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Cough Assist Machines

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  • briars_mom
    Hello all. Briar is currently going through some type of possible respiratory infection which may be just a random chest cold . He has tested negative for
    Message 1 of 6 , Nov 7, 2006
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      Hello all. Briar is currently going through some type of possible
      respiratory infection which may be just a random "chest cold". He has
      tested negative for pneumonia and is doing well but has some moderate
      congestion/secretions that are obviously difficult for him to manage.
      Briar's pulminologist recommended a cough assist machine, which I have
      heard about frequently through this site. Unfortunately, we have been
      informed that Briar's insurance will not fund one of these devices. I
      had spoken with Briar's equipment company about purchasing one out of
      pocket and found out that I'd be looking at spending between $5000 and
      $7000. Do any of you have any recommendations on ways or places to
      possibly acquire one of these machines? I've been told to look for
      places that may sell used and retired medical equipment but I don't
      know where to start. I thought I'd benefit possibly by posting this
      and I will begin an internet search as well. Thank you all for your
      help!

      Stacey
    • Wendy
      Hi Stacey This is just brief - but in UK we are able to borrow a cough machine from our NHS hospital for acute attacks - perhaps you could find out if you
      Message 2 of 6 , Nov 7, 2006
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        Hi Stacey

        This is just brief - but in UK we are able to “borrow” a cough machine from our NHS hospital for acute attacks – perhaps you could find out if you could do the same from

        (Message over 64 KB, truncated)

      • Johnson, Tom
        Is it that your insurance doesn t cover it or that they just rejected the claim as not necessary? Have you attempted a medical necessity letter from the
        Message 3 of 6 , Nov 7, 2006
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          Is it that your insurance doesn’t cover it or that they just rejected the claim as not necessary?

           

          Have you attempted a medical necessity letter from the pulminologist and appealed the insurance’s decision?

           

          Our insurance didn’t want to cover an IPV machine at first (too new, no research that it works etc) but we fought back (with the doctor’s help) now they do.  However, the only company that has the machine (in our area) is not a provider with the insurance so coverage is at 80% instead of 100%.

           

          It’s a lot cheaper to keep the kids out of the hospital than in and this cough assist machine may help.

           

          Sorry I don’t have information on used equipment.

           

          By the way, I am new to this Yahoo group.  My son is 9 (was Superman for Halloween) and has X-link MTM (or mutated gene according to the MDA clinic since we could fine any history).  We also have a 16 year old son (without MTM or other diseases) who loves his younger brother.

           

          Tom


          From: Myotubular_Myopathy@yahoogroups.com [mailto:Myotubular_Myopathy@yahoogroups.com] On Behalf Of briars_mom
          Sent: Tuesday, November 07, 2006 8:39 AM
          To: Myotubular_Myopathy@yahoogroups.com
          Subject: [Myotubular_Myopathy] Cough Assist Machines

           

          Hello all. Briar is currently going through some type of possible
          respiratory infection which may be just a random "chest cold". He has
          tested negative for pneumonia and is doing well but has some moderate
          congestion/secretio ns that are obviously difficult for him to manage.
          Briar's pulminologist recommended a cough assist machine, which I have
          heard about frequently through this site. Unfortunately, we have been
          informed that Briar's insurance will not fund one of these devices. I
          had spoken with Briar's equipment company about purchasing one out of
          pocket and found out that I'd be looking at spending between $5000 and
          $7000. Do any of you have any recommendations on ways or places to
          possibly acquire one of these machines? I've been told to look for
          places that may sell used and retired medical equipment but I don't
          know where to start. I thought I'd benefit possibly by posting this
          and I will begin an internet search as well. Thank you all for your
          help!

          Stacey

        • Kimberly Kowalski
          hi stacey, what about mda? i dont know if they actually can get you one thru them but if they cant maybe they can point you in the right direction. they are
          Message 4 of 6 , Nov 7, 2006
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            hi stacey,
            what about mda? i dont know if they actually can get
            you one thru them but if they cant maybe they can
            point you in the right direction. they are great for
            info/networking.

            they are expensive machines but i know in my sons
            short life it has saved him numerous times.

            good luck and i hope briar is feeling better soon.
            k
            --- briars_mom <briars_mom@...> wrote:

            > Hello all. Briar is currently going through some
            > type of possible
            > respiratory infection which may be just a random
            > "chest cold". He has
            > tested negative for pneumonia and is doing well but
            > has some moderate
            > congestion/secretions that are obviously difficult
            > for him to manage.
            > Briar's pulminologist recommended a cough assist
            > machine, which I have
            > heard about frequently through this site.
            > Unfortunately, we have been
            > informed that Briar's insurance will not fund one of
            > these devices. I
            > had spoken with Briar's equipment company about
            > purchasing one out of
            > pocket and found out that I'd be looking at spending
            > between $5000 and
            > $7000. Do any of you have any recommendations on
            > ways or places to
            > possibly acquire one of these machines? I've been
            > told to look for
            > places that may sell used and retired medical
            > equipment but I don't
            > know where to start. I thought I'd benefit possibly
            > by posting this
            > and I will begin an internet search as well. Thank
            > you all for your
            > help!
            >
            > Stacey
            >
            >
            >





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          • pinksarah21
            Stacey, Does the insurance company have an appeal process?? Most do. There is a template for letters of medical necessity on the website of Dr. John Bach, MD,
            Message 5 of 6 , Nov 8, 2006
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              Stacey, Does the insurance company have an appeal process?? Most do.
              There is a template for letters of medical necessity on the website of
              Dr. John Bach, MD, the speaker that we had on the Teleconference last
              month. Here is the link: http://www.doctorbach.com/letters/
              You would need some numbers from lung studies (often done by a
              pulmonologist), such as peak cough flow, etc. Anyway, Dr. Bach has had
              great success in getting these important devices approved for patients
              with muscle weakness, such as myopathies. You may want to look into
              the appeal process. Sometimes insurance companies may pay for things
              that are not even covered in the policy, IF they realize that it
              creates a cost savings for them. If insurance companies realize that
              these machines can decrease hospitalizations, they may realize that
              the savings pay for the machine. Also, you may want to into rentals
              while going through the appeal process. Good luck, and keep us posted
              on this.
              -Pat
            • kristin.burlage@comcast.net
              I live in the Chicagoland area and there are a couple of organizations one is called Division of Specialized Care for Children or DSCC for short. Our
              Message 6 of 6 , Nov 8, 2006
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                I live in the Chicagoland area and there are a couple of organizations one is called Division of Specialized Care for Children or DSCC for short.  Our insurance wouldn't cover a bath seat so we sent the denial letter and a letter of medical necessity to our representative there and they bought us one.    Also there is a group called Midwest Council for Children with Disabilities my son's therapist told us about it.  She described it as an organization made up of very well to do individuals who want to spend there money to help children with special needs.  I've not had to use this yet so I don't know how it works, there website is www.mccdcares.com.
                I don't know where you live so I don't know it this helps or not but I thought maybe there are similar programs in your area.  My son's therapists were very helpful in getting us in touch with DSCC.  Maybe some of Briars therapists would know of similar organizations in your area.
                 
                We just got are cough assist machine 2 weeks ago.  My son Justin was in the hospital with a mild case of Pneumonia that started with a throat infection.  We all were amazed including the Respiratory therapists at the hospital when we saw how much stuff we were able to get out of Justin his first time using it.  We had been doing Nebs, CPT and Suctioning but this worked so well, it reduced the amount of suctioning we had to do and he was out of the hospital 2 days earlier than his usual 7 day stays in the past. 
                 
                I read that Pat suggested appealing the insurance company- I have heard that a lot of times they deny the first request but will usually approve an appeal.  They just figure most people won't appeal. 
                Hope this helps,
                 
                Kristin Bonny
                 
                -------------- Original message --------------
                From: "briars_mom" <briars_mom@...>

                Hello all. Briar is currently going through some type of possible
                respiratory infection which may be just a random "chest cold". He has
                tested negative for pneumonia and is doing well but has some moderate
                congestion/secretio ns that are obviously difficult for him to manage.
                Briar's pulminologist recommended a cough assist machine, which I have
                heard about frequently through this site. Unfortunately, we have been
                informed that Briar's insurance will not fund one of these devices. I
                had spoken with Briar's equipment company about purchasing one out of
                pocket and found out that I'd be looking at spending between $5000 and
                $7000. Do any of you have any recommendations on ways or places to
                possibly acquire one of these machines? I've been told to look for
                places that may sell used and retired medical equipment but I don't
                know where to start. I thought I'd benefit possibly by posting this
                and I will begin an internet search as well. Thank you all for your
                help!

                Stacey

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