Help for Newbie -- Equipment, etc.

Hi, I just got sleep test results and am waiting to get equipment, but I want to be proactive...any help would be greatly appreciated as I navigate this!
I am told my Rx says: Bipap, system 1, 13/9 cm H20 (and a humidifier is included)
A couple of questions please...
Does System 1 mean anything?
Can I get a better machine (for example, with recording capability, software) from the DME and just pay the extra my insurance company won't cover?
Any suggestions on what unit to get?
Thanks so much.
Jason

System 1 is a Phillips Respironics machine.

The best one to get (if you're staying with that brand)... if you can get it is a Phillips Respironics System 1 Bipap Auto with BiFlex. Get the humidifier.

You could also go with an S8 VPAP Auto 25 (Resmed version). Get the humidifier.

Both of these have software available. The system 1 is newer. On here it'll be listed as PR S1 for the system 1.

Check out this video that we put together.

We took a look at three machines the respironics system 1 which was on your RX, also the resmed S8 series. The S8 on the video is an autoset but the bipap version is exactly the same. Both machines are data capable so there is no worry there.

Check it out, http://www.sleepnation.tv/post/808897740/episode1

Dane

The PR System One Bipap is the "latest and greatest" in BiPaps, though people are very happy with their S8's as well.

They are very expensive--if your co-pay is a percentage rather than a fixed amount, fasten your seat belt!

Yup, yup, my Resmed VPAP Auto in March 2008 was billed on a 13 month capped rental (rent to own) at $239.92 a month. My insurance had a contracted monthly amount of $218.11 of which they paid 80% which was $174.49 and then there was my 20% copay of $43.62 monthly.

If, as you say, your script specifically says "Bipap, system 1" then your local DME provider MUST supply the PR SystemOne Bi-PAP or Bi-PAP Auto. Interestingly, my bi-level titration resulted in an IPAP setting of 13 and EPAP setting of 8 (rather than your EPAP setting of 9).

I will say that I was fortunate to have the loan of a PR SystemOne BPAP Auto for 7 months and was VERY happy w/the therapy I received w/it! I used it in both straight bi-level mode and in auto mode and in both modes the transition of pressure from IPAP to EPAP and vice versa was smooth, easy, comfortable. You weren't even aware of the transition except that you didn't have to exhale against the higher IPAP pressure. And, YES, the PR S1 BPAP Pro is fully data capable. I "think" tho that I saw reference to a PR S1 BPAP Plus and I've never known and Respironics PAP w/Plus in its name to be fully data capable so BEWARE! Just because a PAP has a data card or smart card does NOT mean that it is capable of any more than compliance data which is useless to you.

Jason1955 wrote:Bipap, system 1, 13/9 cm H20 (and a humidifier is included)

Jason,

Welcome to the forum, and, more importantly, welcome to the BiPAP club!

That is a great machine. It is fully data capable. It uses SD cards, where as the S8 has the funny smart card, for which card readers are getting very difficult to find.

Why are you getting a BiPAP? That is a fairly low pressure where BiPAP isn't needed for the higher pressure levels, and the difference between pressures isn't that high. You could get the same thing with an APAP or CPAP using EPR (aka, AFLEX or CFLEX). On an EPR of 3, and a fixed pressure of 13, you would get 13/10, which is close enough for most cases, and would save $1000 on the machine.

Were you diagnosed with central events? If so, I can see why a BiPAP would be needed. In fact, with centrals, and those pressure levels, you might have a case that is kind of tricky to titrate and treat. If this is the case, you are going to want to watch your data closely for the first 60 to 90 days to monitor your AHI and the types of events that the machine detects.

-john-

jweeks wrote:

Jason1955 wrote:Bipap, system 1, 13/9 cm H20 (and a humidifier is included)

Jason,

Welcome to the forum, and, more importantly, welcome to the BiPAP club!

That is a great machine. It is fully data capable. It uses SD cards, where as the S8 has the funny smart card, for which card readers are getting very difficult to find.

Why are you getting a BiPAP? That is a fairly low pressure where BiPAP isn't needed for the higher pressure levels, and the difference between pressures isn't that high. You could get the same thing with an APAP or CPAP using EPR (aka, AFLEX or CFLEX). On an EPR of 3, and a fixed pressure of 13, you would get 13/10, which is close enough for most cases, and would save $1000 on the machine.

Were you diagnosed with central events? If so, I can see why a BiPAP would be needed. In fact, with centrals, and those pressure levels, you might have a case that is kind of tricky to titrate and treat. If this is the case, you are going to want to watch your data closely for the first 60 to 90 days to monitor your AHI and the types of events that the machine detects.

-john-

John and everyone -- thank you SO MUCH for all this information, this will help me greatly in getting the right equipment.
John -- I don't see my ENT for 2 more days and hopefully will be hearing from the DME guy soon, so I don't have my full story yet. I will ask about central events. All I heard so far is that I had "trouble" with the mask during my split study.
But I do have one follow-up question meanwhile, if you see this post -- other than the cost, is there any other downside to getting a BiPAP? I ask only because my insurance will only provide a machine once every two years...
Again, thanks to all, I hope you know how comforting it is to have such support!
Jason

Replacement once every two years is great! Most insurances insist on only every 5 years. Maybe. Generally there isn't much problem when the "upgrade" is to a more sophisticated PAP, such as from CPAP to bi-level PAP, if the bi-level PAP is warranted by symptoms and failure of CPAP.

Hi all again -- I have more info about my CPAP Rx so another quick question please...
My Rx is for the Respironics PR System 1 Bipap Pro, NOT the AUTO version.
I know my doc will be happy to prescribe the AUTO version if I ask.
From everything I've read over the past few days, it seems to me that the AUTO version is better, with no downside?
Hopefully someone can confirm that I should ask for the AUTO version?
Thanks so much!
Jason

yeah I'd go for the Auto

cflame1 wrote:yeah I'd go for the Auto

Thanks cflame1.
Is there any downside you know about the Respironics PR System 1 Bipap AUTO version versus the non-AUTO (or "PRO") version?
At the moment I don't include the price as a downside (the Auto is about $200 more), I just want to get the best/most flexible equipment...
Thanks again.
Jason

the reason to go for the auto is that it can be set to work like the non-auto... but the non-auto can't be set to work like the auto.

AND - if insurance is paying, the straight BPAP and the BPAP Auto are the same HCPCS (insurance) code and reimbursed at the same rate by insurances. Most insurances will not let the local DME provider charge you an upgrade fee from BPAP to BPAP Auto.

The only downside is the fight you will probably have with your DME about the change. Be sure to call your insurance company first and understand exactly how they reimburse so that the DME can't play stupid DME games with you like:

1. Your insurance won't cover that machine (if they pay by HCPC's codes, they will)
2. Your prescription doesn't call for that machine. (Get a very specific RX and ask your doctor to write "dispense as written" on the prescription before you even start with your DME).
3. We have to charge you extra for that machine. (in most cases, the DME's contract with your insurer prohibits them from charging you more, but it doesn't mean they won't try).
4. That machine is not available. (then order it)
5. You don't need that machine. (none of their business)

Thanks to all of you ---Janknitz, Slinky, cflame 1, jweeks (John), Dane -- for all of your great advice.

My ENT doc agreed to Rx the "AUTO" version of the PR System 1 BIPAP -- he had no idea what AUTO meant (otherwise a kind and great doc, but obviously sleep apnea not a chief interest), and so was happy to write for whatever I asked. And the DME didn't balk at the Rx.

A question about my sleep study please? Suggested initial pressure is 13/9. My AHI was about 60 supine, and 5.4 non-supine.
So should I use the straight 13/9 to start, or go to the AUTO mode since the pressure I will need will vary when I am non-supine (which is most of the time).
I hope this question makes sense!

Again, thanks to all, this is an unbelievable resource and you are all so kind.

Jason