(12-05-2018, 02:26 PM)LookingForward Wrote: I haven't talked to my current DME since last week. They were offended that I requested an AirCurve ASV (the machine I thought I went to the sleep study for) and that I didn't what the DreamStation. That's when I got the run-around about the need for the DreamStation based on my prescription and the wording about the Tidal Volume. They didn't like it that I knew ResMed could do the same thing.

So at the beginning of this week I called LinCare back to ask which machine was ordered. I was told the person that I needed to talk to was in a meeting but she would be given a message to call me. She still hasn't called back, so I figured out how to get my own prescription and sleep study results. After studying the results and posting on here, I felt that SleepRider had the two best possible solutions for which machine to get. 

After researching possibilities on how to get one of the machines, I remembered that Apria only sells ResMed products. So this morning I called my insurance first too see if the E0471 has been approved or where it is in the process. I was told that they haven't received a request for that. Even though my prescription says URGENT on it, Lincare is mad enough to not even submit it yet for approval. I then asked my insurance if I could switch to Apria and was told yes.

I then took by prescription and sleep study titration directly to Apria's office. I talked to the lady and told her what was going on and told her that Lincare also has the results but has dropped the ball. I also told her that I have educated myself a bit in this process and that I use a program called SleepyHead and that I learn a lot from online research and forums. I also told her that I knew that Apria only deals with ResMed and that once the insurance code for E0471 was approved that my insurance didn't care if I got the AirCurve ST, AirCurve ST-A or the AirCurve ASV. All three have the exact same negotiated rate. I told her that based on the wording of my prescription, the need for a backup rate and that I have Muscular Dystrophy with a weakening diaphragm muscle, I felt that the ST-A was the best choice for me over the course of the next 5 years of owning the machine. 

She was quite surprised that I knew all that. She said that in the 27 years that she's worked there, I'm the first person that understood the insurance end and the differences in the machines. She said that it was a wonderful thing that I've taken the time to learn. Since I gave her everything she needed to start the prescription process and submitting it to the insurance she was going to start on it today and get it submitted to my insurance. Unfortunately the respiratory therapist is on vacation until Monday but she was going forward with it all anyway and will have as much of it processed as she could by then. She told me to expect a call on Monday. She also made copies of all my documents, including the brochure for the AirCurve ST-A. She attached it all together with my reasoning behind getting that machine.

So hopefully I'll know Monday if Apria agrees with the ST-A.

I haven't decided yet when I'm going to tell Lincare no to bother. I don't really know how that works if two companies end up sending in for approval about the same time. I think that either on Dec 8 or 9 my monthly lease for my current machine renews. So it looks like for one month I'll be paying the rental cost on the old and new machine. But hopefully that also gives me until January 8 to return my current machine since I will have already paid for the rental. I will have two machines for a short time to give me the space to learn to adjust to the new machine.

It's not a victory yet. But I have a different route to take to try to get the ST-A through a different in-network provider.

I can't thank everyone enough on here for helping me. All of you are invaluable! 

(11-15-2018, 12:49 AM)SarcasticDave94 Wrote:

(11-15-2018, 12:07 AM)LookingForward Wrote:

(11-14-2018, 11:25 PM)SarcasticDave94 Wrote: BTW if you're interested, here's my thread on the ASV path.

READ IF YOU WISH BY CLICKING HERE

Thanks for the comments everyone. I will read your journey, Dave. I need all the help I can get to start making these phone calls tomorrow. As for tonight, I think I'm going to take Sleeprider's suggestion and change my settings this way from my original thread "BiLevel Machine...Advise needed" post #25:

"Personally, I think you could do very well in Vauto mode at EPAP min 9.0, PS 4.0 and IPAP max 16.0." 

good plan to do those settings, at least you'd gain some relief for now