New Machine, Is it a downgrade?

I just satisfied my Medicare compliance period yesterday and my new machine was delivered. It looked the same as the Resmed S8 Elite so I thought it was the same but this morning when I went to access the data using the menu I could not find it. After a bit of putzing about I discovered that it was not the S8 Elite but a Resmed Escape II. Was I downgraded? Should I demand an S8 Elite like I used during the compliance period? I am an obsessive data collector. It works for me by giving me the feedback I need on mask efficacy and quality of sleep. I come from a scientific background. Thanks for any feedback. I have had this new machine for one day and it worked fine last night but I need to see the data.

Yes, it does sound like they got you. The name of the machine should be written right on it.

Yep, you were downgraded.. Start complaining and be prepared to stick to your guns. They gave you the el cheapo model. Medicare pays the same, they do a rent to own purchase thing and it doesn't matter if cpap without data, with data or apap. They pay the same amount each month and you have to prove compliance somewhere near or before the 90 day mark.

If you are data junkie this el cheapo model will drive you nuts. On the plus side of this, with Medicare it is a rental, so you can stop the rental and either make them give you what you want or find someone who will.

rbrown3rd wrote:I discovered that it was not the S8 Elite but a Resmed Escape II. Was I downgraded?

Yes, you were downgraded. They gave you a "lesser" machine, data-wise.

rbrown3rd wrote:Should I demand an S8 Elite like I used during the compliance period?

I'd sure try whatever it takes to get an S8 Elite II, instead of the S8 Escape II they gave you.

Thanks everyone. I called first thing this morning after your quick replies and they said they will try to get me one like I had during the compliance period. Your fast and informative replies may have saved the day. They laughed when I told them I was a "data junkie." That is usually a good sign. I think being informed through your responses and a quick call saved me.

The Escape is a more basic machine, so YES, they did downgrade you. Fight it.

After calling them yesterday they said they would "try" to get me the S8 Elite that I had during the compliance period. This provider has a good reputation locally so they probably are trying to get me a better machine but I am posting to ask what your recommended strategy would be if they start dragging their feet. Can I get my doc to write a prescription for a specific machine for better data collection?

You can ask your doctor to write it to an exact machine and fight with the dme company for that machine.It may be money wise to find a middle ground and get the exact machine you want from your dme if you prefer one with bells and whistles..If you have to offer to pay for some of the upgrade it might be wise for you personally to do just that. Get a list of what your coverage covers and what it cost you after allowed amount and go from there.PS- hit em up for a chinstrap too , it looks to be cover by the medicare guidlines every 6 months.

potholerepairman wrote:You can ask your doctor to write it to an exact machine and fight with the dme company for that machine.It may be money wise to find a middle ground and get the exact machine you want from your dme if you prefer one with bells and whistles..If you have to offer to pay for some of the upgrade it might be wise for you personally to do just that. Get a list of what your coverage covers and what it cost you after allowed amount and go from there.PS- hit em up for a chinstrap too , it looks to be cover by the medicare guidlines every 6 months.

Thanks. I can do that very easily. They gave me a chinstrap. I have used it for two nights and it seems to have made a big difference. I kind of put it aside when they first gave it to me but when my wife said she heard me snoring I decided to use it. It made a big difference in the quality of my sleep. I am now just over a month into CPAP therapy with very mild apnea but my nights are better and better and as a result so are my days.

potholerepairman wrote:You can ask your doctor to write it to an exact machine and fight with the dme company for that machine.It may be money wise to find a middle ground and get the exact machine you want from your dme if you prefer one with bells and whistles..If you have to offer to pay for some of the upgrade it might be wise for you personally to do just that. Get a list of what your coverage covers and what it cost you after allowed amount and go from there.PS- hit em up for a chinstrap too , it looks to be cover by the medicare guidlines every 6 months.

It has been 3 or 4 days now and I have heard nothing from my provider. I did however get a delivery of the Swift LT mask I requested. I am happy with it but that would be the subject of another thread. The reason I am replying to you and typing another entry for this thread is to post the draft of a letter to my primary doc. I would be very pleased to receive any comments or suggestions before sending it out. On Monday, tomorrow, I am going to call my homecare provider and find out if they are going to be able to provide me with the machine I want without sending the letter. If that does not prevail then this is a draft of the letter I will send to my primary MD. Any feedback is greatly appreciated.

During my compliance period I was given a Resmed S8 Elite II machine. The purpose of this was to monitor my AI, AHI, mask leakage rates and net pressure and compliance hours for Medicare. Those data proved very useful to me as a patient as well because each morning I could read the data and then determine if my mask needed adjustment and the quality of my sleep that night. I find that personally that kind of feedback each morning helps me to improve my therapy.

In anticipation of having the machine after my Medicare compliance period had been satisfied I purchased software and a card reader to help me chart my progress and to further enhance the feedback loop. After my 30 day compliance period had been satisfied LinCare provided me with a new machine. The next morning, hoping to read the data for the night I discovered that there was no way to display any data. I discovered that the S8 Elite II had been replaced by an S8 Escape. The S8 Escape machine only reports compliance hours, even though it has a data card slot it reports no other data. It will not provide any AHI/Leak data.

This email is to ask if there is any way that a specific request or prescription can be generated to allow me to get the machine that stores and displays AHI/AI/Leak data. For me, an important feedback loop has been broken that would allow me to optimize mask adjustments and compare the efficacy of different mask types. I had taken steps to enjoy the fullest advantage of having the sleep data available by purchasing software and a card reader.

Thank you for assisting me in this matter.

Medicare paid 13 months for the Resmed S8 Elite II w/EPR. THAT is the machine you should have been given sole ownership of. Pure and simple. Medicare does a "capped rental", not "just" a rental. "Capped rental" is the same as rent-to-own. Given your circumstances it is quite likely that you were given a "used" Elite II for the "rental" period, the DME having every intention from the get-go of providing a NEW Escape II at the end of the "capped rental".

It pays to know how to access the total hours on an xPAP when it is first provided to you so you know if you've been provided w/a new device or a used device. That can be a clue right off the bat if they intend to switch you to a new (and most likely lesser) device upon completion of the "rental" period.

Compliance period? Was it the 60 -90 day thing or the 13 month thing? Medicare requires compliance proof somewhere before the 90 day period I think and again maybe near the end of the capped rental maybe.

So how long have you been on CPAP therapy?

I think it was a 30 day period. That is about how long I have been on the therapy.

You are still "renting to own" your machine. There is no reason why you cannot get an Elite II other than DME being stubborn or just wanting to be an ass. You can even change DME if you wish. If current DME doesn't want to give you what you want then start checking around with other DMEs and ask them if they will. Someone will just to get your business. Might check with original DME to see if they will step up when faced with the prospect of no business from you.

Your email letter is nice, probably a lot nicer than I would have worded. I probably would have just told them that it was my body, my therapy, my money and I wanted what I want.. But that is me, I fired my first DME because they were unwilling to work with me at all.

rbrown3rd wrote:I think it was a 30 day period. That is about how long I have been on the therapy

rbrown3rd wrote:This email is to ask if there is any way that a specific request or prescription can be generated to allow me to get the machine that stores and displays AHI/AI/Leak data. For me, an important feedback loop has been broken that would allow me to optimize mask adjustments and compare the efficacy of different mask types. I had taken steps to enjoy the fullest advantage of having the sleep data available by purchasing software and a card reader.

Thank you for assisting me in this matter.[/i][/color]

My suggestion is below - (whether it is email or a letter).
This email is to request a prescription for theS8 Elite II be written to allow me to get the machine that stores and displays AHI/AI/Leak data. For me, an important feedback loop has been broken that would allow me to optimize mask adjustments and compare the efficacy of different mask types. I will be in Tue. at noon time to pick up this prescription so that I may personally hand deliver it to avoid further confusion.

S8 Elite II must be written on the prescription or the DME feels they are allowed to provide me an S8 Escape machine.

ps. Be prepared to deal with the desk dragon who will likely make sure the doc doesn't see your note. If you do get the script, I would bring this machine with me when I delivered the new script. Be prepared for the DME to insist they don't have one in stock and will have to order it. Ask for the loaner you had until a new one comes in. They will likely lie about it not being there.

Good Luck