CPAP Confusion

I had something else planned for today’s blog, but changed my mind.  This early morning, I was sitting on my bed surrounded by three – THREE -CPAP machines.  To understand what happened, you may need some “back story.”  So, here it is.

By now, you know that I have macular degeneration.  I also have AFIB.  I use a CPAP machine.  And, after my fourth (and, I’ve decided, my last) sleep study, my doc ordered an oxygen concentrator for me to use at night; an oxygen concentrator to use with the CPAP machine, as well as a new CPAP machine.

My original machine (a Dream Machine) was provided by US Med, whose office is somewhere in the United States.  My primary insurance is Medicare; so, Medicare was billed for the machine and all of the replacement supplies every time they were needed.  After using the machine for several years, a letter came stating that the machine was being recalled.  A conversation with the supplier let me know that I didn’t need to be concerned about the recall.  I was to continue using the Dream Machine.

The machine has a screen on which it shows the amount of pressure in use; the pressure varied from eight units to twenty.  No one at the company could tell me why there was a difference in pressures.  So, it just continued to vary.  The Dream Machine has a modem of some kind that automatically sends compliance information to someone.  I have never been sure where it goes – just that it goes to someone, who reports it to “wherever” to keep the compliance issues up-to-date.

Compliance is a BIG issue.  Insurance will not pay unless the machine is actually being used by the patient for four hours per night; understandably.  I’ve had more than one conversation with someone at the company about my compliance.  I go to bed around midnight.  Many a night, I apparently take the mask off during the night, because I find the mask on the floor when I wake.  The person(s) with whom I had those conversations assured me that it was okay because many of their patients do the same thing.

After another sleep study, a new CPAP machine was ordered and supplied by Summit Respiratory, whose office is in the metropolitan area.  I stopped using the recalled Dream Machine and started using the machine from Summit.  I don’t like the machine from Summit; it isn’t as easy to use, and I can’t figure out how to get the same kind of information from it that I could get from the Dream Machine.  But, a recall is a recall, so use the new machine, I did.

One requirement when I started using the Summit machine was to have a face-to-face interview with my physician after a month of use.  I questioned my doc about this requirement and was surprised when he said that requirement came about because of fraud.  Apparently, the government insurance was being fraudulently charged by agreement between physicians and patients.  Thus the face-to-face of patient and physician requirement.

For months, I have had the Summit machine in use.  It went with me to Wisconsin for the entire month of December and was used every night.  Back at home, it is beside my bed, while the recalled machine sits in its protective bag on the floor, waiting for instruction to return it – if it really is one of the recalled machines.

So, then, I had two CPAP machines – one in use; the other, not.

This past week, a box arrived with a second box inside with a new Dream Machine 2 in the inner box.  Paperwork said the machine was to replace the Dream Machine that had been recalled (recalled more than eight months ago, that I was told I did not have to stop using, even though the recall was in place).  Now, I had three – yes, three – CPAP machines in my bedroom.  It is time, I thought, to figure out what needed to be done with this problem that seemed to be growing.

I called, left a message for US Med, explained some of the problem, and asked for help.  Today, not quite at the crack of dawn, US Med called at 8 AM needing additional information.  We talked a long time; the rep asked questions, and I attempted to answer.  What is the serial number on the old machine?  On the new machine?  What is the serial number on the machine I’m using now?  I had to ask her to hold while I looked for my glasses and my lighted magnifying glass.  (The miniscule serial numbers on these items are almost impossible to read.  Certainly, not without assistance.)  Responding to that question, I learned that the machine is a Luna II which is NOT a US Med machine.  And, is it a Luna II (Roman Numerals 2) or a Luna Eleven.  Turns out, it’s a Luna II (two).  I explained everything that I’ve written above.  I learned during that conversation which took many repeats of the same information, that I was able to help her understand the problem.  It turns out that the new Dream Machine 2 belongs to me.  Apparently, the old Dream Machine was billed to insurance and became mine after a period of time.  I am expected to follow the instructions to return the recalled machine.  But, only the machine.  Well, it makes sense to me that any mask or tubing is contaminated and must not be returned.  However, there is no reason to keep the machine filters that are “hermetically” sealed in plastic.  I’ll send those with the machine, and they can be sent to another patient.

I also learned that the machine I’m using was supplied by Summit Respiratory.  I don’t carry this kind of information around in my head and learn details like that when I need to.

My conversation with the US Med rep concluded with plans.  I will return the old machine (and usable supplies).  I will decide whether or not I want to continue using the CPAP machine that I have used for several months.  And, those conversations allowed me to learn that the machine I’m using came from Summit Respiratory.

I’m remembering that I’ve had more than one conversation with the Summit folks.  I remember going to their office in the southwest metro area, where a very pleasant, capable young woman helped me get started using it.  Instructions were that after a month of use, I should return the embedded chip media (that was used to record compliance) in the envelope with the correct address to the office.  The envelope also had a new chip in it.  So, I took the chip out of the machine, installed the new chip (that was in the envelope for the next compliance record), and mailed the original chip in the envelope.

My next conversation with Summit personnel was a telephone call, scolding me for not getting compliance information to them.  Yes, they had the first chip, but nothing since.  I explained that I only had the one chip that was sent.  Did not have another chip to install if I sent the second chip that was in the machine.  Did not have an addressed envelope, so I didn’t know where to send the second chip.  That person said she would contact the appropriate office, and I would receive another chip.  That was at least a month and a half ago.  No new chip.  No envelope.  I told her that if this new machine had a modem, this conversation wouldn’t have to happen.  So, we are left with no modem and no chip.

As directed by the US Med person, today, I called Summit, this morning and was put on terminal hold.  I finally took the advice of the computer voice that said if I wanted to have them call me back (there was a several-person wait for my turn), I was to hit #2.  And, within a short time, the phone rang.

I had to re-explain everything to this new person.  Yes, the Luna II was their product, and no, they had not been able to bill insurance because they had no compliance information.  Once again, I explained the problem with the Luna II machine, that it had no modem, that I had no chip to install, etc., etc., etc.  She said that the machine will store the needed information and download it to a new chip when it is installed.  I could take the chip to the metro office.

No, I told her, what I need is an addressed envelope.  USPS could get the chip to their office.  I did not ask (but should have) if they would be sending a new chip or the chip that I sent to them so it could be reinstalled in the machine, once received.

Now, my plan is to return the old Dream Station machine.  Check out the new Dream Station.  Compare the results with the Luna II that I’m using now.  Contact my doc with my information.  Determine with my doc which machine I want to be using, and notify everyone about the decision.  Arrange for delivery of consumable products.

The process took an hour and a half.  No wonder it takes us so long as retired persons to get things done.

Life gets “teeJus,” don’t it!

Be safe and well.

The Cranky Crone

Thoughtful comments are greatly appreciated.