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Compliance question. Do I need to have a follow up if I paid out of pocket?
#1
I was scheduled at the time of my titration to come back to see the DR at the end of this month. I really don't care much for the DR. The clinic is a meat mill as far as I'm concerned.

The question is - if I paid for my machine out of pocket instead of going through insurance is there any reason to hold this appointment? The pressure I was prescribed from my titration (split study + another night titration) was way off and by running the sleep test myself + advice from this board I have achieved better results at a much lower pressure. So my willingness to go back and cough up a copay is rather low.

If I cancel this appt and should I ever want to buy a machine through insurance later, will I have trouble?
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#2
(02-05-2017, 06:42 AM)Piggles Wrote: If I cancel this appt and should I ever want to buy a machine through insurance later, will I have trouble?

You might have to go through another sleep test.
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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#3
My suggestion would be to transfer care to your primary physician. Obviously, you have no compliance requirement unless you want insurance to pay for equipment, or are required by DOT to demonstrate use. You can discuss your CPAP use with your regular doctor, and let him know you are benefiting and want him to assist you in any future prescription needs. That should be about it. You don't need a specialist. Be sure you have copies of all study documentation, recommendations and prescriptions, for your personal records and future use.
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#4
(02-05-2017, 06:42 AM)Piggles Wrote: If I cancel this appt and should I ever want to buy a machine through insurance later, will I have trouble?

You shouldn't have any trouble as long as you keep records.  Get a copy of your Sleep Study and Perscription for your records. 

Down the road, if your needs change and you want to go through insurance, they may require a new sleep study.  Insurance and Medicare requirements change each year, so you never know what to expect.

One thought...are you going to buy supplies through insurance?  If yes, "some" DME's may give you grief if your not seeing a doctor at least once a year.
You can also buy online or Amazon and bypass the doctor and DME.
OpalRose
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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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#5
(02-05-2017, 09:46 AM)OpalRose Wrote:
(02-05-2017, 06:42 AM)Piggles Wrote: If I cancel this appt and should I ever want to buy a machine through insurance later, will I have trouble?

You shouldn't have any trouble as long as you keep records.  Get a copy of your Sleep Study and Perscription for your records. 

Down the road, if your needs change and you want to go through insurance, they may require a new sleep study.  Insurance and Medicare requirements change each year, so you never know what to expect.

One thought...are you going to buy supplies through insurance?  If yes, "some" DME's may give you grief if your not seeing a doctor at least once a year.
You can also buy online or Amazon and bypass the doctor and DME.

Thanks for the info.

No to supplies on insurance. Supplies for the Dreamstation are pretty well priced on amazon so I'll probably just go that route.
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#6
After a few years the cost of supplies really adds up. 

I think of using insurance to get my supplies as an infrequent job which pays a high hourly rate for the number of minutes it takes per month.
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#7
Unless your job or career type requires compliance, no, you don't have to go to a follow up appointment. I also agree with Sleeprider. Try to transfer your needs to your primary if they will take it (mine won't, darn him). You will want to occasionally get updated prescriptions. Make sure that you get copies of your sleep study - the raw data as well as the summary and a copy of the prescription from your sleep doctor!
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#8
Another thing, after talking with your primary doctor and discussing the original prescription, new settings you have made, and the improvement you are experiencing; then ask your doctor for a new updated prescription covering the changes. DMEs follow what the doctor orders. Also simply discuss your CPAP related use during your annual visit and you should have no problems later. Joe
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