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RE: Compliance Questions - OpalRose - 11-28-2019
This is actually from Medicare, which most (not all) insurances follow. It is really up to the patient to touch base with their own insurance company for compliance obligations.
Medicare Coverage of CPAP at Home:
”After the patient starts CPAP treatment at home there has to be documentation of patient compliance. This is done after 31 days but before 90 days of usage. They must have a download of the CPAP usage and a face to face re-evaluation with their physician. Their physician must document that the patients symptoms have improved. Adherence to CPAP is defined as usage greater or equal to 4 hours per night on 70% of nights during a consecutive 30 days anytime during the first 3 months of initial usage.”
Note: 70% of any 30 day period is 21 days. You actually have 90 days to accomplish that.