Replies to This Discussion

Permalink Reply by Donna B. on November 18, 2010 at 7:59pm

So do you recommend that this Big Mouth get on the phone and demand a new machine ? I want an explanation and I want to hear it from the Doc, not my DME guy. How I am supposed to know in between visits if I am progressing with my therapy? Guess? Just go by the way I feel during the day ? This has got my hackles up now.
Donna B.




Rooster said:

Donna B.,

From my personal experience, the experience of friends and associates, and the experience of thousands of people posting on internet forums, it is typical for sleep docs and their labs to prescribe basic machines and keep their patients in the dark about the existence of machines and software which will measure the effectiveness of the therapy.

Why this is I will leave for another discussion. But for me, it is unacceptable, even negligent. Even for a patient with a mild case.

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Permalink Reply by Rooster on November 18, 2010 at 8:14pm

Use your skills to get people to do something they don't want to do. Being a big mouth may not be the best use of your skills.

Do you know if the insurance company has purchased the machine or are they still renting it on a trial basis as is common?

It may be much easier to get it switched if it is still being rented.

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Permalink Reply by Donna B. on November 18, 2010 at 8:33pm

Oh no Rooster, I turned in my trial machine and they gave me a brand new ResMed S8. Was told that my insurance would pay in full for the machine. So does that mean I cannot trade it in now?
I just meant by being a big mouth that I don't like to be deceived, cheated or lied to. I will speak my mind and speak so as to get what I want. It just frosts me that "they" think all of us SA patients are uneducated.
Do you really think this doctor doesn't care what kind of machine his patients are using ?




Rooster said:

Use your skills to get people to do something they don't want to do. Being a big mouth may not be the best use of your skills.

Do you know if the insurance company has purchased the machine or are they still renting it on a trial basis as is common?

It may be much easier to get it switched if it is still being rented.

• ▶ Reply

Permalink Reply by Judy on November 18, 2010 at 8:42pm

If I am understanding you correctly, that your sleep doctor and your DME provider are in the same office .... how cozy and convenient for them. So the doctor has a vested interest in the profit margin of the DME provider?

I would

1] Call my insurance and ask what local DME CPAP providers they are contracted with.
2] FAX a WRITTEN request to this sleep doctor for
a] a copy of his dictated results from my in-lab sleep tests (1-2 pages each)
b] a copy of the full scored data summary report w/condensed graphs from my in-lab sleep tests (5+ pages each)
c] my prescription for CPAP and accessories

These are all part of your medical records and you have a LEGAL RIGHT to them under HIPAA. You want to send a WRITTEN request so that you establish a paper trail should you need to file a complaint w/HIPAA.

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Permalink Reply by Donna B. on November 18, 2010 at 8:45pm

Why yes Judy they work hand in hand. I didn't know I could get my equipment elsewhere. So again, is it too late to turn in my S8?





Judy said:

If I am understanding you correctly, that your sleep doctor and your DME provider are in the same office .... how cozy and convenient for them. So the doctor has a vested interest in the profit margin of the DME provider?

I would

1] Call my insurance and ask what local DME CPAP providers they are contracted with.
2] FAX a WRITTEN request to this sleep doctor for
a] a copy of his dictated results from my in-lab sleep tests (1-2 pages each)
b] a copy of the full scored data summary report w/condensed graphs from my in-lab sleep tests (5+ pages each)
c] my prescription for CPAP and accessories

These are all part of your medical records and you have a LEGAL RIGHT to them under HIPAA. You want to send a WRITTEN request so that you establish a paper trail should you need to file a complaint w/HIPAA.

• ▶ Reply

Permalink Reply by Rooster on November 18, 2010 at 9:06pm

Donna B. said:

So again, is it too late to turn in my S8?

It is never too late to turn it in. Whether you get a suitable replacement depends to a great deal on how well you negotiate with the alligators.

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Permalink Reply by Janknitz on November 19, 2010 at 3:09pm

". According to me DME guy, I was prescribed the S8 because I have MILD sleep apnea. My Doc did not think I needed a full data machine. It does record hours used and and he said it does record my AHI. I go back for a follow up in January. I am still sleeping well since I last posted."

I think your DME is a lying snake. To my knowledge (anybody is welcome to correct me if I am wrong) the S8 Escape II collects efficacy data ONLY. NO AHI data. None. It collect compliance data only, so that lying DME can be certain he will get paid by your insurance company, and for no other reason than that. Try this--take your card into the DME and ask them to print out your AHI's so you can see how well the therapy is going. And make sure you watch to make sure it's YOUR card they are printing out.

And as others have pointed out, it's highly unlikely that your doctor said you didn't need a full data machine. If your doctor has a piece of the DME's business he might have said "give her whatever's cheapest so we make more money", but the doctor surely doesn't care about your access one way or the other.

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Permalink Reply by Judy on November 19, 2010 at 3:44pm

You've got 30 days to take that S8 Escape II back. But check w/your insurance company first to ask what local DME CPAP suppliers they are contracted with. Then shop each one of them before committing yourself to any one of them. Ask how lenient their mask exchange policy is, what brand and model CPAP they prefer to provide, tell them what brand and model CPAP you would prefer, ask them if they are willing to provide you w/that brand and model - or are they willing to provide you w/a comparable model that will provide Leak, AHI and AI data. You'll want a provider you feel comfortable with.

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Permalink Reply by Donna B. on November 19, 2010 at 7:14pm

I'll be on the phone Monday to my Doctor's office.




Janknitz said:

". According to me DME guy, I was prescribed the S8 because I have MILD sleep apnea. My Doc did not think I needed a full data machine. It does record hours used and and he said it does record my AHI. I go back for a follow up in January. I am still sleeping well since I last posted."

I think your DME is a lying snake. To my knowledge (anybody is welcome to correct me if I am wrong) the S8 Escape II collects efficacy data ONLY. NO AHI data. None. It collect compliance data only, so that lying DME can be certain he will get paid by your insurance company, and for no other reason than that. Try this--take your card into the DME and ask them to print out your AHI's so you can see how well the therapy is going. And make sure you watch to make sure it's YOUR card they are printing out.

And as others have pointed out, it's highly unlikely that your doctor said you didn't need a full data machine. If your doctor has a piece of the DME's business he might have said "give her whatever's cheapest so we make more money", but the doctor surely doesn't care about your access one way or the other.

• ▶ Reply

Permalink Reply by Donna B. on November 19, 2010 at 7:34pm

Thanks Judy, Didn't even think about the money/profit issue in all of this. What a shame that it is at the expense of the patients.
I wonder how many other people at his practice are sent on their merry way and don't have a clue. They just take what he says as word and don't question it. This makes me so mad. I will have a hard time trusting him in the future. I am running out of places to go, there are only so many sleep docs here. If it weren't for all of you I would have had no clue either. UGH !
Thank you so much,
Donna B.




Judy said:

You've got 30 days to take that S8 Escape II back. But check w/your insurance company first to ask what local DME CPAP suppliers they are contracted with. Then shop each one of them before committing yourself to any one of them. Ask how lenient their mask exchange policy is, what brand and model CPAP they prefer to provide, tell them what brand and model CPAP you would prefer, ask them if they are willing to provide you w/that brand and model - or are they willing to provide you w/a comparable model that will provide Leak, AHI and AI data. You'll want a provider you feel comfortable with.

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