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Changing PCP is a nightmare in the US
#1
Changing PCP is a nightmare in the US
So, I have changed Doctor (PCP) -  I have great insurance but the Sleep center I have wants my new doctor's approval. She will sign but also wants me to have a new study. All I care about is the equipment and I like what I have but it is leased. So the Doctor must OK, or NOT? I doubt that they will leave me without a machine but I am curious of this scenario. What happens?
I think a year from now I can do a new sleep study (actually it is recommended because I have restless leg syndrome too). By then I'd own the machine. 
I am on medication there is no second guessing especially not by a general practitioner, why is this happening with equipment. BTW the new Sleep Center is part of a Hospital and I am sure medically far better than the first, where I never met the doctor. Still, I am little worried about the equipment - I already told them that I accept only Auto machine.
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#2
RE: Changing PCP is a nightmare in the US
Just tell her you aren't eligible for a new sleep study... Ins won't pay. usually that gets them to come around.
هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه  هههههه
Tongue Suck Technique for prevention of mouth breathing:
  • Place your tongue behind your front teeth on the roof of your mouth
  • let your tongue fill the space between the upper molars
  • gently suck to form a light vacuum

Practising during the day can help you to keep it at night

هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه  هههههه
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#3
RE: Changing PCP is a nightmare in the US
Maybe I am. She is talking with my insurance. It is up to Western Health now. I am not too worried...Dignity health has a GREAT sleep center (minutes from my house) and the equipment not the only factor BUT...I can refuse to take crappy equipment..I hope....
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#4
RE: Changing PCP is a nightmare in the US
Your new doc wants a new sleep study? When was the last one you had?

--

I own my CPAP - is leasing it common?
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#5
RE: Changing PCP is a nightmare in the US
I have about 60 days on CPAP so the titration was around that time. My deal is a $100 month lease (insurance pays the whole thing) and the Sleep Center has a modem installed etc . I do not think anyone looks at my data because I have changed the setting to Auto, from fixed. After 12(13) month I own the machine and return the modem. I doubt that the insurance will go for a new study, because they can do so in about a year. I am making good progress so there is no need to.
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#6
RE: Changing PCP is a nightmare in the US
You are in charge of your own health care. Ask your doc why she thinks you need a new study. You might find out that working WITH your doctor works out better than working FOR your doctor. Mine has gotten used to me questioning him, so he knows he has to explain his reasons for everything.
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#7
RE: Changing PCP is a nightmare in the US
You should have copies of your past diagnostic and titration study in hand, as well as detailed data from your current Dreamstation Auto. I would think you could discuss your treatment efficacy or deficiencies with your new PCP intelligibly and find out what her concerns are that compel her to request a new study. Ask her what she hopes to learn from a new study that is not already available from the wealth of information in hand. If she has concerns that are not addressed by what is known, then she should be able to make the case for insurance to reimburse the new study. At the very least, a new study should solve a problem, and the problem will have to be defined by your new PCP...so what is it, and how will the new study identify a solution?
Sleeprider
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#8
RE: Changing PCP is a nightmare in the US
(12-10-2017, 09:42 AM)KSMatthew Wrote: You are in charge of your own health care.  Ask your doc why she thinks you need a new study.  You might find out that working WITH your doctor works out better than working FOR your doctor.  Mine has gotten used to me questioning him, so he knows he has to explain his reasons for everything.

It is a good idea and I am following your advice. I am curious how to give SleepyHead data to a third party, just print out the summary or give the whole data set? I suppose there are export features...
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#9
RE: Changing PCP is a nightmare in the US
Just print the reports and take them with you. Your doc will scan them into your records.

Changing PCPs doesn't have to be a nightmare. Expect some growing pains at first, but remember that you are in charge...it's your health. Your doc might be limited by insurance requirements for treatment options, but that's a two way street. Your doc doesn't want to do something and not get paid for it, and you don't want to pay out of pocket, and the insurance co doesn't want to pay anything. What gets lost in all that is what the best course of treatment should be.
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