I got it!!! DME/Insurance giving me an IntelliPap

I know you want some SLEEP, restful sleep. BUT - once you accept a CPAP less than what you want it can be a real hassle to exchange it for one more acceptable to you AND to do so you MUST do so w/in 30 days or before the DME supplier's first billing cycle after you receive it.

I wouldn't accept that DeVilBiss IntelliPAP - UNLESS it is the IntelliPAP AutoAdjust.

Don't rely on what "they" tell you your insurance will cover. Call your insurance yourself. Ask them what local DME suppliers they are contracted with. Ask them just exactly what your CPAP benefits are. Was it your insurance that told you that they wouldn't cover an APAP unless your AHI was above 15? Or was that the DME supplier? Way too many local DME suppliers are "less than truthful" when it suits their needs. Many is the time I had to take a printout of my Medicare benefits in and rub it in my first local DME supplier's RT's face to get what I needed all the while she's insisting "Medicare doesn't cover this".

Ask your doctor if he/she would write the script for a Resmed S8 Elite II w/EPR. It isn't an APAP - BUT - it IS fully data capable AND a lot of the data is easily available via the LCD screen. And have her write it DAW (dispense as written). And have the script include "Detailed patient menu access turned on".

Or if you prefer have the script written for the Respironics M Series Pro w/C-Flex and again add DAW. The Pro is also "just" a CPAP BUT it IS fully data capable.

Thanks everyone for your input -- and especially for your quick responses.

I sent DME#2 walking -- with his silly little Intellipap that could tell me how many hours I've used the machine. DUH? Can't I figure that out myself?

The RT on the phone who promised me it was data capable lied. I'm guessing that surprises all of you! She claims to have been doing this for years and never heard of a data capable machine that provides the PATIENT with leaks and apneas, etc.

Was it your insurance that told you that they wouldn't cover an APAP unless your AHI was above 15? Or was that the DME supplier?

I am waiting for a return call from my insurance co now. I can't remember who said what -- I think it was the DME.

Ask your doctor if he/she would write the script for a Resmed S8 Elite II w/EPR. It isn't an APAP - BUT - it IS fully data capable AND a lot of the data is easily available via the LCD screen. And have her write it DAW (dispense as written). And have the script include "Detailed patient menu access turned on".

Thanks, Slinky, that sounds do able -- but of course, now I need to find another DME -- I've gone through two of them in a week!

lanndi wrote:Thanks, Slinky, that sounds do able -- but of course, now I need to find another DME -- I've gone through two of them in a week!

Make SURE you tell that to the next one! Call them and lay it on the line. Say you have dealt with 2 DME's who won't give you what you want, tell them what you want and ask them if they can accomodate you. If they need/want the business, they will agree. If not, on to DME #4!

Just to throw them off track, tell them you are not a mushroom, either.

The IntelliPAP autoadjust machine (can't speak for the straight CPAP IntelliPAP but suspect it is similar) comes with a feature called 'smartcode'. If you want the data capable version, it requires an add-on accessory called 'Smartlink'. As supplied by CPAP.com, Smartlink comes in two packages: One package contains the Smartlink module. The other contains the software and the adapters needed to use it on your computer.

If they just give you the IntelliPAP, you can add the Smartlink part yourself. It snaps on the back of the machine. You install the software on ylur computer (Windows XP or Vista required - But you can download WIndows 7 Release Candidate for free.)

If your DME still insists on you sending in the card, it is just a standard SD card. You you can read the data from your machine, copy it on to you computer and look at the data yourself. And still send the card to your DME.

You might be able to get the machine through your DME (The IntelliPAP is a good machone-- I love mine!), and purchase the Smartlink package outright. That way, you can monitor your own therapy. Or, if they supply a machine with the Smartlink module installed, maybe you can get just the software from CPAP.com, etc. and 'hijack' the data as described above.

All machines, AFAIK record hours of usage. You aren't likely to find a decent machine that does not.

Ask your doctor if he/she would write the script for a Resmed S8 Elite II w/EPR. It isn't an APAP - BUT - it IS fully data capable AND a lot of the data is easily available via the LCD screen. And have her write it DAW (dispense as written). And have the script include "Detailed patient menu access turned on".

Slinky -- is this the correct machine? http://www.cpapauction.com/auction-list ... -cpap.html

Ooh. My insurance co is calling DME2 to find out why they didn't give me the machine prescribed!! I'm on hold w/ ins co while she calls them. Stay tuned!

Update 1:
I think I have a good insurance person. She's having her director call DME2 about their claim that they would have to charge me an extra $100 for the machine I want -- which, surprise, surprise, is not accurate! (Of course, this follows conversation that the RT never heard of a machine that would let the patient know what their AI, HI or leak rate! )

INSIST on the APAP, even if you are going to only use it for CPAP. That is the one that is fully data compatible.
That would be Part Number DV54D "Devilbiss IntelliPAP AutoAdjust Travel CPAP Machine.

The heated Humidifier (DV5HH) and Smartlink Software (DV5FP-cpap) also.

Where in MI are you. I have a pretty good sleep Dr at RO Beaumont if you need one (PM me)

Fred

Where in MI are you. I have a pretty good sleep Dr at RO Beaumont if you need one (PM me)

More important (to me right now) is who is your DME???!!!

If autopap is in your prescription, it would seem very important that they give you an autopap. I have an Intellipap auto and like it. It does provide useable data. If they don't want to set it a range of pressures, they can set it in CPAP made at the titrated pressure - it is definitely an option with this machine. That should settle there concerns (except the part about raking in a higher profit margin ). You and your doc can go from there.

I gave up on local DME's, Binson's didn't want me because I used W&F originallly and use cpap.com for mine. As long as your Rx says CPAP you can get any CPAP/APAP from them.

Fred
in Troy

I gave up on local DME's, Binson's didn't want me because I used W&F originallly and use cpap.com for mine. As long as your Rx says CPAP you can get any CPAP/APAP from them.

Fred
in Troy
I gave up on local DME's, Binson's didn't want me because I used W&F originallly and use cpap.com for mine. As long as your Rx says CPAP you can get any CPAP/APAP from them.

Fred
in Troy

Oh, bummer. I was hoping for a clue to a good Detroit-area DME! My insurance won't reimburse for on-line purchases. We'll see what I end up with after insurance co and DME2 finish fighting it out. I've seen a couple of machines on cpap auction that might come in around the same range as what I'd pay out of pocket. (http://www.cpapauction.com/auction-list ... -cpap.html)

I didn't hear back from my insurance co before close of business. Guess I'll have to wait until tomorrow for an update. They'll probably call back while I'm getting pulminary testing to determine if I have asthma. Maybe I can hi-jack a doctor to write out yet another Rx!

Yep, that Resmed S8 Elite II w/EPA in the link you gave me is a darn good fully data capable CPAP!!! That's the one I suggested. But note, that the auction does NOT include the Humidiare 4i integrated, heated humidifier. Be sure to take that into consideration if you bid on it. That reduces the price as you will need to get the humidifier from the local DME supplier or watch for one at auction too.

IF you really want to go to the hassle of trying for an APAP, then give serious consideration to the Resmed S8 AutoSet II w/EPR. Its also fully data capable. But really, w/all the hassle you've been having I'm not at all sure that an APAP is worth it. A fully data capable CPAP like the Elite II can do the job and is a great little CPAP.

that the auction does NOT include the Humidiare 4i integrated, heated humidifier

Thanks for pointing that out!

I will accept CPAP, but it MUST be data compatible. We'll see what ins co. ends up with tomorrow!

I think you need to call yor DME and tell them what machine you want and tell them your not going to accept anything else. I own a large insurance brokerage in CA and deal with all kinds of claims for these things all the time, you need to get what you want! You are in the drivers seat because they want your money, if your on a PPO you have many options. If you are on an HMO you may have limited choices. I am in an HMO and my DME tried to pull the same stuff on me. My Doctor (one of my best friends) sent the RX to them and they called and said I could come down for orientation and too pick up my machine. I asked what machine and they told me it was a Resmed s8 compact, I said no way i need the elite II by Resmed. They tried to tell me I would have to pay and upgrade of $260.00 for the Elite and $400.00 for the Humidifier, I told them they were crazy. I called my doctor and told him to redo the rx and specificaly state the Resmed Elite II with Humidifer (this way they have to give you the Resmed Elite II and humidifer). I went back and forth with them about insurance covering it and I said they will cover it as long as it is scripted (rx) correctly. I told them I am an insurance broker and I know how things get paid and I know what to do to get things paid. After that conversation I got what ever I wanted and even got a free second nasal mask, to this date I have not recieved any kind of bill.

The main thing to remeber its YOUR machine and get what YOU want.

Good Luck!