I recently received a REMstar M Basic (no cflex) and a Respironics comfort gel mask. I had hoped I would get a machine with  more features, but the DME gave me the run around when I asked. I read the posts that suggest to hold out for a decent machine, but after twenty minutes of song and dance from the DME, I ran out of steam. I just wanted to get started on the road to feeling better so I took the machine. I think this falls under the 13 month "rent then own" program w/my insurance. I should mention that it did come w/the heated humidifier. I am only 3 nights in on this setup,however, I have a few problems. First, I wake up after about 4 hours. then it is tough to fall asleep again. Also, when i get ready for bed, and have the mask on snug, the pressure and fit seems good. but when I wake up it seem like the pressure isn't the same, some kind of mask issue but I don't think it's from leaks, at least not from the fit. the humidifier will heat up the air, but I still wake up super dry. I realize this may be a lot for one post, I really want to benefit from the therapy and this is truly a great forum.

Well, I'm sure sorry you felt you had to give in. You're going to be living w/this CPAP for the next 5 years of your life. You can still return it and exchange it for a fully data capable device w/in the first 30 days so think it over and see if you feel up to standing up for yourself and your therapy. No one has a more vested interest in your health than you do!

There is less than a $75 difference in cost to the local DME supplier between a fully data capable CPAP and a bare bones CPAP. The only one worried about their profiot margin is them. They contract at one set price w/the insurance companies for a CPAP and it is a pretty darn generous price!! Multiply what our insurance is paying and your copay for the 10 to 13 months and figure out what they are getting paid for that CPAP of yours. Then decide if you still want to stick w/the CPAP you've been given.

We adjust to the pressure as we sleep thru the night and we have all experienced that waking up and wondering if the pressure is the same or even if the device is running. Open your mouth and you'll know its still running!! W/o that data from the CPAP there's no way of knowing for sure WHY you are waking up w/a dry mouth. You may need to turn yuor humidifier higher. More likely you have too high a leak rate. And it isn't always the mask that is leaking, you could be leaking air gently thru your lips (the "lip flutters") a good share of the night. Pressure lost thru leaks is therapy lost for you and your apnea.



Last edited by CrohnieToo on Sat Jul 26, 2008 9:48 pm; edited 1 time in total
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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 VPAP Auto. Humidaire 3i, Simplicity & Micro masks, ResScan 3.4, S8 ResLink, Embla oximeter.

Thanks CrohnieToo, That was my intention all along with this machine, return and get a model that I can live with for 5 years. The DME didn't even try to work with me on this, so I won't feel bad when they get it back. I guess the main issue was to have the doc write out a script more specifically. My doc was on vacation for a couple of weeks so I could not call him at the time. What kind of data does the better machines give you?

The pressure at or below which you spent 95% of the night.
The Leak rate at or above which you experienced 5% of the night.
Your AHI for the night
Your AI for the night
Your HI for the night
and the averages for one week, one month, 6 months and 1 year after you've been using your device that long
The total number of hours on the device
The total number of hours you've used the device
The number of hours you used it that night
The number of nights you've used the device and the number of nights since you first used the device.

Insist on a:
Resmed S8 Elite w/EPR
Resmed S8 II Elite w/EPR
Respironics M Series Pro w/C-Flex

Good luck - and don't wait too long to insist on the exchange or you will be outta luck and have lost all your bargaining and negotiating power! The one you have is now a "used" device and you're gonna be pushing for a new, unused device. Fair is fair, tho I feel no sympathy for these local DME suppliers who foist off bare bones CPAPs on unsuspecting, bewildered newbies.


_________________
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 VPAP Auto. Humidaire 3i, Simplicity & Micro masks, ResScan 3.4, S8 ResLink, Embla oximeter.

There is less than a $75 difference in cost to the local DME supplier between a fully data capable CPAP and a bare bones CPAP. The only one worried about their profiot margin is them. They contract at one set price w/the insurance companies for a CPAP and it is a pretty darn generous price!! Multiply what our insurance is paying and your copay for the 10 to 13 months and figure out what they are getting paid for that CPAP of yours. Then decide if you still want to stick w/the CPAP you've been given.

Is that what it's all about!
                                       The set price that the DME charges my insurance covers all (or nearly) of machines billed under that medical code, meaning the cheaper the product the higher their profit. OUTRAGES!  They told me that in no way would insurance pay for anything other than a bare bones model unless I needed a bipap. They also said that data capable models were only for in home studies and that they should know--they have been in the biz for 30+ years. Lies!

zombieguy wrote:

There is less than a $75 difference in cost to the local DME supplier between a fully data capable CPAP and a bare bones CPAP. The only one worried about their profiot margin is them. They contract at one set price w/the insurance companies for a CPAP and it is a pretty darn generous price!! Multiply what our insurance is paying and your copay for the 10 to 13 months and figure out what they are getting paid for that CPAP of yours. Then decide if you still want to stick w/the CPAP you've been given.

Is that what it's all about!
                                    

This is what it is all about. Its not focused on patient care. And while I understand that we are speaking of businesses, the system really does suck.

Your current DME supplier is being 1] less than truthful, 2] guilty of sins of omission and, possibly, 3] just plain not very knowledgeable about the various brands and models of CPAP.

Call your insurance company. Ask them what local DME CPAP suppliers they are contracted with. Hopefully you have the option of more than just this one sorry excuse. But, you really have only 30 days to 45 days pretty much maximum to dump this DME supplier and get another if you have that option.

If you have no other choice of local DME supplier then your next step is up the ladder there to a supervisor or manager. Be TACTFUL, be DIPLOMATIC, but be FIRM! You are NOT asking for an autoPAP (which is also coded as a CPAP) you are "only" asking for a fully data capable CPAP that will help to determine what any problems you may be having w/CPAP therapy are in order to correct them.

Good luck!

My first local DME supplier provided me w/a basic Respironics Plus. My script specifically said a Respironics M Series Pro w/C-Flex. They delivered it Friday (it also had 13 hours on it before it was delivered). Monday morning I called them and told them I was returning it. They told me I couldn't return it w/o a doctor's order. WRONG THING TO TELL ME! I was at their office in less than 1/2 hour w/their equipment, demanded a receipt to prove its return and when I had it in my hand, I left. (I was also aware that I had the option of 2 other local DME suppliers).

I then stormed into my sleep lab and told them what I had done and asked for a new script to take to the other suppliers my insurance was contracted with. Long story short after telling the sleep lab why I had asked for the Pro, specifically for the data it could provide and that I fully intended to get the software, they suggested one of the other local DME suppliers and that they script a Resmed S8 Elite w/EPR instead since more data was available via the LED screen than was available via the LED screen w/the Respironics Pro w/C-Flex. And THAT is how I got my Resmed S8 Elite w/EPR which I LOVED.

I've since been retitrated for a bi-level due to having COPD and have been switched to a Resmed VPAP Auto bi-level and I LOVE it! This new EasyBreathe technology is so smooth and so easy to breathe with. All of the new Resmed S8 IIs have this new EasyBreathe technology. But that Resmed S8 Elite w/EPR was and is a honey of a CPAP. I had no complaints whatsoever w/it and put 3051 hours on it before I was switched to the VPAP. I'm having trouble convincing myself to part w/it and sell it.    (Hey, we were good buddies, inseparable at night, for 3051 hours! You get attached).


_________________
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 VPAP Auto. Humidaire 3i, Simplicity & Micro masks, ResScan 3.4, S8 ResLink, Embla oximeter.

My first local DME supplier provided me w/a basic Respironics Plus. My script specifically said a Respironics M Series Pro w/C-Flex. They delivered it Friday (it also had 13 hours on it before it was delivered). Monday morning I called them and told them I was returning it. They told me I couldn't return it w/o a doctor's order. WRONG THING TO TELL ME! I was at their office in less than 1/2 hour w/their equipment, demanded a receipt to prove its return and when I had it in my hand, I left.  

     This is where I am at now. Should I just take this machine back monday morning?, Since the DME was not honest with me the first time, I don't trust them to be honest about return/exchanging this unit. Can they charge me a restock fee? I screwed this one up, But I don't intend to do it twice. If anyone could offer some more advice, I would be grateful. Otherwise, I will proceed as quoted above. I will talk to my doc, but that's going to take another ten days unfortunately. I tend to over stress these issues. I tried to find previous posts on this, haven't found any yet. I forgot to mention that I got the machine on July 23rd.

No one can make that decision but you. Do you have the option of another local DME supplier thru your insurance? Nope, there should be no restock fee. Not w/in that first 30 days. It is usually 45 days before they get around to billing your insurance.

You really need to call and talk to your insurance first. How long is the rental period before the CPAP becomes your personal property? What copays and/or deductables apply? What other local DME CPAP suppliers are they contracted with? If you go w/a DME supplier they are not contracted with you could end up w/your insurance paying nothing towards your equipment.

Even if it turns out due to insurance you are stuck w/this local DME supplier, ask to speak to the manager and explain the situation, the either lack of knowledge or the untruths from their RT, the sins of omission, the inaccurate information, etc. Be DIPLOMATIC, be TACTFUL, but be FIRM. YOU are paying for this equipment you are going to spend the next 5 years of your life with.

Another little tidbit: Resmed, Respironics and Fisher & Paykel will replace FREE to the local DME suppliers MOST of their masks that patients have tried and been unsuccessful with IF the DME fills out a form AND RETURNS them W/IN 30 DAYS. So if one mask doesn't work out for you you should be able to exchange it for another w/in 30 days. In all fairness it can take up to 10 days to 2 weeks for find out a promising mask isn't gonna work out. Some you can tell right in the DME's office, others it can take that 10 days to 2 weeks to be sure it is gonna work for you.

You should ask to try at least one of all 4 basic types of mask: full face, nasal cushion, nasal pillows and the "hybrid" type consisting of both nasal pillows and mouth piece. And the DME's RT "should" fit your mask whilst you are laying down and w/a CPAP turned on to your set pressure or 10 cms whichever is higher.

Good luck!


_________________
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 VPAP Auto. Humidaire 3i, Simplicity & Micro masks, ResScan 3.4, S8 ResLink, Embla oximeter.

So if I understand correctly, I can just walk away from this deal if, there is another DME contracted w/my insurance. Unless they decide to give me some choice, which I doubt. Thanks again for the info, I will talk to my insurance co. on monday and go from there. The info on the masks was going to be my next question, but you cleared that up. Again, this DME gave me two masks to try (sitting up) and told me to pick carefully because I could not take it back. Seemed strange because how would I know, this situation is new to me. I am always polite with people,. however, I chose to ignore that small voice telling me NO, NO!

Sometimes our instinct knows best and we do well to listen to it. Yep, as long as you have the option of more than one local DME contracted w/your insurance you're free to walk away. Take it all back and hand it to them. And tell them why you are returning it.


_________________
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 VPAP Auto. Humidaire 3i, Simplicity & Micro masks, ResScan 3.4, S8 ResLink, Embla oximeter.