How it works??

I'm just trying to get an idea of the process going forward....

I have a titration scheduled for next Tuesday (so greatful have to waiting a month and a half since I set the appointment), and my question is, is it pretty much similar to the sleep study just with the mask, they still wire you up and everything? Do the techs change the pressure remotely to the xPAP machine (I would assume so, couldnt imagine them walking in the room every so often to change it)?

I met with the sleep doctor, in May, before the titration, who told me that I wouldnt need to come in to review the results of it since I live far away from the sleep center (3hrs), and that he would see me 2 months after the study to see how I was doing on xPAP and make any necessary changes then.

My question then is, since I am three hours away, I feel that I wont be set up with a local DME (around the sleep lab) and that I will have to find one on my own (Have already found a few but one is Lincare and have been told to steer clear from them). Does it normally take a week or so after the titration to get a prescription for the xPAP and pressure, similar to inital sleep study, or is a prescription written the morning after the titration? Does the sleep doctor normally write the prescription or does another doctor do it? The reason I ask was the ENT,who recommended that I go to the sleep center, wanted me to schedule an appointment, 3 weeks after my sleep study, in order to get a prescription from him (the ENT). Is this usual or because I live far away from sleep center? Then once I get my prescription, and I go to the DME of my choice, how long does it normally take to get a appointment and equipment from them?

Thanks

The titration study is a lot like your first study. At my sleep lab, the tech sat down with me before she wired me up and had me try on a few different masks with the machine on so I could get used to how it felt. It was a little weird for me, so she let me wear the mask with the machine on while she went to take care of some other stuff for about 15 minutes so I could get used to it. The hook up was exactly the same, except that they don't use the sensors on your nose since you're wearing the mask. They can change the pressure remotely.

After the study, it has to be scored, and then the doctor has to review it before the prescription can be written. I'm not sure why the ENT wants to write the presciption. If the sleep center doctor is willing to write the prescription, I'm not sure why I'd want to pay an extra copay to see the ENT. I was able to pick up my study results and prescription from the sleep lab after 2 weeks.

To find a DME, you need to start by calling your insurance company and finding out who they participate with. I had a choice between 2 larger companies and then one locally-owned company that's statewide that I ended up going with. One thing I did was ask the tech at my sleep study if she knew anything about the companies, and she gave me some good advice. I think, in general, you're better off going with a smaller company, so you don't get lost in the red tape. You should also spend some time calling the different DMEs to find out what their policies are on mask exchanges (they should let you try as many as you want, within the first 30 days) and what machines they typically use (You want the Resmed S9 Elite or Autoset, or the PR System 1 Pro or Auto).

Once you choose a DME, the sleep center (or ENT) will fax the study results and prescription to them, then they verify your insurance coverage. For me, the prescription was faxed on a Thursday and I got my machine on Monday (only because they didn't have any appointments available on Friday).

The process varies and depends on insurance, the sleep lab policies, etc., etc.

You're correct, the titration study involves the same "hook up" as your sleep evaluation study other than no leads at the nose as you will be wearing a CPAP mask the night of the titration instead.
And, yes, the tech changes the pressure remotely from the "control room".
Usually you don't receive the script until the doctor's dictation of the results is also ready, probably in the same time frame as after your sleep evaluation study.
Sleep lab policy dictates whether your script is written and provided by the sleep doctor or by the referring doctor.

As far as choice of DME CPAP provider, call your insurance and ask the what local DME CPAP suppliers they are contracted with. Hopefully you will have the option of more than one as that gives you more bargaining/negotiating room to get the equipment you want (w/in reason, of course). Certainly you should "shop" each one to get the best CPAP you can get, to find one w/staff you are comfortable with, that has a lenient mask exchange policy, that has an RRT on staff readily available as you need him/her ...

Prepare a WRITTEN request for a copy of the sleep doctor's dictated results (usually 1-2 pages each) and the full scored data summary report w/condensed graphs (usually 5+ pages each) from BOTH your sleep evaluation study AND your CPAP titration study and that you be given your prescription so that you can shop your local DME suppliers yourself before committing to buying from any one of them. Give a copy of this WRITTEN request to the sleep tech to attach to the paperwork you fill out the night or morning of your titration study.

Be sure to keep these "original" copies for our own records and ONLY provide copies of them as needed, including only a copy of your script, for the DME suppliers.

The process w/the local DME suppliers can vary as well so those are questions to ask as you "shop" your options before committing to the one you feel most comfortable with.

My internal medicine Doctor that gave me the referral to the sleep clinic, wrote the prescription. You might mention where you live and what Company your insurance is. Someone on this site might be able to give a you a very good reccomendation for a DME.

Southeastern CT......United HealthCare


Also how to I get a real response on xPAP replacement parts, like pillows, ect., cause my insurance company just gives me the standard line, "the DME will know"?

Padron192664 wrote:Southeastern CT......United HealthCare


Also how to I get a real response on xPAP replacement parts, like pillows, ect., cause my insurance company just gives me the standard line, "the DME will know"?

I fought for a month to get this info out of my insurance. Felt like squeezing blood from a turnip. And everytime I called I got a different answer to "How often can I get a set of replacement pillows?"

Fortunately I've got an excellent DME. The manager there has taken on dealing with my particular file herself because of several paperwork snafus. In talking to her about my frustrations, she offered to start doing the phone calls for me and eventually wrangled the information from them verbally over the telephone. And wrote it down for me since I am still NOT at all confident of my ability to accurately transcribe info given to me over the telephone.

So----if you wind up liking and trusting the DME, they may be able to shake this info out of the insurance company. But it sure would be nice if the insurance companies would be up front and send us something in writing when we're first diagnosed and are looking for the equipment.

If you haven't already done so, you should also read a blog by JanKnitz on What you need to know BEFORE you meet your DME

Most insurance companies follow Medicare guidelines. Those say you can replace your cushions/pillows and disposable filters each month. The frame (hard plastic part of mask) and long tubing every 3 months, and the headgear, non disposable filter, humidifier chamber, every 6 months. There are good arguments for going with a small local company, but a national based company is in your better interest if you are a snowbird or do alot of traveling. They typically have offices around the country to assist you if need be.