Hello all,

I need some quick help as I need to call my DME back this afternoon.  Just to backtrack and give you the whole story...

I currently have a CPAP with a pressure setting at 16 (originally 14).  When I discussed the possibility of an APAP with my DME they didn't like that at all.  They kept steering me away from them.  Since I have insurance, I'm guessing they would prefer to have me on a low-end machine since the insurance will pay the same set amount for either machine.

Anyway, after reading a different thread on this board that had suggestions on how to get your doctor to approve an APAP, I decided to give it a try.  After all, when they did my sleep study they had me just sleeping on my back.  I DON'T sleep in that position, if at all possible.  I'm a tummy and side sleeper. Plus, with an APAP it will allow the pressure to be more accurate so I won't be stuck at a straight 16 if I don't need to be.  Well I left a message for my doc asking for a new prescription and she okayed it and called it in to the evil DME.

I had requested a PB 420E.  When I just talked to the DME they want to set me up with a Resmed Vantage.  Can anyone give me a breakdown on which is the better machine?  Are they comparable softwarewise, etc or is one clearly the better machine?  I do travel so would like a small and compact machine.

Thanks for all the help.

Melinda

I can only comment on the resmed s7 auto, I've been happy with this machine and it is very quiet, my doctor said to have a fixed unit at 4 but it's my money and opted for the auto and my pressures have been between 11-13.5 so what do doctors know.
Like you I did the study mainly on my back but I always sleep on my side, if i was you i'd go for an auto, at the higher pressure the auto would compensate for your needs.

Each manufacturer has their own software.  So, no, they are not compatible that way. If it is the new S8, that is supposed to be a good machine.

MelindaR wrote:

Hello all,

I need some quick help as I need to call my DME back this afternoon.  Just to backtrack and give you the whole story...

I currently have a CPAP with a pressure setting at 16 (originally 14).  When I discussed the possibility of an APAP with my DME they didn't like that at all.  They kept steering me away from them.  Since I have insurance, I'm guessing they would prefer to have me on a low-end machine since the insurance will pay the same set amount for either machine.

Anyway, after reading a different thread on this board that had suggestions on how to get your doctor to approve an APAP, I decided to give it a try.  After all, when they did my sleep study they had me just sleeping on my back.  I DON'T sleep in that position, if at all possible.  I'm a tummy and side sleeper. Plus, with an APAP it will allow the pressure to be more accurate so I won't be stuck at a straight 16 if I don't need to be.  Well I left a message for my doc asking for a new prescription and she okayed it and called it in to the evil DME.

I had requested a PB 420E.  When I just talked to the DME they want to set me up with a Resmed Vantage.  Can anyone give me a breakdown on which is the better machine?  Are they comparable softwarewise, etc or is one clearly the better machine?  I do travel so would like a small and compact machine.

Thanks for all the help.

Melinda

Hi Melinda,

Two questions. why does your doctor want a 420E ? Why does your DME want ResMed ? They need to explain this to you. I suspect that the the DME supplier has a supply of ResMed equipment and doesn't want to order another brand.

I believe that both machines are equally good. In fact with the advance in technology I believe that there is little overall difference in brands.

Make the DME work for you. Maybe free software ? You are the consumer !!!!!!!!!

Daniel

Melinda, Daniel's right...you're the consumer.  You're the one who has to use the machine.  You should have whichever brand of autopap YOU want, since the doctor has okay'ed you having one.  The DME should order the machine you want for you.  If they can't, or won't, then you might want to shop around for another DME if possible.  Sometimes just mentioning that you will check to see if another home health care store can get it for you would be enough to get your DME to try a little harder to please the customer...you!

That said, there are features on each of the major brands of autopap that the others don't have.  Without getting to try out each one, there's no way for you to really know which one you'd like best.

But there are a few obvious things that might make a difference to you, like:

1. size of the machine - Puritan Bennett and ResMed currently being the only two that manufacture a small autopap.   Respironics has announced they have a small machine coming (the "M" series), but it may be just a cpap to start with...I haven't found whether they've announced it in a small autopap form yet.

2. whether the autopap can give exhalation pressure relief when being operated in auto mode - Only Respironics REMstar Auto can; ResMed S8 Autoset Vantage can't in auto mode; Puritan Bennett 420E can't in any mode.

3. where the controls for the humidifier are if you plan to get an integrated humidifier.  (I prefer separate heated humidifier, myself, so that it can work with any machine I get in the future.)

Of the major brands' software, I personally prefer the Silverlining software with the Puritan Bennett machines.  Next best, Encore Pro for Respironics' machines.  I don't like the Autoscan software for ResMed machines at all.  On the plus side for ResMed machines, though, they are the only ones that allow you to see AHI and a few other bits of info in the display window without needing software at all.  But to see the full graphs and charts, you'd have to have the software; and Autoscan has poor graphs, imho.

Thanks for replying everyone.  As they say, the saga continues.  I seriously believe that insurance companies are out there to find a loophole in order to NOT pay for anything.  They do this by not making their system user friendly.  Ok here goes, my dr. (AWESOME DOC) ok'd my reasoning of why I want an APAP and sent the prescription to the DME.  Now the DME after giving me major grief was supposedly going to order the machine, humidifier, and software.  I find out a week later (middle of last week) that they have in fact not ordered the machine.  They are stilling trying to get the cost information.  Oh and because my insurance paid for a humidifier on the CPAP they won't for the APAP per my DME.  So they are trying to say I'd be stuck paying $300 for the humidifier alone.  It gets better.  When she asked if I wanted to be able to view my information and I said yes she made a big production that the software would be very expensive.  As I decided on the PB 420E, the cpap store I checked out had the software for $99.  Oh yes, they sell the humidifier for $182.  She let me know she'd work on the costing.  Well I was a touch irritated and called my insurance company.  Let the run-around begin.  The first time I called, I was informed that I can't order online.  The second time I called I found out I could, but it would be considered an out of network provider so I'd have to pay a $500 before they would pick up a portion.  The big kicker is that my new plan year began in November so I have to begin paying co-pays again.  Soooo, if I get this new machine I'm going to have to pay $250 in network before they start picking up any portion of the charge.  My insurance rents a CPAP/APAP machine for 10 months and then it's yours.  Then the nice insurance person informed me that they hadn't gotten the new prescription and it wasn't approved.  Apparently these scripts go through their review board.  Soooo, I called the DME but my support person was out.  I told them to have her give me a call and there was a problem.  It's been a week and haven't heard back.  One more glitch is the fact I'm looking for a new job, so my insurance will be changing.  Can we say I'm in a bit of a pickle?  When I looked up the cost of buying at a reputable online company the machine, humidifier, and software came to $799. I'm thinking of using the CPAP I have now and then seeing what happens with my job and new insurance.  I figure I can always purchase my machine online.

Yes rested girl I did check out the bill my insurance and they can't help as my insurance won't deal with them.

Doesn't give you much confidence in DME's, does it? My DME tried to tell me the humidifier alone was $700 and the software was $1000. What a crock. I just laughed and told them I knew better. Fortunately my insurance didn't require a deductable for the machine but the DME insisted on getting an extra $225 from me for the upgrade to an APAP. One person quoted me $250 and another quoted $200, so they said they would do it for $225. They claimed the insurance wouldn't cover it but I talked to my insurance company and they said they would pay 100% of the cost up to $1000. I was desperate for the equipment so didn't argue about the money. I bought the software online for $200 including the card reader.

I left the DME with a bad taste for them. I think they all lie to everyone and are out to cheat both the consumer and the insurance companies out of all the money they can. We all pay for it with higher insurance premiums.

BTW, you don't have to use any particular DME. Call your insurance company and find out what DME's they use in your area. My first DME told me it was going to take 4-6 weeks to get me the equipment, and that was after waiting seven days to get an appointment with them. My insurance company told me of another DME and I went with them instead. I had my machine in 2 days. They're all crooks but you may be able to speed up the process. Your doctor will just need to fax the prescription to whatever DME you end up using.

It sounds like you have really been doing your homework.  Its truly unfortunate that the insurance companies don't care that you can get the same equipment for less.  They force you to use whatever method will be less out of your pocket.  You might be better off renting until you get your new job if they have a 10 month rental requirement (don't get me going on what they are paying over those 10 months!)

But you are very wise to explore all the options and picking the one that makes the most economical sense to you.

Regards,

Mike

MelindaR wrote:

Thanks for replying everyone.  As they say, the saga continues.  I seriously believe that insurance companies are out there to find a loophole in order to NOT pay for anything.  They do this by not making their system user friendly.  Ok here goes, my dr. (AWESOME DOC) ok'd my reasoning of why I want an APAP and sent the prescription to the DME.  Now the DME after giving me major grief was supposedly going to order the machine, humidifier, and software.  I find out a week later (middle of last week) that they have in fact not ordered the machine.  They are stilling trying to get the cost information.  Oh and because my insurance paid for a humidifier on the CPAP they won't for the APAP per my DME.  So they are trying to say I'd be stuck paying $300 for the humidifier alone.  It gets better.  When she asked if I wanted to be able to view my information and I said yes she made a big production that the software would be very expensive.  As I decided on the PB 420E, the cpap store I checked out had the software for $99.  Oh yes, they sell the humidifier for $182.  She let me know she'd work on the costing.  Well I was a touch irritated and called my insurance company.  Let the run-around begin.  The first time I called, I was informed that I can't order online.  The second time I called I found out I could, but it would be considered an out of network provider so I'd have to pay a $500 before they would pick up a portion.  The big kicker is that my new plan year began in November so I have to begin paying co-pays again.  Soooo, if I get this new machine I'm going to have to pay $250 in network before they start picking up any portion of the charge.  My insurance rents a CPAP/APAP machine for 10 months and then it's yours.  Then the nice insurance person informed me that they hadn't gotten the new prescription and it wasn't approved.  Apparently these scripts go through their review board.  Soooo, I called the DME but my support person was out.  I told them to have her give me a call and there was a problem.  It's been a week and haven't heard back.  One more glitch is the fact I'm looking for a new job, so my insurance will be changing.  Can we say I'm in a bit of a pickle?  When I looked up the cost of buying at a reputable online company the machine, humidifier, and software came to $799. I'm thinking of using the CPAP I have now and then seeing what happens with my job and new insurance.  I figure I can always purchase my machine online.

Yes rested girl I did check out the bill my insurance and they can't help as my insurance won't deal with them.

Melinda,

God help you.....because the system wont.

I thought our system in Ireland was bad enough, but I do believe it is way ahead of what you have to endure. The great thing about a small country is that we only have 7 cpap suppliers, each of which has to be approved by a reputable sleep clinic before they can deal with a patient of that particular clinic. If their service proves !@#!, we can complain to the clinic or our support group who will liase with one another and create hell.
I know of one company that was 'blacked' by the largest clinic in the country (because of non existent back up service) until such time as they got their act together. It took 18 months for them to get back 'on the list' in that particular clinic, during which time they received no new business referrals from the said clinic. It's expensive, and they were made jump through a few hoops before they got back.

Best of luck.

Daniel.


_________________
The untreated Sleep Apnoea sufferer died quietly in his sleep.......
Unlike his three passengers who died screaming !!!!!!

(Anon)