Posted by mbankat on February 15, 2011 at 15:13:49:I have diagnosed and treated OSA with RLS and PLMD for over a decade. I have gone through 3 sleep studies and countless doctor office visits and medical device meetings/replacements.
Here is some of what I have learned:
Know your insurance and how it covers sleep apnea diagnosis, treatment and maintenance. Know the durable medical equipment (DME) clauses and the referral clauses. Know the deductibles. Otherwise, it WILL bite you in the backside, and usually right when you need something the most.
(IMHO) Sleep Health Centers (SHC) is by FAR the best place to get your sleep study done. Sleep is ALL they do. The hospitals are just quickly nailing together staff and beds to make 'sleep departments' because they see this is a huge and rapidly growing area with tons of money to be made. If the place you are looking at does not SPECIALIZE in it... and have years of experience... DON'T use them for the study.
My system allows 2 regular maintenance visits to the doctor each year, and 2 ‘extra’ visits to a technician who deals with the machine, mask, parts and fittings. I can get more if there is a problem or emergency. BUT you NEED the referral FIRST.
(The “tech” is, IMHO, clueless. He knows less than I do about his field. I hate it when a doctor or “tech” asks me questions like: ‘what is your CPAP pressure, what mask are you using now, etc. They SHOULD KNOW THAT stuff BEFORE I arrive. I ALWAYS took at least an hour to review my client’s situation before a meeting.)
After the study get your CPAP, mask, etc from ANOTHER OUTFIT. NOT the one who did your sleep study. They will want to provide the entire cycle to you as ‘turnkey’, but IMHO, this is NOT to your advantage. Otherwise, when you have an insurance billing problem - and you will - they can't hold you hostage not providing replacement masks/gear/etc while you still owe them for a disputed bill or one tied up in an insurance referral snafu.
This has happened to me each of the last three years. So, I NO LONGER LET Sleep Health Centers provide both the sleep study and the equipment. If you have any outstanding balance on one, you won't get the other or either. It is like owing the last $100 to your mechanic on a $900 brake job and not being able to buy gas from him.
You are held hostage. They don’t disclose this, and they SHOULD. It is wrong.
I understand the business end; I hold a magna c*m laude degree in business. I ran my own business for 22 years. But, they should not hold up medical care when you owe money to ANOTHER company because they made a supply and billing arrangement that is to THEIR advantage NOT YOURS. I think it stinks of collusion and should be illegal. It is like when your Visa, MC and your car loan all raise your interest rates because you were late on a student loan.
ALSO, MOST of the time, if you go to ONE source for all, they ONLY get their equipment and supplies from ONE manufacturer. They say they get from all, but in practice ALL I EVER GET SUGGESTED is ResMed. They are good, but so are others, and not all masks they provide will help all patients. My last quick count was 15 MAJOR CPAP equipment and parts manufacturers. Don’t let them get you stuck into the one THEY made some sweetheart deal with. My SHC guy only pushes ResMed and talks bad about others. I let him talk me out of another brand mask I researched to take one that ultimately did not work as well and cost me almost 8 months to get right.
Know your insurance: coverage/DME/referrals/deductibles.
BUY DIRECT from local (or online) DME Durable Medical Equipment suppliers. They can and will provide service, support and replacement parts.
Let the Sleep Center provide you with your doctor/physician and they STILL CAN read your equipment to get all the data they need. They might not like it, but tough. You will get better treatment overall.
Make CERTAIN you can use products from different manufacturers. You can have a CPAP machine from ResMed, a mask / hose / headgear from Resprionics – or whatever combination fits YOU best. Not what is best for their bottom line and their convenience.
Not all pieces of this apnea puzzle will work with others; different makers or masks or machines may not always work together - but there are many occasions when you will find a mix of brand names works best for you.Pleasant dreams!