And all Im getting is the run-around...Call my Ins company and they said all the DME would have to do is ru nthe codes and it should go through...call the DME and now they say after i told them i had talked to my Ins co that they do not get fully data capable machines?!?!? Then they proceeded to ask ME what the code was for the ins...shouldn't THEY know this?! All I want to do is keep track of how my health is and I don't think my Dr is goin to stay on top of it so i feel that i need to! What is so wrong with that?! WHY should they make it so hard, they act like it's tabu or something!

I don't feel well, but had to respond to this. Tell 'em it's the same freaking code they used when they gave you the bottom of the line leftover stuff they had on the shelf.
There is only one code (the SAME code) for CPAP and APAP. There  is not a different code for data-less-keep-me-in-the-dark-and-alone-while-you-clear-your-inventory-of-old-merchandise and fully data capable.

I don't remember how long you've had your machine or if you've talked to your ins company. If you haven't talked to ins company i would do that tomorrow or today if they aren't closed. I'd find out which DME providers I had to choose from.
What are you talking about? Of course I don't get irritated easily.
Good luck to you,
-me

Thanks for responding even tho you aren't feeling well! First off I hope you get to feeling better soon! I contacted my ins co yesterday and they said it was as simple as running the code and it should be approved...there is only one other place i can go to and i have a call into them now...hopefully they call me back today! I have had my machine a week today and was gonna get on calling the ins and DME right away about this but came down with the flu and have been barely able to lift my head!

Well I talked to the other dme that I could go to... And was told that all he stocks are fully data capabale machines...he actually believes that its needed! Now I just have to figure out how to take This machine bck and go to the other dme to get exactly what I need! And be sure. My ins pays for everything!

Amyd76 wrote:

Well I talked to the other dme that I could go to... And was told that all he stocks are fully data capabale machines...he actually believes that its needed! Now I just have to figure out how to take This machine bck and go to the other dme to get exactly what I need! And be sure. My ins pays for everything!

Hi Amy,

Reading your post was like deja vu - all over again. I have just been through the same thing. My first DME told me that the machine I was getting was fully data capable (compliance only, I found out later). After I had got the machine and tried to extract some useful information from it, they told me that that is the only machine they foist on poor suspecting tired and/or very sick patients with sleep apnea.  I called my insurance company who told me that the sleep center had sent out the prescription, not them ...

All you need to do is call your sleep doc and have them send your prescription to the new DME (my new one is also a CPAP (I think) user). Check with them when they can set you up with the new machine. Call the old DME and tell them the machine is not working for you. If you are lucky they will come and pick it up. I had to have someone return mine. No problems, so long as you are within the 30 day time limit.

Get your new machine, and you are back in sleep land again, this time with data. I think you do need to ask the sleep doc to request on the script that the advanced patient data is accessible to you, so try it and see.

Good luck!


_________________
SleepyToo
Philadelphia Area
Newly diagnosed, Respironics M Series Pro w\ humidifier
Zest nasal mask, also have Full Life ff mask, and FlexiFit 407
(Also have a FlexiFit 405 that damaged the bridge of my nose)

Return your current not fully data capable CPAP. Get a receipt proving it has been returned. Simple as that. I've done it. If they make a note on the receipt or any paperwork you must sign that you refused treatment. Write a notation on that same paperwork your are refusing an unsatisfactory device.

Now, be CAREFUL w/this new DME supplier. Some will try to claim a compliance data only CPAP is fully data capable. Just because a CPAP has a data card does NOT mean it is full data capable.

The Resmed S8 Elite II w/EPR is fully data capable. The Respironics M Series Pro w/C-Flex is fully data capable.

The Resmed S8 Compact, Resmed S8 Escape II w/EPR and Respironics M Series Plus are NOT fully data capable.

And the HCPCS (insurance code) for all CPAPs, from straight compliance data only thru fully data capable CPAPs thru fully data capable APAPs is e0601. Bi-levels, VPAPs, etc. are an entirely differnet HCPCS code.

Don't let them try to snow you. This is YOUR health, YOUR therapy, YOU are paying for this equipment whether thru insurance or out of pocket is immaterial, YOU are the one paying for 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 mask, ResScan 3.7, S8 ResLink, Embla oximeter.

Thanks so much...gonna get back on the ball in the morning..the new DME said he deals with respironics machines, he was very understanding of my needs and was very helpful...also basically told me just why he thinks this other company does what they do! I actually liked his attitude...he was rather comical as well, Thanks again for the advice as to what to do next and what not to do! I can use all the info i can get!

Don't let them try to snow you. This is YOUR health, YOUR therapy, YOU are paying for this equipment whether thru insurance or out of pocket is immaterial, YOU are the one paying for it.


I have to tell you my Doctor said the same thing to me when I confessed to him that I had learned how to access my data. He said it is MY machine and I should be allowed to do what ever I want with it. Of course we have the understanding that I would not mess with any of the settings...why would I?

Good luck returning your machine and getting a new one. It is very reassurring to see in the morning that you really did have a good night sleep.

Thanks so much! I go see my new DME @ 3:30 today for my new CPAP machine....i returned the other one, they weren't very friendly when i returned it, of course i had to keep my mask and humidifier...and they had me sign a "refusal of treatment" form..to which i added my own note thanks to the advice i had gotten on here!

Good on you, Amy. Good luck w/this new local DME provider. Hopefully they will have learned from the experience of the previous DME provider and they will treat you well and provide a good fully data capable CPAP to go w/the humidifier, etc. you have now. It sounds like it will probably be the Respironics M Series Pro w/C-Flex that you will get.


_________________
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 mask, ResScan 3.7, S8 ResLink, Embla oximeter.

You were right on that note...I got the Respironics M series pro w/c flex....AND he gave me a different mask to try...Free of charge....AND since my old DME wouldnt take back my humidifier (which the new DME said wasn't right) he included the humidifier and said if they do not get paid for it he isnt gonna bill me for it, that they just wont worry about it!  I really felt like this new DME is in it for my health and not just for the $$ he took the time to go over everything with me and took very good care of me.....I am very pleased!

WONDFERFUL, Amy!! Congratulations. It sounds like now you will get the good care you deserve - at least from your DME supplier anyway.


_________________
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 mask, ResScan 3.7, S8 ResLink, Embla oximeter.

Thanks! I am very happy to have finally found someone who understands and actually seems to care!