I have been using my CPAP daily (except during a recent 2 weeks vacation) for about 2 months, averaging 8 hrs a night, usually with an AHI at or below 1. A recent letter and follow up phone call with Apria informed me that I may be required to pay the CPAP charges myself due to a failure to satisfy a Medicare requirement of a qualifying sleep study. To make a long story short, although I have had 5 sleep studies (I had previous CPAP as well as dental appliance therapy), the most recent was in January, 2014, so it may well be that Medicare requirements were not met. (How should I know?)
My question, however, is didn’t Apria have an obligation, under Medicare or otherwise, to investigate and inform me of this Medicare deficiency before providing me with the CPAP equipment?
FWIW, after my 30-day follow-up with the doctor who prescribed the CPAP, he referred me to a new doctor (“the guy who wrote the text on sleep medicine”), and prior to seeing him I will have a new sleep study on 8/26.
07-29-2015, 03:55 PM
(This post was last modified: 07-29-2015, 03:59 PM by PaytonA.)
Medicare may just need a copy of that sleep study. That is assuming that it was done at a sleep lab facility. Medicare has not been involved in any of my CPAP use to this point. When I got my second machine (an S9 VPAP Auto) I was on a different medical insurance than when I was initially diagnosed and they wanted a copy of the original sleep study before they would pay for it. All of this happened through the DME before they delivered the machine. I supplied the study and everything went smoothly. That was through Apria.
Yes, in my opinion, your DME should have been aware of this and gotten it straightened out before they delivered the machine.