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Hello everyone. I am new to sleep apnea and to that beautiful face mask that I am so privileged to wear. Anyways,.......

 

My dr is about an hour away from me, and he is selling the cpap and head gear stuff.  He does the sleep study as well. They sent me home with a mirage face mask. It felt huge and caused an indention on the bridge of my nose, that lasts about 2 hours. I called and they sent me a comfortgel, smaller in size, but it causes an indention on my nose as well. I have the straps loose, and have it kinda loose on my face, but no air leaks. It is as if it builds up a suction on my face. I called to report this to the drs office and was told to just wait until my appt which is over a week away.

 

My question is I am wondering if it would be better to just get a RX and go with a DME company here in my town, or would it be better to stick with the drs office. I am using him to treat hypothyroidism,(anyone that has this knows how difficult it is to find a dr for this). I just don't want to run the risk of making him mad if switching would be the better route to follow.

 

I am such a novice with this thing. I haven't yet decided if it is going to be worth it. And it is SO getting on my nerves. I don't want to end up with a permanent mark on my face, and be out in public and people say...OH! You wear a cpap mask!

 

Thank you in advance for any thoughts or advice you can share with me.

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Hey Peggy,
Welcome to CPAP!

So far it sounds like the Dr's staff is working with you in finding a proper fitting mask. Keep asking until you are satisfied with the comfort and fit.

A couple of things though.

GET THE SCRIPT and a full and complete copy of your SLEEP STUDY. You will need both in the future. You are entitled to them by law also. I would also get a script for distilled water, which will allow you to deduct it's cost from your taxes as a medical expense. (Hey-every dollar counts!) You will learn that these items will become invaluable in the future.

Make sure the machine you get is a full data compatible machine, not just a compliance data machine. The DME or Dr get the same insurance payment for either, but the full data machine will help you with your therapy.

Keep asking questions and don't settle for anything short of the best equipment.

Dan
Dan, thank you so much for that. I did not know you could get a Rx for distilled water. That is a great idea. How would I tell if they are giving me new equipment or used? Right now, I am renting one.

Dan Lyons said:
Hey Peggy,
Welcome to CPAP!

So far it sounds like the Dr's staff is working with you in finding a proper fitting mask. Keep asking until you are satisfied with the comfort and fit.

A couple of things though.

GET THE SCRIPT and a full and complete copy of your SLEEP STUDY. You will need both in the future. You are entitled to them by law also. I would also get a script for distilled water, which will allow you to deduct it's cost from your taxes as a medical expense. (Hey-every dollar counts!) You will learn that these items will become invaluable in the future.

Make sure the machine you get is a full data compatible machine, not just a compliance data machine. The DME or Dr get the same insurance payment for either, but the full data machine will help you with your therapy.

Keep asking questions and don't settle for anything short of the best equipment.

Dan
Peggy, I've been on CPAP for two years. You might try padding your nose or that part of the mask that hits the bridge of the nose (moleskin, bandaids, be creative). Maybe when you go to your appointment they can sit down with you and help you find a mask that's comfortable. I unfortunately loved my Mirage Quatttro FFM, but the skin on my nose broke down so badly from the pressure I had to take almost three weeks off therapy to let it heal. I change to the Respironics FitLife Total Face Mask with does not touch my nose and it's an improvement though it does leave marks on the side of my face. I have never heard of a doc who sells equipment. A script so that you can deal with a DME may be the way to go. A good DME will make an effort to get you a mask that works. I know I got tired of people sayint "what happened to your nose?"!
The mask is the achilles heel of dialysis, I think.
The mask is the tricky part of the game. Many of us have had to use numerous masks to find one that gives us the best fit and the fewest leaks.

If your doctor is selling the equipment, that means he has a vested interest in that end of it. Which machine did they provide for you? The full name should be written on it, probably on top. It would be interesting to find out if he sold you a bare bones machine to keep you tethered to him (provides no useful data, which may mean more money in his pocket). If he is that far away, I would say find a local DME to deal with. Chances are if you need adjustments, other masks, etc. you are going to have to wait for mail service or drive the hour, wait for sevice, and then make the return trip home. Not always an easy task to arrange if you have a work schedule.

Get a copy of your script and sleep study report. These belong to you, all you have to do is request them. The doctor may balk at giving them to you, but is required to by law.

Things to thing about before switching DME's -- how is the service? what are the costs? with deductible? out of pocket? what happens in an emergency with the current one being so far away? could you do better by using on on-line supplier (still have to wait for shipping but usually the cost savings is worth it)?
Peggy McGalliard said:
Dan, thank you so much for that. I did not know you could get a Rx for distilled water. That is a great idea. How would I tell if they are giving me new equipment or used? Right now, I am renting one.

Dan Lyons said:
Hey Peggy,
Welcome to CPAP!

So far it sounds like the Dr's staff is working with you in finding a proper fitting mask. Keep asking until you are satisfied with the comfort and fit.

A couple of things though.

GET THE SCRIPT and a full and complete copy of your SLEEP STUDY. You will need both in the future. You are entitled to them by law also. I would also get a script for distilled water, which will allow you to deduct it's cost from your taxes as a medical expense. (Hey-every dollar counts!) You will learn that these items will become invaluable in the future.

Make sure the machine you get is a full data compatible machine, not just a compliance data machine. The DME or Dr get the same insurance payment for either, but the full data machine will help you with your therapy.

Keep asking questions and don't settle for anything short of the best equipment.

Dan

Peggy, ask him/her.

I also would be very interested in knowing what brand and model of machine you are renting. I agree with Carol. The mask is the tricky part. It is like a pair of shoes - if they don't fit you right, you won't wear them again. Same applies for the mask.

So far as where you deal, keep all your options open. That is but one of the reasons you need a copy of the script and the full sleep study.

Another thing I would do is contact your insurance company directly and request, in writing, what their policy & time frames are for equipment replacement, i.e. mask, cushion, hose, etc. Do they use the Medicare standards or just what?

Based on my personal preference - I would ask for a Resmed VPAP Auto25 or the new S9 Auto Set. You cost is the same.
Just to clarify: the Resmed VPAP Auto 25 is a bi-level and NOT the same HCPCS (insurance) code as the Resmed S9 AutoSet. The VPAP Auto 25 can NOT be purchased w/a CPAP script, it requires a bi-level script and is CONSIDERABLY more expensive than a CPAP.

The being said, the fully data capable CPAPs (and APAPs - same HCPCS code) are:

Resmed S8 Elite II w/EPR
Resmed S9 Elite w/EPR
Respironics M Series Pro w/C-Flex
PR SystemOne Pro w/C-Flex
(I'm not sure of the specific fully data capable model names by DeVilbiss, Fisher & Paykel and Sandman)

The fully data capable APAPs (auto titrating CPAPs) are

Resmed S8 AutoSet II w/EPR
Resmed S9 AutoSet
Respironics M Series Auto w/C-Flex or A-Flex
PR SystemOne Auto w/A-Flex
(again I'm not sure of the specific fully data capable model names for DeVilbiss, Fisher & Paykel and Sandman)

What you want from your sleep doctor whether you stay w/him and his provider or switch doctor and/or provider is the doctor's dictated results (1-2 pages each), the full scored data summary report w/condensed graphs (5+ pages each) from BOTH your in-lab sleep evaluation PSG and your in-lab PAP titration PSG "as well as" your equipment order (script). Assuming you are in the USA you have a LEGAL RIGHT to these copies and your script under HIPAA. I even request a DVD of my entire in-lab PSG. I sometimes have to get a bit pushy and insistent to get the DVD.

You need NOT supply a reason for wanting these copies. They are part of your medical records and as such you have the LEGAL RIGHT to those copies.
Thank you. I have a copy of the dictated report and was wondering if there was anything else I need. I am one of those that gets a copy of my records, I don't really trust the drs. Too Many bad experiences, so thank you for that.

Judy said:
Just to clarify: the Resmed VPAP Auto 25 is a bi-level and NOT the same HCPCS (insurance) code as the Resmed S9 AutoSet. The VPAP Auto 25 can NOT be purchased w/a CPAP script, it requires a bi-level script and is CONSIDERABLY more expensive than a CPAP.

The being said, the fully data capable CPAPs (and APAPs - same HCPCS code) are:

Resmed S8 Elite II w/EPR
Resmed S9 Elite w/EPR
Respironics M Series Pro w/C-Flex
PR SystemOne Pro w/C-Flex
(I'm not sure of the specific fully data capable model names by DeVilbiss, Fisher & Paykel and Sandman)

The fully data capable APAPs (auto titrating CPAPs) are

Resmed S8 AutoSet II w/EPR
Resmed S9 AutoSet
Respironics M Series Auto w/C-Flex or A-Flex
PR SystemOne Auto w/A-Flex
(again I'm not sure of the specific fully data capable model names for DeVilbiss, Fisher & Paykel and Sandman)

What you want from your sleep doctor whether you stay w/him and his provider or switch doctor and/or provider is the doctor's dictated results (1-2 pages each), the full scored data summary report w/condensed graphs (5+ pages each) from BOTH your in-lab sleep evaluation PSG and your in-lab PAP titration PSG "as well as" your equipment order (script). Assuming you are in the USA you have a LEGAL RIGHT to these copies and your script under HIPAA. I even request a DVD of my entire in-lab PSG. I sometimes have to get a bit pushy and insistent to get the DVD.

You need NOT supply a reason for wanting these copies. They are part of your medical records and as such you have the LEGAL RIGHT to those copies.
So then, I need to get myself educated with the machines and see what they offer. I wouldn't know if the one they sell me is one he has had backlogged in his office or if it is a more modern up to date machine.
Its not a matter of up-to-date. The manufacturers produce a basic compliance data only capable model in the same series as the fully data capable models.

EXCEPT, perhaps, they just MIGHT be FORCING the local DME providers into providing fully data capable PAPs by NOT producing compliance data only models in their latest series released just late last year and early this year. The model names to refuse are any Resmed w/Escape in the model name or any Respironics w/Plus in the model name.

Now that you've mentioned it, the only two Resmed S9 models I am aware of - so far - are the Elite and the AutoSet and in the PR SystemOne series the only models I'm aware of - so far - are the Pro and Auto.

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