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heavybreathing wrote:Interesting that people are recommending the S9 Autoset. I was going to consider myself fortunate if I could get the S9 Escape, and real fortunate if I could get the S9 Elite. I wasn't going to try for the Autoset because the doc wrote the prescription for a fixed pressure and a fixed EPR value. I figured that getting an S9 Autoset with that prescription would be impossible. Was I wrong? Could I actually insist on an S9 Autoset?

[snip].

I called the insurance company, and they can switch the authorization to a different DME if this one is unwilling to do what is best for me. From what I can tell, the insurance simply authorized certain CPT codes (and stated some are for rental and some are for purchase). They did not specify what brands/models the DME should provide with those codes.

I welcome all tips. Thanks! You guys/gals are great!

Here are the codes: http://www.cpap-supply.com/v/cpap-insurance-codes.asp Note the ones for CPAP and Auto-PAP are the same.

E0601 Continuous airway pressure (CPAP) device (e.g. smart CPAP, auto CPAP, CPAP)

If the doc writes the prescription for a fixed pressure, that is ridiculously easy for the DME to program into an S9 Autoset or any other Autp-PAP. Don't let them tell you you can't have an auto machine because the prescription is for CPAP. The price difference is only about $50 betweent he S9 and the S9 Autoset. Offer to pay the difference, if you have to. Better yet, tell them if they don't give you the auto-machine you'll find another DME who will.

Still dealing with the DME. No CPAP yet. Ugh. Hopefully very soon.

My doctor has now specifically requested the heated hose, so that is now an official doctor request that the DME cannot balk on. The DME has agreed to provide it. Thank you to everyone for the tips and encouragement.

My doctor specific he wants an S9, but he did not specify the Autoset. Due to insurance silliness, I have to change doctors, but I have no idea when my appointment with my new doctor will be.

The DME has made it clear (a bit rudely and WAY excessively sternly, I might add) that they will not provide the S9 Autoset, only the S9 Elite.

I called my HMO to find other DME companies. They definitely have others, but they do not simply have a list they can provide me with (crazy, I know). To get a new DME, I have to ask for them to switch DME companies, which they will (no problem), but I will not know to which company they will switch until after the fact. And who knows what the new DME will provide (maybe better, maybe worse).

Since my prescription is for a constant pressure (with an EPR as well), I'm not sure how important the Autoset will be. I'm tempted to just settle for the S9 Elite to get this thing done. But if that's a bad idea, let me know, and I'll request a DME switch.

I do plan on dropping some weight, so the Autoset seems ideal for that, but another sleep study would take care of that too.

This is a pain in the bottom. Let me know what you all think. I really appreciate the help in this less-than-fun process.

heavybreathing wrote:This is a pain in the bottom.
Let me know what you all think.
I really appreciate the help in this less-than-fun process.

I think:
it is a pain in the pa-toot...to start.
it is a less than fun process ....it is a cpap Rite of Passage.

eventually,
it is such a pleasure to have working brain cells.

....and having a life again,
is everything it is cracked up to be.

Go the distance.

Still no CPAP. I finally had another appointment with my doctor. They wrote me a prescription that specifically says ResMed S9 Autoset with ClimateLine hose. Now if the DME doesn't give me the equipment I'll report them for not filling the prescription properly.

heavybreathing wrote:Still no CPAP. I finally had another appointment with my doctor. They wrote me a prescription that specifically says ResMed S9 Autoset with ClimateLine hose. Now if the DME doesn't give me the equipment I'll report them for not filling the prescription properly.

Excellent, he sounds like a GOOD Dr. He seems to have your best interests at heart, too bad for the dme. john