I have been reading the threads regarding fully data capable machines. I understand the reasons for having data capability. The questions:
 
1) Is my RemStar Plus "fully data capable?"
2) I only got my CPAP about a month ago. How / when do I convert to a capable machine so that insurance will cover? (assuming my current    
    machine is NOT capable)
3) When I asked the sleep center doctor about this option, she told me that she considered that "overkill". If they won't prescribe such an  
    option, can I override that opinion with the DME? (I kinda like the idea of overkill when my quality of life is on the line!!)
4) What software is needed and where do I get it?
5) Most important - How do I correctly interpret the data to drive my therapy?


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Respironics RemStar Plus W/humidifier
ResMed Activa mask
Pressure 15
Humidity 3

Your machine is not fully data capable.  you would need the PRO version rather than the PLUS version.  I don't think fully data capable is overkill.  You will most certainly have to be very firm if you're going to get it.  Decide that's what you need, and don't take no for an answer (doctor included).  Other posters would probably have better tips on how to deal with your DME than I, so I'll defer to them.  Good luck though.

OK, more stuff.  So much for deferring to other posters.  But I'm sure they'll weigh in as well.

First step is to get the right machine. Once you do get the PRO version (assuming you stick with Respironics), you can purchase the "EncoreViewer" software through an online DME along with a smartcard reader.  Combined, it will cost you about 175 bucks.  Once you get that, you could repost and ask for help figuring out what it is telling you.

Your doctor might think that data capable is overkill, but you could just tell your doctor that you disagree to the point that you will be seeking the services of an alternate doctor who is more open to your involvement in the process.  Then be willing to do just that if the doc doesn't come around.  Once the doc is on board, use the doc to get what you need from the DME.  If the doc doesn't come around, you really should look for a different doctor.

I agree w/Raymart. However, you might try "laying" on both the DME and the doctor that you are concerned that neither is interested in knowing what may be the cause of any problems w/CPAP therapy you might be having which obviously they aren't or they wouldn't balk at providing you w/a fully data capable CPAP. You are NOT comfortable w/changes to your therapy being made by "guess and by gosh" nor are you thrilled w/the idea of multiple titrations to determine a problem.

I'd also remind BOTH doctor and DME that YOU are the one paying for your equipment (makes no differenc whether out of pocket or via your insurance) and you are aware that a CPAP is HCPCS code E0601 and that E0601 does NOT differentiate between a bare bones CPAP such as the Plus and a fully data capable auto PAP such as the Respironics M Series Auto w/A-Flex so your request for a Pro is NOT AT ALL out of line and TOTALLY REASONABLE.

Be DIPLOMATIC but be firm. You're less than 45-60 days into this current Pro so it is still not too late to return it and go elsewhere for your CPAP equipment (assuming you've first called your insurance to ask what local DME CPAP suppliers they are contracted w/and have the option of more than this one). And if you are willing and able to purchase out of pocket there is always the option of purchasing your equipment online.

If you have to go the route of returning your equipment, first determine whether your insurance purchased the mask, hose, etc. outright and just "rented" the Pro for a set period. You sure don't want to return a mask, hose, etc. your insurance has already paid for w/o being sure that you can get new ones paid for from a different DME supplier!

I wouldn't stress the software issue at first. Just your "insecurity" w/a doctor and RT who aren't interested in the data these fully data capable xPAPs can provide when you encounter problems w/your CPAP therapy.

If you do have to get into the software issue THEN you can remind them that Respironics DELIBERATELY developed PATIENT software.

Assuming that your insurance does allow you the option of one or more other local DME suppliers you might even want to "shop" them first and see which xPAP they are willing to provide you with and if they will provide you w/the Pro as you want.


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Some people are like Slinkies... Not really good for anything, but they still bring a smile to your face when you push them down a flight of stairs.
Resmed's new VPAP Auto. Humidaire 3i, Simplicity & Micro mask, ResScan 3.4 software, SPO 7500 oximeter.

CrohnieToo wrote:

Be DIPLOMATIC but be firm.

Totally agree.  My message was direct, but with your doctor, it would be more of a polite conversation.  In the end, though, you are not being unreasonable to expect an equipment upgrade.

My process for upgrading from a Remstar to a Remstar Pro went like this:

1. Called my DME and said I wanted to upgrade my machine to one that is data capable.  "Data what?  You mean one with a smart card?"  "Yeah." "We have an open clinic every thursday.  Just bring your machine in and we'll see what we can do."

2. The next thursday came and I was told that they needed the doctor to tell them that I needed the upgraded machine.  The tech volunteered to contact my doctor and ask for approval.  She was very friendly and said they would send the new machine UPS and include a return label for the old one.

3.  I never heard anything else from them.  I didn't press the issue because I knew I had a followup with the doctor.

4.  Told the doctor I wanted to upgrade the machine and he said "sure, do you need a prescription or something?"  I told him I wanted a machine that was data capable, or as the woman had said before one that uses a smart card.  He literally wrote "Give xxx a CPAP machine with smart card" on a prescription slip and signed it.  The woman at the front made a copy for their records and faxed a copy to the DME for me.  Very helpful.

5.  The next day the DME called and said they'd received the 'scrip and asked how I wanted to pick it up.  I said I'd just come in during the normal thursday hours.

6.  Today I walked in and said I wanted to upgrade the machine.  The tech said "no problem, what's your pressure?"  He came back a few minutes later, handed me the new blower, picked up the old one and handed me a handful of filter elements.  Never asked my name, never asked me to sign anything.  I guess he could have looked up the serial number of the old blower to pull up my records.  

It seems like if I'd gotten that tech the first time around I'd have been using a data capabale machine for over a month now.  At least I have it now.

Just a little different slant on what krb said:  The REMStar M Series "Plus" *has* a smartcard.  DO NOT ASK FOR A MACHINE WITH A SMARTCARD.  Ask for exactly what you want:  A prescription for a fully data capable machine.  More than one person has asked for a "machine with a smartcard" and gotten the PLUS which records compliance only data to the smartcard.  krb was very lucky they knew what he/she meant.

Also ask to specify on the script, that the machine display should be set so the PATIENT can read the nightly and summary AHI and leak figures.  These displays are hidden by default on most machines.  Many have gotten that nice new data capable machine home, only to find they can't see the figures.  Many DMEs do not unhide this information, assuming the prescription for the data capable machine was for the use of the doctor and not the patient.

So ask for a script for a fully data capable machine, with patient-accessible AHI and leak figures on the display.

Blessings,
--pseudonym

Right on, Pseudonym!!!


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Some people are like Slinkies... Not really good for anything, but they still bring a smile to your face when you push them down a flight of stairs.
Resmed's new VPAP Auto. Humidaire 3i, Simplicity & Micro mask, ResScan 3.4 software, SPO 7500 oximeter.

pseudonym wrote:

DO NOT ASK FOR A MACHINE WITH A SMARTCARD.  Ask for exactly what you want:  A prescription for a fully data capable machine.  

The ultimate is to do your research and have your doctor write a prescription for the exact machine/make/model you want.  Have the scrip read "Resmed S8 Elite w/Heated Humidifier", etc.

Then there is no confusion or wiggle room.

Right on, Barry. I both told my sleep tech and wrote on that night's paperwork I would NOT accept ANY equipment until I saw the doctor and we came to a MUTUAL AGREEMENT on what equipment I would accept.


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Some people are like Slinkies... Not really good for anything, but they still bring a smile to your face when you push them down a flight of stairs.
Resmed's new VPAP Auto. Humidaire 3i, Simplicity & Micro mask, ResScan 3.4 software, SPO 7500 oximeter.

Agreed with everyone here. If not for the peeps here I would have gotten stuck with the cheapest cpap out there. My insurance was not prob, the doc rewrote my script for a auto cpap full data capbable, it was the DME that gave me the hardest time. The sleep study tech told me to get the best my insurance would let me buy. After getting into an argument with the DME they told me it would be three weeks to get the one I wanted, I said "goodbye". I got my remstar auto fully data capbably and I couldn't be happier. Stick to your guns, and get what you want!

Hey krb
How long did you have your first Remstar before they let you get the Pro?  You mean your insurance covered it without a problem?  I had to get a script just to borrow a Resmed Elite for a week and the DME was not happy to even let me do that.  I am pretty sure my insurance company will not pay for another machine after only eight months. They don't even want to buy me a new mask when mine is six months old. I have to have a reason like my old mask is broken, doesn't work, wore out.  Well, it's not any of those. I worry about what if something does happen and I have be be without a mask until I can get a new one. Why can't I have a spare?  Anyway, I want to change to a different DME but there's only one other one in the area that is in my insurance network.  My insurance company is adamant that I don't go to an out of network DME.  I also have a doctor who asked me how I want the prescription written...It's nice except that I wish I felt like he knows more than I do.
Grandma


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ResMed Quattro Full Face Mask
ResMed S8 Escape with heated humidifier
Pressure set at 10

BarryKaraoke wrote:

pseudonym wrote:

DO NOT ASK FOR A MACHINE WITH A SMARTCARD.  Ask for exactly what you want:  A prescription for a fully data capable machine.  

The ultimate is to do your research and have your doctor write a prescription for the exact machine/make/model you want.  Have the scrip read "Resmed S8 Elite w/Heated Humidifier", etc.

Then there is no confusion or wiggle room.

While I don't disagree with you at all I also see a lot of posts from people who do attempt to do the research, but still aren't sure which models have full data capability.  There are so many models with similar names, it's understandable that a person might not be sure.

If they have an Rx from the doc for a "fully data capable machine" and additionally a request to "reveal AHI and leak displays to patient" then it is no contest when they are delivered a machine that doesn't do that.  It may result in delays but it won't result in a compliance-only machine

Blessings,
--pseudonym

Right on, Pseudonym


_________________
Some people are like Slinkies... Not really good for anything, but they still bring a smile to your face when you push them down a flight of stairs.
Resmed's new VPAP Auto. Humidaire 3i, Simplicity & Micro mask, ResScan 3.4 software, SPO 7500 oximeter.

So I just have to chime in.  I recently got an IntelliPAP.  I wanted quiet and light weight, but it only records compliance.  So I've lost a lot of weight and my pressure was blowing my brains out.  My doc. (who I LLLOOOVVEEE) and who works closely with me got me in the sleep lab within a week.  But guess what he asked me before I had my study--"So what does your CPAP say?"  I had to tell him it wasn't data capable.  Can't we have it all??? **sign**

Vicki


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That which does not kill you makes you stronger-Friedrich Nietzsche
Friedrich must of had apnea.