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+--- Thread: Compliance Rules (/Thread-Compliance-Rules)
Compliance Rules - 0rangebear - 02-26-2016
What are these and where do they come from?
RE: Compliance Rules - PoolQ - 02-26-2016
I don't remember the total package but it's at least 4 hours? for like 90% of the time over 30 days. best I can remember but someone will correct if wrong
they are only used by insurance, including medicare, for them to pay for the machine or take it back
RE: Compliance Rules - OpalRose - 02-26-2016
(02-26-2016, 07:33 PM)0rangebear Wrote: What are these and where do they come from?
Orangebear,
Medicare requires a data report from the patients (PAP) device which documents use of said device for at least 4 hours per night on 70% of nights for a 30 consecutive day period during the first 90 days after starting treatment. For example, if a patient starts (PAP) treatment on January 1st and from January 30th to February 28th they use the device every night. If 21of the 30 nights the patient used the device for at least 4 hours then they are considered to be compliant.
Medicare also requires all (PAP) patients must have a face to face visit with their physician during the second or third month of using their (PAP) device. (Between day 31 and 90 after starting on the PAP treatment) During this visit the patients physician must document an improvement of systems. This means is imperative that patients make follow up appointments to meet with their physician prior to the 90 day cut off.
Even if your not on Medicare, most insurances follow Medicare guidelines.
RE: Compliance Rules - PaulaO2 - 02-26-2016
The rules typically come from the insurance company. They don't want to pay for this machine without proof you are using it. They don't care if it is actually working out as adequate treatment or not, just that you are using it. Like PoolQ said, it is usually for x percentage a night for anywhere from 30 to 90 days which equal about 4hrs a night.
Sometimes an employee will want to see compliance data as well.
You cannot simply turn on a machine and let it run for 4 hrs and call it done. These newer ones can tell if a person is attached to the other end and will not count that time.
RE: Compliance Rules - Sleeprider - 02-26-2016
Ha ha! Welcome to the club. I just got my first insurance replacement since 2008 and am back on compliance monitoring. considering my minimum use is 7.5 hours and average use is over 8-hours per night, this is not a problem. Use the machine (it's good for you), and the compliance will fall right into place. At some point in the first 90 days you need to meet with your doctor and discuss this therapy and persuade him that it is benefiting you. That should not be too difficult. Do this and you're home free with your machine. Failure is not an option.
RE: Compliance Rules - 0rangebear - 02-27-2016
(02-26-2016, 08:07 PM)Sleeprider Wrote: Ha ha! Welcome to the club. I just got my first insurance replacement since 2008 and am back on compliance monitoring. considering my minimum use is 7.5 hours and average use is over 8-hours per night, this is not a problem. Use the machine (it's good for you), and the compliance will fall right into place. At some point in the first 90 days you need to meet with your doctor and discuss this therapy and persuade him that it is benefiting you. That should not be too difficult. Do this and you're home free with your machine. Failure is not an option.
Wow! I don't know
how you do it. I cant ever remember sleep 7.0 hour let alone 8. I am usually wide awake between 5 and 6 hours. I have tried to sleep longer just unable.RE: Compliance Rules - Sleeprider - 02-27-2016
I'm such a slouch in retirement. My Sleepyhead data shows 8.42 hours average for the last year with 100% compliance.
RE: Compliance Rules - 0rangebear - 02-27-2016
(02-27-2016, 07:57 PM)Sleeprider Wrote: I'm such a slouch in retirement. My Sleepyhead data shows 8.42 hours average for the last year with 100% compliance.
I envy you my friend
My Dr. prescribed 5 hours a night 6 days on a week on the machine. This a bit different that the compliance stats in sleepyhead. Sounds like it must of actually come from my insurance company. I just hit my 60th day yesterday and it looks like I am on the fence on the compliance issue.
RE: Compliance Rules - Sleeprider - 02-27-2016
(02-27-2016, 10:37 PM)0rangebear Wrote:(02-27-2016, 07:57 PM)Sleeprider Wrote: I'm such a slouch in retirement. My Sleepyhead data shows 8.42 hours average for the last year with 100% compliance.
I envy you my friend
Well no wonder! You're drinking coffee late at night! Try this.
