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Anyway to Cheat on CPAP Compliance Logs!

(deactivated member)
on 2/24/11 2:55 pm - university park, IL
Hello All,

As a sidenote...WOW there are some hostile posts on here as of late..SHEESH!! Well, here's hoping my post is not met with hatred and hositlity! Ok, as you can tell from my post I am looking for a way to circumvent the stupid CPAP logs required by my surgeons office. Now, wait, before I get flamed and reamed a new one about the importance of CPAP, I have a REALLY good reason I need to get around this...I have a old CPAP machine around here somewhere (from a fea years ago.) The thing burned my throat and nose so bad it continued throughout the day. I would snatch it off druing the night.. I couldnt tell you who supplied it. If the name of the company is etched on the CPAP...ok then theres hope...maybe, I had two new sleep study's performed in preparation of this surgery and because of a bunch of stupid inefficient staff at the sleep center, these studies and subsequent CPAP recommendations took from December to mid January. Just in time for all my deductibles to reset! Lucky Me! se CPAP. BUT, and heres where my good  We have a 6K insurance deductible. Getting a SECOND CPAP machine is ludicrous since I already have one, PLUS even though our insurance wont be paying for this machine, because we pay outta pocket until that deductible is met. Tthey STILL  REQUIRE a 3 months rental on the machine, meaning I must pay for three months of rental out of pocket.

Still not convinced? Ok fine, the anti blood clotting drug needed for after surgery....Y'all know, The one that gets injected into your stomach twice a day? Well I have NO prescription  coverage for that!!!  (The surgeons office requires you call and get your coverage information from your insurance company and fax it in to them.) Thats a whopping 2400 out of pocket and it will be paid all at once, to the pharmacy!!!!   No bills, no payment plans.  So, yeah, so paying for the A SECOND stupid CPAP machine is an added expense we don't wanna have to bear.

Still not a good enough reason?? Ok fine, NOW the plot thickens, according to the program coordinator, my insurance will be changing it's requirements from a 12 week medically supervised weight loss program (which I completed todayy) to a 6 months requirement. This will happen March 1, 2011. According to her, I SHOULD be allowed to be approved under the old requirements, but she said it best....Why be caught up while BCBS transitions into this if I don't have to be? I contacted BCBS IL and the nice but utterly useless rep said she could send me out a copy of the WLS portion of my policy (my 4th in 3 months.) She said she had no knowledge of the requirements changing and that WHEN , not IF, but WHEN they did I would get something in the mail....Ummm NOT helpful.


PLUS not all surgeons require the CPAP compliance logs. I say that to say, this surgoen obviously believes patients are less than honest about CPAP and so to make sure patients are using their CPAPs he requires the logs from the company that supplised the device. Fine, but Im sure other surgeons are aware of this fact as well, and they don't require logs. I say this to say, this is not a universally recognized practice. I cannot just switch surgeons as I am in the Chicagoland area and considering the staggering out of pocket costs for the anti clotting drug, I absolutely cannot afford to travel for this surgery.

Has anyone convinced a surgeon THAT REQUIRES CPAP logs to proceed without them? I was diagnosed with mild to moderate apnea and the surgeons office already said they would require CPAP during my stay at the hospital. Also the intern SLIPPED and said they PRESCRIBE CPAP for patients AFTER surgery when they do not have a machine at home.... So thanks for letting me rant! .
nightowl
on 2/24/11 3:47 pm - Topeka, KS
You don't need to change CPAP machines, you need to try a different mask with your current CPAP.  Call the medical equipment company to do this.

Don't cheat.  Ask the surgical practice if they can tentatively accept you (pending getting a mask that you can comply with) and proceed with application to your insurance while it will still be under the old 12-week supervised dieting rule.  I don't know if the surgical practice will work with you on it or not, but you can at least ask, and show good faith on your part in working towards CPAP compliance.
nightowl
on 2/24/11 5:53 pm - Topeka, KS
I read your post again, and I should modify my post.  You said the CPAP "burned [your] throat and nose so bad it continued throughout the day."  Okay, now I'm thinking that a change in mask might not be enough.  You probably need to add a humidifier that attaches to your CPAP, or add water to the current one if you have a humidifier attached already.  If that and the change in mask aren't enough, you may need to get a new CPAP.  I couldn't entirely follow what you were saying about requiring a rental, but if you need a new machine, consider just renting it at first.  If you don't know who supplied your old machine, you can start with a new medical supply business.  Some of the CPAPs have a ramp feature, whereby you can start the use with a lower force of air when you go to bed, and then over a few minutes it ramps up to your assigned pressure.

You could inquire if the drug company that makes the expensive drug your surgical practice thinks you need has a patient assistance program, and see if they will approve you for it and let you have it free, even though you do have insurance.  One time I was in need, and I did get approved for a free med even though I had insurance that covered pharmacy, because my co-pay for it was unaffordable. 
walter A.
on 2/24/11 4:52 pm - lafayette, NJ
DS on 11/12/10 with
the machine logs it usage if it was made within the last ten years. either on the screen, or on the data card.  Apnea can give you a serious heart condition, it did me. are you sure you are up for wls? 
P. Poster
on 2/24/11 6:02 pm
 Try a different mask and add a humidifier to your current Cpap machine.

As for the blood thinner, I am guessing you are speaking of Lovenox (and yes, it is stupid expensive, even WITH insurance)?  Find out why your insurance doesn't cover it, if you had a clot, would they make you pay out of pocket for it?  Also, see about Heparin instead, that MAY be covered.
(deactivated member)
on 2/24/11 7:40 pm - university park, IL
Thanks for the replies. And I am absolutely ready for WLS. FWIW I started my pre req's in OCTOBER of LAST year even though my meeting with the surgeon wasn't until JAN 26th. While they casually mentioned in an INFORMATION SESSION that sleep studies would be required, they made no mention of compliance with CPAP or madatory activity logs. I came here and asked questions and gleamed information from people here that they MAY require logs, and they MAY just ask me if I wear the CPAP. 

I posted about a month ago about the stupidly inefficient people at the sleep center where I did the test. For whatever reasons they scheduled these appointments MONTHS apart. I also told the doctor that I did not do well with CPAP and would like a BI PAP (something else I learned here) the doctor did not pass the information on and I had a second sleep study with a CPAP. The technician that performed the study assured me that I could simply request a BI PAP when it was time to order the machine. Well needless to say NONE of this is true. Meanwhile I did not find out until the first week in Feb that the surgeon would be requiring CPAP LOGS. This is also the same time I found out that I would be required to rent a new CPAP machine for three months.

I say all that to say, everyone is entitled to their opinion, but i was unbelievably pro active in getting stuff done. The stupid CPAP machine logs came out of left feild. But even if they didnt, non compliance with that means one is not ready for WLS? Sheesh.

Anyways, I took the advice of the other posters and contacted the surgeons office and requested another way to meet the CPAP compliance log thing. I honestly considered that my LAST option but thanks to you guys I had the coruage to simply give it a shot...Thanks for letting me rant!
Ms. Cal Culator
on 2/24/11 8:14 pm, edited 2/24/11 8:15 pm - Tuvalu


Hello All,

As a sidenote...WOW there are some hostile posts on here as of late..SHEESH!! Well, here's hoping my post is not met with hatred and hositlity!


That won't work...this is just lke the real world...some days things run smoothly, some days, not so much.


Ok, as you can tell from my post I am looking for a way to circumvent the stupid CPAP logs required by my surgeons office. Now, wait, before I get flamed and reamed a new one about the importance of CPAP, I have a REALLY good reason I need to get around this...

Uhm...not so much...you understandably hate the damned thing--which explains why you can't find find it.   And why I know where one of mine is but not the other.

I have a old CPAP machine around here somewhere (from a fea years ago.)  The thing burned my throat and nose so bad it continued throughout the day. I would snatch it off druing the night.. I couldnt tell you who supplied it.
   Been there done that...it's a pain.  Find it and get the parts you need to make it work for you...could be a heater, a new mask, a humidifier...OR a new and better machine that isn't as oppressive.  (More on that in a minute.)

If the name of the company is etched on the CPAP...ok then theres hope...
if the name ISN'T etched on it, then you go to a local durable medical equipment company and ask them if it's theirs or if they have that model and can reset it to your newest test results.  (They'll need your doctor's orders.)  ALTERNATIVELY, you can find CPAPs (and I prefer the AutoPAP or Auto CPAP or even a BiPAP to the basic CPAP for sale used or even for rent on the old interwebs.  I just found one in SoCarolina for $45 a month...not free, but you don't need it that long.

maybe, I had two new sleep study's performed in preparation of this surgery and because of a bunch of stupid inefficient staff at the sleep center, these studies and subsequent CPAP recommendations took from December to mid January. Just in time for all my deductibles to reset! Lucky Me! se CPAP. BUT, and heres where my good  We have a 6K insurance deductible. Getting a SECOND CPAP machine is ludicrous since I already have one, PLUS even though our insurance wont be paying for this machine, because we pay outta pocket until that deductible is met. Tthey STILL  REQUIRE a 3 months rental on the machine, meaning I must pay for three months of rental out of pocket.  
Hey!  The geniuses at my mother's assisted living refilled all her Rxs for the new year the last week in December...months after she had hit her MediCare "donut hole" and had no coverage...so I got to pay TONS for them.  Had they waited until January 1st, they would have been free.  And my mom is low income.  

Still not convinced? Ok fine, the anti blood clotting drug needed for after surgery....Y'all know, The one that gets injected into your stomach twice a day? Well I have NO prescription  coverage for that!!!  (The surgeons office requires you call and get your coverage information from your insurance company and fax it in to them.) Thats a whopping 2400 out of pocket and it will be paid all at once, to the pharmacy!!!!   No bills, no payment plans.  So, yeah, so paying for the A SECOND stupid CPAP machine is an added expense we don't wanna have to bear.


Well, I don't know what you do for a living or how rich or poor you are.  The drug manufacturer--if it's Lovenox--has a low- or no-cost benefit program.  They SAY it's for people who have no insurance, but they accept appeals for the "underinsured."  Of course, your income has to be pretty low...so maybe you'll need to write a reallly good letter or bite the bullet on this part.


Still not a good enough reason?? Ok fine, NOW the plot thickens, according to the program coordinator, my insurance will be changing it's requirements from a 12 week medically supervised weight loss program (which I completed todayy) to a 6 months requirement. This will happen March 1, 2011. According to her, I SHOULD be allowed to be approved under the old requirements, but she said it best....Why be caught up while BCBS transitions into this if I don't have to be? I contacted BCBS IL and the nice but utterly useless rep said she could send me out a copy of the WLS portion of my policy (my 4th in 3 months.) She said she had no knowledge of the requirements changing and that WHEN , not IF, but WHEN they did I would get something in the mail....Ummm NOT helpful.


Their policies are online.  Or they were.  Get your own copy.


PLUS not all surgeons require the CPAP compliance logs. I say that to say, this surgoen obviously believes patients are less than honest about CPAP and so to make sure patients are using their CPAPs he requires the logs from the company that supplised the device. Fine, but Im sure other surgeons are aware of this fact as well, and they don't require logs. I say this to say, this is not a universally recognized practice. I cannot just switch surgeons as I am in the Chicagoland area and considering the staggering out of pocket costs for the anti clotting drug, I absolutely cannot afford to travel for this surgery.    So your choice seems to be to do what THIS surgeon wants...suit up, Bubba.  You'll look great in the headgear.

Has anyone convinced a surgeon THAT REQUIRES CPAP logs to proceed without them? I was diagnosed with mild to moderate apnea and the surgeons office already said they would require CPAP during my stay at the hospital. Also the intern SLIPPED and said they PRESCRIBE CPAP for patients AFTER surgery when they do not have a machine at home.... So thanks for letting me rant! .

I didn't let you rant...I pretty much told you that most of these isses have solutions...sorry to rain on your pity party...but it's for your own good you know.

Sue

(deactivated member)
on 2/24/11 8:26 pm
Where else do you plan on cutting corners and cheating?  The best advice I can give is to delay getting your DS.  It doesn't seem medically or financially feasible at this point.  Get everything else straightened out first and give yourself the best chance of having an uncomplicated procedure with a smooth, compliant postoperative course. 
Elizabeth N.
on 2/24/11 9:02 pm - Burlington County, NJ
You need a humidifier attachment for the CPAP machine. There are both heated and unheated versions available. I'd suggest trying the unheated one first since it's cheaper :-). Some people do better with a heated humidifier, though.

I understand that CPAPs are a pain in the ass. But this is important. Invest some time in making it possible to comply. Sleep apnea kills.
Sheanie
on 2/25/11 7:13 pm
DS on 08/21/09 with
I re-read your post to make sure I was reading it correctly.  So your main complaint is money, if I understand you right.  Your second complaint is "hoop-jumping", or meeting your insurance requirements.  Well, put your flame-retardant panties on.

If you think Lovenox is expensive, you surely better go price out some Proferrin, dry D, dry A, oh heck, go price out a year's worth of DS vitamins.  Just for fun, throw in the first year's worth of labs, too.  Lovenox is a one time expense.  The rest are RECURRING expenses for the rest of your LIFE.  While you're still reeling from those dollar signs, you might want to consider temporarily switching deductibles for a year.  Or asking your insurance company to please waive one of the requirements.  Or list another co-morbidity.  The possibilities are endless.

But labeling a post with a request on how to "cheat" to get the DS?  Really, sincerely?  Did you also go for your weigh-in with rolls of quarters in your pockets?  Slouch when they measured you (to increase your BMI)?  Get real.

I.  am.  not.  a.  doctor.

HW 250ish  SW 219  CW 110  LW 100