Who to contact about compliance?
Hi!
I've had my airsense 10 autoset since september, and I've been using it pretty much daily. Now I'll go on travel for a month and a half, and I'll take my newly purchased airmini (which I've used quite a lot over the last month...I actually manage to sleep with the noise).
So, for the next 1.5 month my airsense will say I'm not using it (which will be true, I'll be using the airmini). My question is do I need to worry about compliance? And who should I contact? Normally that would be my sleep doctor, but I haven't been able to reach him in 3 weeks.
How does compliance work? Does it go through the doctor? Should I contact HME from which I got the device, or my health insurance?
RE: Who to contact about compliance?
Compliance is only for insurance and medicare purposes. Contact your insurance ask them for their requirements.
RE: Who to contact about compliance?
Usually compliance is met within the first 90 days, but may be dependent on your particular insurance coverage. Call them to be sure.
RE: Who to contact about compliance?
some state's DOT licenses require compliant downloads for the driver's yearly physicals. It should be possible to to have 2 separate reports from both machines for the year and match them up? I'm not sure how to get the airmini reports though...
RE: Who to contact about compliance?
I haven't gotten to the point where I need to replace my first unit, and then to seek reimbursement from the insurer. They might need proof of compliance again, but I just don't know. However, my understanding is that the matter of compliance is very much an initial concern for everyone, patient, consulting specialists and therapists, and for those insuring against success/failure. All of those would want to see a reasonable adaptation to, and a record of consistent and beneficial use of, PAP therapy of some kind. This typically takes place over a short trial period of about 30 days...ish. Thereafter, with thumbs up from everyone, the insurer gives the agreement and go-ahead to acquire a machine and to commence what ostensibly will be a life-long therapy, and agrees to reimburse for a portion of all subsequent costs.
With a worn unit ready for replacement, or with an updated titration and diagnosis or prescription, I don't believe compliance is an issue for the insurer. They would just agree to continue to compensate at the prescribed/published rate for all new and ongoing expenses that are subject to reimbursement under their existing policies. I doubt anyone failing, or having failed, to use PAP therapy would even bother to incur the expenses for new or replacement machines, or even to submit to the tests needed to have a change of therapy. So, one is deemed to have satisfied the matter of compliance early in their diagnosis and trials.
I hope someone with a contrary experience or knowledge speaks up. I wouldn't be at all surprised to learn of even more variance in this field.
07-02-2018, 07:52 PM
(This post was last modified: 07-02-2018, 07:54 PM by OMyMyOHellYes.)
RE: Who to contact about compliance?
So, you're callin me to see if it's OK to quit using the CPAP we bought you? Bought your own CPAP now, didja? Well, I guess you won't be needin the one we supplied. Now that you mention it, I see you're not using it any more anyway .....
OMMOHY
There. I said it.
OMMOHY
Contrarian in Residence
RE: Who to contact about compliance?
Most likely, you're past compliance, which should have been accomplished within the first 90 days of having the CPAP. The timing does depend on your individual insurance, so I'd call customer service and ask what they require.
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: Who to contact about compliance?
I believe that my compliance period is one year (and don't want to open a can of worms, so to speak, by inquiring) and if I don't maintain the required usage they'll take my precious PAP away. I do know that I'm still under the scrutiny of my sleep doctor, for which I am deeply grateful.
RE: Who to contact about compliance?
Someone is knocking on ShaunBlake's door...well, well, it's the compliance police. What to do? Follow Dave and bribe 'em with unfortunate for SB he ended up in jail then because he unknowingly broke a java code...
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: Who to contact about compliance?
Just check with whoever pays for your machine (typically insurance company). Some folks don't realize that they are on a permanent rental and the 90 day requirement may differ. People who have pilot's licenses, truck drivers, etc, can use multiple machines as long as they can produce a report that combines them.
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