RE: Home Sleep Study - Low AHI but significant desat
Glad to hear you doctor appointment went so well. I though your case was very straight-forward and the need for bilevel was well established by what you have documented throughout this thread. Well done on making a persuasive argument for your health. In the interest of helping others, what do you think most influenced your doctor to come to this conclusion?
RE: Low AHI but significant desat
That's a good question...
In this case, my new PCP is a DO, so she's a bit more focused on whole-person care. She started in a mindset that was open to the discussion.
In the end, she was pretty clear that having data helped, but actually understanding the data was the deciding factor. I could answer her "why" questions as she absorbed the information I was giving her. So she was comfortable that the plan made sense.
Your pre-written prescription language was super helpful. She took it and copied it verbatim. She said that allowed her to skip the titration/sleep study requirement completely.
RE: Home Sleep Study - Low AHI but significant desat
Congrats, sounds like you actually have a good doctor
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
RE: Low AHI but significant desat
(03-19-2024, 03:23 PM)ArcherNeedsSleep Wrote: That's a good question...
Your pre-written prescription language was super helpful. She took it and copied it verbatim. She said that allowed her to skip the titration/sleep study requirement completely.
That's good to know. I'll try to include that information when it's clear and relevant.
PS. You went to Lanky Lefty before me? Oh my!
RE: Low AHI but significant desat
(03-19-2024, 04:11 PM)Sleeprider Wrote: PS. You went to Lanky Lefty before me? Oh my!
You need to make some videos, too....you'd be a YouTube sensation. 
(Sorry. Won't happen again. I definitely get the best advice here.)
RE: Home Sleep Study - Low AHI but significant desat
Next on Apnea Board YouTube, dealing with crazy DMEs
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
RE: Home Sleep Study - Low AHI but significant desat
SarcasticDave94, you are so right....
I hadn't heard anything for nearly two weeks, so I asked the doc for the DME contact info. When I reached them, the DME said that it's taking 6-8 weeks to get through the insurance queue, then another 2 weeks for their schedulers to call me, with up to another month more before I can pick up a machine.
04-02-2024, 03:36 PM
(This post was last modified: 04-02-2024, 03:36 PM by SarcasticDave94.
Edit Reason: Typo
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RE: Home Sleep Study - Low AHI but significant desat
Back in 2017 when I was waiting impatiently for my ASV, I was calling insurance customer service, DME and doctor as well, alternating daily between those 3. Especially important when first, the doctors office messed up something about the script, then insurance lost the script and order, and this added to delays.
Not to forget the DME, they were sending me messages saying the ASV would be ready next day, before they ever sent it. Repeat that about 6 times, I did type this correct, 6 bungled messages.
Call so they don't forget.
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
RE: Home Sleep Study - Low AHI but significant desat
That's great advice that I plan to follow!
RE: Home Sleep Study - Low AHI but significant desat
I've now been two rounds with the DME. They say that the BiLevel machine isn't covered because my sleep study AHI was below 5. So even with the consistent desaturations, I fall in the "investigative treatment" category, and there's no coverage for it.
It sounds like insurance wants an in-lab sleep study, and that they will only accept it for treatment if the AHI is higher than 5, regardless of the oxygen levels.
So....is it worth fighting them for the machine based on my current test (showing <5 AHI but with significant, long-duration SpO2 drops) and the ongoing low SpO2 readings from my Wellue ring?
...or should I go ahead and do the additional sleep study with the hope that I come in higher than 5 AHI to just get the insurance qualifications taken care of going forward (but also with the risk that I come in below 5 again and am still in the same situation as I am now)?
...or should I just take a copy of my prescription from the doc and save up for the Bilevel machine on my own?
...or, finally, should I pursue adding supplemental O2 to my current machine instead?
I'm torn, and looking for some input on the decision. Has anyone been in this type of non-qualified insurance situation and had success navigating the process?
Also, is there any real risk in adding oxygen to my current machine? Each of my doctors has indicated that they don't want to go down the oxygen route if we can avoid it. I'm not sure if it's based on the discordance between supplemental oxygen and my age and general health (I'm early 50s and otherwise healthy and physically fit), or if there is some inherent risk to starting on oxygen, like an increasing dependence on supplemental oxygen, or other health concerns. If anyone has insight or experience on the topic, I would love to hear it.
Thank you.
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