RE: First night with new Bipap after sleep study and 37 AHI mostly CA
The insurance will not pay for an ASV machine unless an new titration study is done. It really doesn't make any sense. They would rather pay for me to go to the sleep center again which is extra cost for them - my co pay is only $35.
I will certainly take my charts with me when I go for the tech at the sleep center to review. Hopefully he uses them as referance.
RE: First night with new Bipap after sleep study and 37 AHI mostly CA
I suspect the tech will use the ASV default values, the same way we did here. He may fine-tune those and recommend a higher EPAP pressure and less PS. Great minds do think alike.
RE: First night with new Bipap after sleep study and 37 AHI mostly CA
I'd recommend my doc in Monroeville, but he's a UPMC doctor so I doubt AHN would cover him. Its nice that you have a low co-pay for titration study. Out of pocket those are crazy expensive.
RE: First night with new Bipap after sleep study and 37 AHI mostly CA
JCP519, just in case, who is the doctor you like? My insurance (Medicare and Anthem) is agnostic to AHN/UPMC. I have not had a sleep doc since 2008 in California, and have been doing my best to avoid it.
RE: First night with new Bipap after sleep study and 37 AHI mostly CA
I was able to get a waitlisted appointment with someone at AHN on Wednesday. Is it worth seeing someone. Don’t have much confidence considering what I have been through so far.
RE: First night with new Bipap after sleep study and 37 AHI mostly CA
(04-12-2024, 08:22 PM)Sleeprider Wrote: JCP519, just in case, who is the doctor you like? My insurance (Medicare and Anthem) is agnostic to AHN/UPMC. I have not had a sleep doc since 2008 in California, and have been doing my best to avoid it.
His name is Dr. Thomas M. Kaffenberger and he does appointments out of University Ear, Nose, and Throat Specialists in Monroeville. I believe he also does appointments at UPMC Mercy in Pittsbugh as well. I think he is an ENT and his specialty was in OSA.
If you google his name he's the first or second link that comes up for me. He was awesome! Great listener and very polite to me.
RE: First night with new Bipap after sleep study and 37 AHI mostly CA
Great to hear. Thanks for that.
Panda, all you can do is to present what you already know concerning your history with CPAP, BiPAP and your current ASV. Your titration test dis not suggest ST could achieve the efficacy you have achieved with self-titration with ASV. The titration test of a fully automatic device when you already have actual usage seems to be folly. The doctor could agree with that viewpoint and use your data and prior tests as adequate evidence of medical necessity and benefit from the use of ASV without further clinical testing. That opinion would be good enough for any insurance.
RE: First night with new Bipap after sleep study and 37 AHI mostly CA
Thanks, maybe I will keep appointment and see what she has to say.
RE: First night with new Bipap after sleep study and 37 AHI mostly CA
Hi all, wanted to give you an update. I did end up talking with the pulmonologist . She feels that I have treatment emergent CSA due to the fact that my at home study that I initially did, did not show any centrals. She still feels that ASV would be the correct treatment (mentioned an oral device) and said if I am able to tolerate ASV to continue with it. Had ASV titration last night and have to wait for report before they will order me a new machine.
RE: First night with new Bipap after sleep study and 37 AHI mostly CA
sounds like you're on the right path for this. Keep us posted.
