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[CPAP] Insurance Compliance Period
#1
Insurance Compliance Period
I have an appt. for my compliance evaluation period at my sleep clinic.  What takes place at this visit?  will they just read my SD card to see my results to verify I am in compliance for the Insurance co. or will I actually get to review my reports for the in home and in clinic sleep studies all so what am I able to expect to  or get copies of i.e. my actual study results graphs or summary data??

If anyone in the forum has been to one of these visits let me know and or any one in this field of study that may know what I maybe able to request an obtain.
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#2
RE: Insurance Compliance Period
c2workout,
I go for mine on 24 MAY. I am curious too and anxious to hear responses from the board leaders. I have been watching my nightly data via DreamMapper by Phillips Respironics, so I know already that I should be in compliance with 100% of nights with hours used above 5. It will be interesting to see if I am 'nicked' for changing min/max pressures and other settings myself. Are you feeling better since using your CPAP?
Have a good nights sleep,
NickAsleep
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#3
RE: Insurance Compliance Period
I suspect it depends on the clinic. I just had mine last month. I was asked if I was comfortable with the machine and felt it was helping me and to confirm that I had used it at least 4 hours a night for 70% of the nights. There was no interest in my SD card. I did bring some SleepyHead data and there was some interest in that but primarily it was just usage and whether or not I felt it helped.
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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.

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#4
RE: Insurance Compliance Period
If this is your first visit, it is to validate your usage (percentage of nights over 4 hours), to see how you are acclimating to the machine, and depending on the physician, whether or not they want to change your initial settings. My visit was pro-forma and the doctor filed the necessary paperwork required by the insurance company. No special questions. Unfortunately, I did not have a great forum like this one, nor did I have access to software. I had a ResMed Elite II CPAP with a single setting. I needed to read the screen each day and track my own numbers.

However, this is an opportunity for you to get a much better handle on your therapy. Feel free to request the doctor if you are seen by a tech or an assistant.

Best of luck with your visit.
"The object in life is not to be on the side of the majority, but to escape finding oneself in the ranks of the insane." -- Marcus Aurelius
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#5
RE: Insurance Compliance Period
I was only required to see my sleep doctor before the first 90 day period was up.  He asked how I felt, commented that my average AHI was under 1, which he thought was unusual because none of his other patients had a low number.  

He didn't care about seeing data, and just laughed when I told him about this forum and how I was learning to tweak my settings.  He just said.....Do whatever works!

I only see him once a year now to satisfy insurance requirements, and we normally talk about
ways to lose weight.   Eat-popcorn

It's great if you have a doctor that is knowledgeable about your data, but if not, no big deal, and I would never worry about tweaking settings.  It has nothing to do with compliance.

Other than a serious medical condition, you will find help here.
OpalRose
Apnea Board Administrator
www.apneaboard.com

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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE.  ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA.  INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#6
RE: Insurance Compliance Period
(05-10-2017, 06:14 AM)OpalRose Wrote: He didn't care about seeing data, and just laughed when I told him about this forum and how I was learning to tweak my settings.  He just said.....Do whatever works!

I only see him once a year now to satisfy insurance requirements, and we normally talk about ways to lose weight.   Eat-popcorn

Sounds like your doc is a real winner! (sarcasm)
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#7
RE: Insurance Compliance Period
Yes he is (double sarcasm). I'm certain I know more than he does, at least where SA is concerned.
OpalRose
Apnea Board Administrator
www.apneaboard.com

_______________________
OSCAR Chart Organization
How to Attach Images and Files.
OSCAR - The Guide
Soft Cervical Collar
Optimizing therapy
OSCAR supported machines
Mask Primer



INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE.  ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA.  INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#8
RE: Insurance Compliance Period
OpalRose - That's hilarious! At least he's not giving you a hard time and hindering you.

My insurance doesn't require compliance, so I can't speak to that. But as far as papers to request - definitely request a copy of your sleep study and your prescription/diagnosis; you are legally entitled to them, and (besides being interesting to read for yourself) you never know when you might need them.
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#9
RE: Insurance Compliance Period
Yes, very good advice. I haven't looked at mine for over a year. Should be good reading.
OpalRose
Apnea Board Administrator
www.apneaboard.com

_______________________
OSCAR Chart Organization
How to Attach Images and Files.
OSCAR - The Guide
Soft Cervical Collar
Optimizing therapy
OSCAR supported machines
Mask Primer



INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE.  ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA.  INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#10
RE: Insurance Compliance Period
Thanks to everyone for this feedback.   From the comments so far, I will not be expecting much, but I will not let it become a 1 minute appt.   I have done this before and I have no problem asking them tough questions and to requesting my complete Study results not just some Drs. report that talks down to you, explains simple terms with the end result of my official report to be " Your AHI = 74 and do not sleep on your back sleep on your side"  end of written report. That they posted to "My Chart"   Online program some medical facilities use in my area to perform a number of simple task  i.e. make appt., refill meds., post some test results like the great report mentioned above, etc.
 I will report back and fill you in as to how it went.
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