME.

When I called the DME about returning the machine they said I couldn't because is a medical device that couldn't be resold to anyone else. I feel like I am being completely lied to by them and just want to drop the whole thing off on their desk, but I want to make sure that my insurance is credited so I can try to go elsewhere. I'll probably end up sending the DME a complaint as well as the insurance company, my benefits department (work for the state so hoping to give the DME a heart attack) and the better business bureau.

Is there anything else I can do?

Thank you all for your input on this. I'm sure it's nothing new to most on the board.