01-03-2017, 03:38 PM
(This post was last modified: 01-03-2017, 03:40 PM by Mosquitobait.)
RE: Do Sleep Doctors...
(01-03-2017, 01:40 PM)OpalRose Wrote: I have my yearly visit next month. I just play along so that my Script will be renewed. It seems my DME wants a new one every year. They said it's now required by Medicare.
Yes, checked this and that is apparently how the DME is interpreting this. See: Replacement of Accessories used with a Beneficiary-Owned Continuous Positive Airway Pressure (CPAP) Device or a Respiratory Assist Device (RAD) Purchased by Medicare at the link below.
2017 Medicare DME Rules
BTW, if you look carefully at these rules, if you've already had an xpap device, you do not need all sorts of other documentation for supplies ONLY. So, technically, you should be able to go to any Medicare DME just with your prescription and get your order...naw...it's not that easy, but we can dream!
RE: Do Sleep Doctors...
This topic I think is a microcosm of the way a lot of things in life work. There are very knowledgeable and expert people available on most issues and then some not so good and some downright poor folks. You have to do your homework to find and get to the first tier folks. Some of us are lucky in that we live in areas with outstanding physicians and teaching hospitals as I do in the Seattle area. Others are not. This board offers a great service to supplement what we can't find on our own or just don't want to waste our time with doing things we can do for ourselves.
Proof that there are many good sleep medicine doctors can be found by going through the speaker list at this conference:
http://www.apneaboard.com/forums/Thread-...Conference
Happy Pappin'
Never Give In, Never Give Up
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA.
RE: Do Sleep Doctors...
(01-03-2017, 03:38 PM)Mosquitobait Wrote: BTW, if you look carefully at these rules, if you've already had an xpap device, you do not need all sorts of other documentation for supplies ONLY. So, technically, you should be able to go to any Medicare DME just with your prescription and get your order...naw...it's not that easy, but we can dream!
Yes, I agree with you on that. I shouldn't need a new script every year just for supplies. 
I think that DMEs are just covering their butt in case they are audited. Can't blame them.
I do buy some things online though, less hassle.
RE: Do Sleep Doctors...
(01-03-2017, 03:56 PM)sonicboom Wrote: This topic I think is a microcosm of the way a lot of things in life work. There are very knowledgeable and expert people available on most issues and then some not so good and some downright poor folks. You have to do your homework to find and get to the first tier folks. Some of us are lucky in that we live in areas with outstanding physicians and teaching hospitals as I do in the Seattle area. Others are not. This board offers a great service to supplement what we can't find on our own or just don't want to waste our time with doing things we can do for ourselves.\
I agree, but what I DO NOT get is why ANY sleep doctor would not look at the results of the wave forms from the machine instead of just AHI? To me, this is a doc who is not upgrading his skills as new medical recording becomes available. How can you possibly maximize your patient's therapy without looking at that data? While I agree, "how do you feel" is a good marker, how would you know what to fix if the answer is "terrible?" Oh yeah, another $2,000 sleep study. . . .
01-03-2017, 06:37 PM
(This post was last modified: 01-03-2017, 06:41 PM by chill.)
RE: Do Sleep Doctors...
My sleep doc feels that the data from the machine has zero credibility. He absolutely does not trust it to be accurate enough to be worth looking at.
I have no idea if he is right or wrong. I have never been in a position to compare the machine recorded data to PSG results. Certainly, much of what we rely on in SH is in extrapolation or assumption based on air flow and pressure alone. We rely on it as it is all that we have. If I were a doctor, I don't think I would put much weight on it either. Probably the best to be expected is that it would cause him to order a new PSG.
RE: Do Sleep Doctors...
I think the machine data or flow and pressure is very accurate and much easier to read than PSG data. The one area of data that is missing from machine data that is of real use is the EEG data that shows sleep states. i guess leg movements would be of interest to some. My sleep techs still had a great deal of difficulty interpreting the combination of flow from the nasal thermistor combined with the belt data. PSGs are using some very old technology.
Rich
RE: Do Sleep Doctors...
(01-03-2017, 06:37 PM)chill Wrote: My sleep doc feels that the data from the machine has zero credibility. He absolutely does not trust it to be accurate enough to be worth looking at.
I have no idea if he is right or wrong. I have never been in a position to compare the machine recorded data to PSG results. Certainly, much of what we rely on in SH is in extrapolation or assumption based on air flow and pressure alone. We rely on it as it is all that we have. If I were a doctor, I don't think I would put much weight on it either. Probably the best to be expected is that it would cause him to order a new PSG.
The accuracy of the machines has been studied and I think reported on here by me and others in the past. I will try and look for that research post and post the link again.
Happy Pappin'
Never Give In, Never Give Up
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA.
RE: Do Sleep Doctors...
Happy Pappin'
Never Give In, Never Give Up
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA.
RE: Do Sleep Doctors...
(01-03-2017, 05:41 PM)Mosquitobait Wrote: (01-03-2017, 03:56 PM)sonicboom Wrote: This topic I think is a microcosm of the way a lot of things in life work. There are very knowledgeable and expert people available on most issues and then some not so good and some downright poor folks. You have to do your homework to find and get to the first tier folks. Some of us are lucky in that we live in areas with outstanding physicians and teaching hospitals as I do in the Seattle area. Others are not. This board offers a great service to supplement what we can't find on our own or just don't want to waste our time with doing things we can do for ourselves.\
I agree, but what I DO NOT get is why ANY sleep doctor would not look at the results of the wave forms from the machine instead of just AHI? To me, this is a doc who is not upgrading his skills as new medical recording becomes available. How can you possibly maximize your patient's therapy without looking at that data? While I agree, "how do you feel" is a good marker, how would you know what to fix if the answer is "terrible?" Oh yeah, another $2,000 sleep study. . . .
Great point. Lousy doctor.
Happy Pappin'
Never Give In, Never Give Up
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA.
RE: Do Sleep Doctors...
Sleep doctor is a nice guy but almost useless. Primary care doctor is great. He is not a sleep doctor so when I talk to him about what I want he hands me his script pad and tells me to write it up. He just says that he does not know what to write. He signs it and off I go.
He will ask later how it is working and look at the outcome. I do not know how to judge him. Is he trusting me? or with all of the other problems is he just making me feel good?
Without this forum I would be lost in the system and not had the better outcomes. I never expected to see the new year.
To all of you that share yourselves 
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