[Equipment] New DME, New Machine - Respironics 640 ??

[MAPnea]

Hi, Everyone,

Just spoke with my doctor's assistant and they said they want me to have a "top of the line" machine with "auto" capability like the ResMed S9 and that I should STAND MY GROUND until I get what I want! They said that Lincare, especially in Ely, has a tendency to give an unknowing patient (I'm far from "unknowing", thanks to all of you on this board) the bare minimum machine to someone who is on Medicare. So, I should simply stand my ground and get what I want…. and my doctor will stand behind me. If the local Lincare won't provide, then they'll call their "higher up" contacts at Lincare to get things straightened out. I have a back up!!

(**note, I've been using a ResMed S9 since starting therapy in October 2012, but Medicare refused to pay for that machine because the doctor in St. George ordered it BEFORE he ever saw me in person…. so I could "get used to it" before a sleep study. I've never paid a dime for it, but I've paid for all my supplies. I feel awful that the DME never got paid, so I want to return it to them. It wasn't their fault the doctor goofed. Plus, I want Medicare to pay for the ResMed S9 and my supplies. So.. new doctor, new sleep study, new ResMed S9.)

Then the assistant had me, over the phone, go to my machine and change it to straight CPAP with a pressure of "9" and an EPR of "2" (which I've been using that setting) and a ramp time of 15 minutes. She knows I know how to do this and thinks it's wonderful to have an "informed, active participant" as a patient. So… I get to try it out tonight!

Also, the doctor wrote "mask of patient's preference" and I'm going for the ResMed Air Fit P10 as the mask the DME gets to pay for. Oh… and my doctor will send me a prescription, too, so I can get my "spare" on line. The "spare" will be the Nuance Pro which I used for most of my sleep study.

I am SO HAPPY… and now begins the battle with the DME in Ely.

[retired_guy]

This is really good news MAP.

My personal feeling is that many doctors and their staff's are becoming much more enlightened to the advantages of having informed and proactive patients. It sounds like you've got a keeper there.

As far as the DME is concerned, they have to fill the prescription as written. If they elect to not do so, you can fill a complaint with them to your local medical boards.

[JWR]

I am SO HAPPY… and now begins the battle with the DME in Ely.

Good job on standing your ground ! It payed off .

[diamaunt]

Just spoke with my doctor's assistant and they said they want me to have a "top of the line" machine with "auto" capability like the ResMed S9

there are *13* basic models of the RESMED S9.

saying "the resmed s9" is like saying

"I want a general motors 2014 car!"

you might WANT a caddilac, but you're more likely to get a cheap low end chevy with that nonspecific request.

36001 S9 "Escape" (CPAP Only, no data)
36002 S9 "Escape Auto" (No data, apap mode)
36003 S9 "Elite" (cpap only)
36004 S9 "VPAP S"
36005 S9 "AutoSet" (advanced autoset mode)
36006 S9 "VPAP Auto"
36007 S9 "VPAP Adapt" (older)
36009 S9 "VPAP ST-A" (older)
36037 S9 "VPAP Adapt"
36038 S9 "VPAP ST"
36039 S9 "VPAP ST-A"
36050 S9 "VPAP Tx"
36065 S9 "AutoSet" 'for her' Pink

[MAPnea]

Hi, diamaunt,
I guess I was so thrilled when I wrote my last post I forgot to write "ResMed S9 Autoset". As Zonk said, and my doctor agrees, I need a machine that can do both APAP and CPAP. The doctor's assistant said something like, "We don't want to wait around while they try different machines…" and then she said if I had any problems, they would contact Lincare OR write the script for a ResMed S9 Auto "as prescribed". So… I'm on my way! And thanks for the model numbers.
When I bought my first car I only knew that it was "blue"… That's what I wanted. A Blue Car. Turned out to be a Ford and was the best car I ever owned… well, until my last car which was a Mazada RX-7, the last year of the classic body style. Even though I knew I was losing my sight, I thought I'd go out in grand style (for me). Oh, and it was a silver blue. I got to drive it almost 2 years...

[robysue]

Hi, Everyone,

Just spoke with my doctor's assistant and they said they want me to have a "top of the line" machine with "auto" capability like the ResMed S9 and that I should STAND MY GROUND until I get what I want!

This means the doc wants you to have one of the following two machines:

The Resmed S9 AutoSET. The S9 Escape Auto is NOT equivalent.

The PR System One REMstar Series 69 Auto CPAP with A-Flex (model 560 or 561)

The model 460 PR machine is indeed the equivalent of the S9 AutoSet. For a detailed comparison between the S9 AutoSet and the System One APAP, see my post at http://www.apneaboard.com/forums/Thread-...1#pid49331

[Sleepster]

It's the PR System One Model 560 or 561 that's equivalent to the ResMed S9 Autoset, and to be completely equivalent it should have the option for the heated hose.

Well, as close to equivalent as you can get.

The PR System One Model 460 or 461 is equivalent to the ResMed S9 Elite. But again, it should have the heated hose option.

That comes standard on the S9, but it's an option on the PR System One.

Now whether you actually connect a heated hose is your choice, but with the PR System One it's your choice only if you get the machine with that option. Confusing, but that's the way they do it.

[MAPnea]

Hi, robysue,
Thank you for posting the names of the two machines I should insist the DME give to me. I found your link earlier today in a post by Payton A on the thread "Which Res? Urgent!" by cowboy 1970 and book-marked your comparisons of ResMED and ResPIRONICS to read later today or tomorrow. zonk also made a good point in this thread about how an APAP machine would give my doctor and me more treatment options and greater data gathering abilities - and I used that when I talked with the doctor's assistant…. and she agreed.

So, I called the DME back to find out EXACTLY what they "had in stock" that they planned to bring out to me when my mask arrived and she said, a "Rem Star Pro #DS46OHS" which isn't capable of APAP. So, I think I "P*ssed her off" when I said I thought my doctor wanted a CPAP with APAP and DME lady said, "Well, I'll just return this one when it comes and wait for your doctor's new prescription". "And", she continues, "if you weren't tritrated on an AUTO PAP, then Medicare won't pay for it." Does anyone know if that's so?

It's exhausting work being assertive and advocating for one's own self and treatment. I couldn't do it without all of you helping me.

[Sleepster]

I feel awful that the DME never got paid, so I want to return it to them.

You are far more gracious than me.

But maybe that's at least partially due to my being burned by DME's too many times.

[MAPnea]

Thanks, Sleepster,

I'm still in the process of emailing my doctor's capable assistant while referring back to this thread to double-check what I want to say (because so many helpful members have "said it better" than I ever could and deserve to be quoted or paraphrased in my email) and now you've given me exactly what I was looking for: The Phillips-Respironics models that are equivalent to the ResMed S9 Autoset. Although I'm "set" on the Autoset, I should at least give a nod to the PR equivalents. So THANK YOU!

I don't know if I'm "gracious" or not. I just feel sorry for the poor ladies at the old DME. It wasn't their fault they didn't get paid.