Is it important to meet with a Respiratory Therapist/DME?

Thanks for this site - it's been invaluable to me being newly diagnosed.

I'm wondering how important is it to meet with a RT at a DME? I'm waiting for insurance verification and then to get an appointment. In the meantime, I could have ordered a machine and gear from online for most likely less cost than my deductible. How helpful is it meeting with the RT? What are the benefits, that is if the DME has a good RT? Or should I just order everything from online and take my chances?

I'd order my machine online, from our hosts CPAP.com, or the CPAP.com auction site; or from second wind if I were interested in a used machine. If you aren't sure about mask fitting you could get that from a local DME. IMO , DMEs aren't all that useful or helpful, I manage just fine without them. kathy

A good RT is worth his or her weight in gold because they can help you find the right mask, get it adjusted properly, set up the machine and then help you tweak it for optimal therapy.

BUT . . .

A good RT is hard to find. Most work for DME's who are all about maximizing the profit and don't give their staff RT's the time and support they need to do do a great job for their customers. It's mostly "set 'em up as quickly and cheaply as possible and move on to the next sucker."

So do you spend a few thousand more dollars of your money to play the lottery and PERHAPS get a good RT, or do you learn everything you can and do it yourself as your own best advocate??? It's a steep learning curve, and having a good and knowledgeable RT can be of great benefit.

In the end, it's a call only you can make.

I would give the DME/RT's my first option before I throw them to the sharks. Many are reliable, informative and helpful. If you get along with them, then you have a "GO-TO" person with info and help. That alone might be worth the extra $$ you may have to spend. You give up that option with an on-line buy. At least meet with them to discuss your situation. You don;t have to use them any more then a car dealer.

DouglasL wrote:Thanks for this site - it's been invaluable to me being newly diagnosed.

I'm wondering how important is it to meet with a RT at a DME? I'm waiting for insurance verification and then to get an appointment. In the meantime, I could have ordered a machine and gear from online for most likely less cost than my deductible. How helpful is it meeting with the RT? What are the benefits, that is if the DME has a good RT? Or should I just order everything from online and take my chances?

I ordered everything online and have done fine so far. This site is probably more helpful than my sleep doc and any DME combined. I can see that getting used to therapy is a process that takes time and there is much tweaking to be done initially on my own. My sleep doc pretty much said to me his job is pretty much done after he gets me the CPAP.

DouglasL wrote:Thanks for this site - it's been invaluable to me being newly diagnosed.

I'm wondering how important is it to meet with a RT at a DME? I'm waiting for insurance verification and then to get an appointment. In the meantime, I could have ordered a machine and gear from online for most likely less cost than my deductible. How helpful is it meeting with the RT? What are the benefits, that is if the DME has a good RT? Or should I just order everything from online and take my chances?

Have you had a sleep test? Do you have a prescription in hand?

If you do it on your own, there is a lot to learn and a lot of ways to do it wrong. I set my machine wrong once and suffered from it. It's easy to think you understand something and be wrong about it.

Sometimes those of us who think we have it figured out now forget our own mistakes and how difficult it was to figure it out at first.

Local DMEs can often answer questions for you and help. It's good to have someone local who can help you right away and actually look at your equipment. Warranty service may be better. Mask exchange policies may be better, but you can pay for mask return insurance with some online sellers. Actually measuring your face in person for the correct mask and trying the mask on is good.

Unfortunately, lots of DMEs don't do a good job of helping you get it right. On this board, you'll mostly hear about the DMEs that don't do it right. Or you hear from patients who think the DME didn't do it right.

Many local DMEs will try to screw you by giving you a non-data capable machine. Sadly, a lot of them don't even understand the difference.

I've had my sleep study (severe apnea diagnosis with a setting of 17cm indicated) and have my prescription in hand. One would think that in a city the size of Los Angeles that there would be a large selection of DMEs but not so - hence my considering ordering from online.

DouglasL wrote:Thanks for this site - it's been invaluable to me being newly diagnosed.

I'm wondering how important is it to meet with a RT at a DME? I'm waiting for insurance verification and then to get an appointment. In the meantime, I could have ordered a machine and gear from online for most likely less cost than my deductible. How helpful is it meeting with the RT? What are the benefits, that is if the DME has a good RT? Or should I just order everything from online and take my chances?

I been CPAPING for 9 months and I don't know any RT. As matter of fact I don't know the diff between RT, Clinician, Technician, etc. If you call those employees at the DME RTs then in my opinion they are just sales girl and know almost nothing about treatments (the only man at my DME is the owner with his wife the nurse, both owning the place). So I have no RT.

But I do have about 12 MDs in diff specialtists. The one who checked my sleep study and whom I tried to meet was "too busy" and his partner who has MDs in Internal Medicine and Geriatrics said that he will be my "Sleep Doctor". But after three month and being on this board I realized that this MD that assigned himself to me knows only some very basics in OSA. So I called the MD who did my PSG analysis and arranged for an appointment, to be paid by Medicare. Actually, these smart MDs who call themselves Consultants are NOT Medicare providers. But I don't mind to pay some extra cash (from my pocket) over the Medicare rate b/c these guys are good. So for half hour appointment, Medicare pays some $100 and I add $25. For 15 min appointment it's $72 plus $20. This group of MDs consultents in internal medicine own a "sister company" that is a certified sleep clinc for PSGs (by Medicare).

Overall, I talk to the MD about stuff that I is not covered here on this board which is very little. By the way, this guy has MDs in both internal Medicine and Pneumatology. He does not trust any CPAP's data. Only PSGs.

I plan to arrange with him for my second PSG sleep study later in the year when it will be one year since my last one.

I am hoping that you'll walk away from my post knowing that you MUST have a person who is knowledgeable and who let you have access to him/her in a reasonable time.

p.s. I forgot to relate to this: How helpful is it meeting with the RT? What are the benefits, that is if the DME has a good RT? Or should I just order everything from online and take my chances.

The only two pluses that I got from my DME were that they agreed to swap my first CPAP S8 Escape II, which is not DATA output, with S9 Elite, for no extra cost, under Medicare 13 months rental. After 2 months I decided that I wanted the S9 Autoset instead. But they made me pay $800 for a new S9 Autoset flow generator. The humidifier fits both CPAPs.

The other plus that I got from them has been the help with choosing the correct size of masks which models I picked myself beforehand (in 8 months of CPAPING I tried 8 masks and still not happy with any). I would gladly pay some more money to be able to test a mask and return it if I was not happy with it.

Nothing else from the DME except aggravation.

I bought my machine privately. Set it up myself. Got the software and I was off and running. I do have a DME who is aware of this and was willing to "help me in any way he could" (his words) ... I fired the first choice DME as they treated me like I was stupid. Anyway.. I do use the DME who as willing to help me and who spoke to me like I was someone, to purchase what masks and supplies I am allowed with my insurance. Other stuff online.

Do the math. How important is the potential $ savings by doing it on your own vs cost of having a DME hold your hand (if they are any good at it).? Only you know the answer. It isn't that hard unless you have some weird stuff going on and need one of those high end ASV machines.

I finally heard from the out-of-network DME who tells me over the phone that the machine they would supply me would be a Remstar. I asked how did they come to the conclusion that would be the best machine for me. Silence on the line from the DME Rep.... I said I needed to speak with an RT to go over options and needs (I travel a great deal and live on a boat and need DC power as an option) The rep says, "This is the machine we have for you." I asked what the cost would be and was told the machine and gear would be $1,140.00; I have a $1,200 deductible. I've decided to purchase the Devilbiss D54 IntelliPAP AutoAdjust Travel CPAP Machine with Smartflex. I realize I may need to get the additional Smartlink software, but for now will use the Smartcode for info.

The Intellipap is a fine machine, I use one for travel/backup though I don't bother with the soft wear for it( use softwear on my PR). You'll get lots of help here, just ask. kathy