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My medical provider called me, they want to schedule my titration study. Should I go? - Printable Version

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My medical provider called me, they want to schedule my titration study. Should I go? - Phil487 - 06-28-2023

Just a little history, I had a sleep study in late 2021. In early 2022, they finally got back to me and said I had mild apnea. Several months went by that I didn't do anything but my apnea got worse. Jan of 2023 I asked my GP for a referral for the titration study. He puts the request in. I never heard back even after inquiring again about it. I got frustrated and just bought my own Airsense 10 on Craigslist and learn a ton from here and Lankylefty. Last nights screen print is below. 

My question is should I go in for the titration study? One issue is the insurance, I have PPO so it means I would have to pay a portion of it. I put in a request for quote, I'm estimating I'd have to pay a $1K or $2K for the copay, deductible, etc. It's not like I can't afford it, but I'm not sure it's a good use of my $$$. 

So my question is, would it be worthwhile to go get a titration study done? I've been adjusting my own pressures and think I have it dialed it pretty good. Or is it possible to make an apt and have the sleep doctor just look at my own data from my own machine without doing the titration study? I'm not sure if they would even entertain that. Maybe it's not even worth going down this route. I'm happy with my own machine, if I got a machine from my provider, aren't those rented from the insurance so you generally have to pay a set amount? Also aren't you not allowed to adjust anything?

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RE: My medical provider called me, they want to schedule my titration study. Should I go? - Melman - 06-28-2023

You treatment is already very effective. In my opinion a titration would be waste of $$$.


RE: My medical provider called me, they want to schedule my titration study. Should I go? - Phil487 - 06-28-2023

(06-28-2023, 08:13 PM)Melman Wrote: You treatment is already very effective. In my opinion a titration would be  waste of $$$.

Thanks, that's what I was thinking too, but wasn't sure if I was missing something.
My only remaining issue is obtaining a better mask. I'm using a Respironics FF masks that is okay but it's a medium, I need a large or better yet a better full face mask.


RE: My medical provider called me, they want to schedule my titration study. Should I go? - Sleeprider - 06-29-2023

I think the way to go on this is to share your use of CPAP with your doctor along with hours. This will establish for your medical record that you are being treated effectively by auto CPAP and that you benefit from that treatment. This can put you on schedule to obtain insurance benefits for equipment and supplies. You already have a diagnostic study that meets all requirements to establish medical need, and a titration study, which is normally optional anyway, would be redundant to your efforts to self-titrate. You have adequately demonstrated effectiveness.

I don't know what doctor you are using to manage your care, but I would encourage you to move away from a sleep specialist and discuss this with your primary doctor and ask him to manage your sleep disordered breathing care. You should be certain to obtain copies of your diagnostic test, and at your next appointment request that your doctor manage your care. You clearly do not need a specialist, and there is no reason to continue that. It is not needed for insurance or your care.


RE: My medical provider called me, they want to schedule my titration study. Should I go? - PaulaO2 - 06-29-2023

In all my years of this, I've had one sleep study. I've seen my "sleep doc" twice. Useless and smirky. When it came time to get a new machine, I asked my GP to write the script. That's all you need is a script from a doc, doesn't have to be a sleep doc.


RE: My medical provider called me, they want to schedule my titration study. Should I go? - RainbowFish - 07-01-2023

It might be reasonable to get a referral to a sleep provider to consider a home study to give further data re oxygenation, ensure DME insurance coverage, and to discuss mask options. But medically, it sounds like you do not need a titration study unless your O2 sats are not acceptable on your present settings.


RE: My medical provider called me, they want to schedule my titration study. Should I go? - Homerec130 - 07-05-2023

Talk to your "sleep doc" and bring some of the reports from OSCAR. I see my "sleep doc" twice a year and it is an in/out short appointment. Insurance covers the appointment and supplies. I had to get a new sleep study when I got my last machine as I was also changing insurance - went on Medicare. BTW, my "sleep doc" is also my ENT and we have developed a good relationship over the years.


RE: My medical provider called me, they want to schedule my titration study. Should I go? - lexit957 - 07-05-2023

Could you share your methods of arriving at that pressure range? Just trial and error?

Thanks!


RE: My medical provider called me, they want to schedule my titration study. Should I go? - RNeil - 07-06-2023

Insurance coverage for supplies is very overrated. They will try to sell you a ridiculous schedule for replacing masks, pillows, hoses ect. Every thing the DME sells will be very high priced. If you must pay a fraction of that, you are being ripped off.

I got my mask from the DME. It cost triple what others were selling it for. They said insurance would cover it, but I had not met my deductible. I did not return their calls regarding supplies.