01-10-2020, 08:44 PM
Cpap vet getting Medicare coverage and a "new patient" exam - need advice please!
Just wondering if I’m getting into another endless loop with my apnea treatment and if anyone has advice they would share w/me. I have been on a successful CPAP program since April 2016, and enrolled late last year in Medicare. My DME phoned this week advising Medicare won’t cover supplies until I can provide the DME a “doctor’s followup”, which they say needs only be a note or a Xerox of his notes to document that I’m adequately controlled and am compliant. The last I saw my sleep doc was 2016. My AHI was 6 at my January 2016 sleep study, I began CPAP in April and he saw me 3x over the next several months, each time, after CPAP, my AHI was consistently 0.0 or 0.1, at times going up to 0.2 or 0.3. He was delighted and told me I didn’t need to come again unless things started changing or I had any problems. I never did, I’m still getting those great numbers and 100% compliant except for 3 weather-related power outages.
Unfortunately when I phoned to see him for this Medicare thing, I learned he had left private practice, he is now a hospitalist. Two docs could see me now – one who was there in 2016 with whom I had bad experiences, and one who is new to me, a PA. I set an appointment with the PA, but got a call from staff that same day that I needed to move the appointment to earlier in the day because they had to see me as a “new patient” since I hadn’t been in since 2016 and she would not have time to do everything she needs to do. I had scheduled, initially, the last slot of the day because the parking is a nightmare unless you get in there first thing in the morning or come in very late in the day. I get it that the PA would not want to rubber-stamp an approval on something that happened nearly 4 years ago, but I never did get a “new patient” visit with the sleep specialist at that time and I don’t know what to expect, and when changing this appointment the staff couldn’t explain it to me. My misgivings are that, except for the therapist and the doctor who has left, I was treated pretty shabbily by the sleep medicine section of this practice when I first entered the world of apnea and CPAP and I don’t want to have a proven-successful program tweaked and upset while I am automatically marched down some path of unnecessary exams and testing. The DME says the therapist cannot do the Medicare followup. My primary is in the internal medicine side of this practice, and I asked him if he could do the Medicare followup at my upcoming checkup - he said it was better for me that the PA do it to assure I was still being effectively treated.
Has anyone reading this come into a new practice already on a CPAP program that has been working for them? What happened there? Has anyone here done one of these “Medicare followup” visits? What happened? Were you able to make Medicare happy?
Unfortunately when I phoned to see him for this Medicare thing, I learned he had left private practice, he is now a hospitalist. Two docs could see me now – one who was there in 2016 with whom I had bad experiences, and one who is new to me, a PA. I set an appointment with the PA, but got a call from staff that same day that I needed to move the appointment to earlier in the day because they had to see me as a “new patient” since I hadn’t been in since 2016 and she would not have time to do everything she needs to do. I had scheduled, initially, the last slot of the day because the parking is a nightmare unless you get in there first thing in the morning or come in very late in the day. I get it that the PA would not want to rubber-stamp an approval on something that happened nearly 4 years ago, but I never did get a “new patient” visit with the sleep specialist at that time and I don’t know what to expect, and when changing this appointment the staff couldn’t explain it to me. My misgivings are that, except for the therapist and the doctor who has left, I was treated pretty shabbily by the sleep medicine section of this practice when I first entered the world of apnea and CPAP and I don’t want to have a proven-successful program tweaked and upset while I am automatically marched down some path of unnecessary exams and testing. The DME says the therapist cannot do the Medicare followup. My primary is in the internal medicine side of this practice, and I asked him if he could do the Medicare followup at my upcoming checkup - he said it was better for me that the PA do it to assure I was still being effectively treated.
Has anyone reading this come into a new practice already on a CPAP program that has been working for them? What happened there? Has anyone here done one of these “Medicare followup” visits? What happened? Were you able to make Medicare happy?
