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Compliance
#1
Compliance
Once you have met the criteria for compliance does that mean you can start adjusting your settings without worrying about insurance not paying for the monthly rentals on the cpap machine?
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#2
RE: Compliance
You can change them now. You only have to meet two criteria. Use of the machine and successful treatment which is under 5 API.

Most insurance want a statement from a doctor or dentist each year stating these two criteria are met.
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#3
RE: Compliance
Thanks,so if I make changes to my settings,the insurance rental will not be in jeopardy correct?
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#4
RE: Compliance
Not as far as I know. Why would it if your sleep apnea is treated and your using the machine?
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Advisory Members serve as an "Advisory Committee" to help shape Apnea Board's rules & policies.

Membership in the Advisory Members group does not imply medical expertise or qualification for advising Sleep Apnea patients concerning their treatment.



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#5
RE: Compliance
Makes sense.  Thanks Walla Walla!
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#6
RE: Compliance
Just a caveat - I would not publicize the fact that you're changing settings to either the DME or an insurance company. 

Even if it's not illegal, nor against any "agreement" that you (unknowingly) signed off on, or that it's not likely to affect your coverage, why give them ammo that can potentially be used against you?

If you have any doubts at all, it's probably best to allow the DME or sleep doctor to make the pressure changes... that would be the ultimate safe route to go.  But we here tend to be something of a group of mavericks who often throw caution to the wind in order to lower our AHI.   Grin

...

"Pressure changes you say?... What pressure changes?  We ain't got no stinkin' pressure changes...."   Whistle
SuperSleeper
Apnea Board Administrator
www.ApneaBoard.com


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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#7
RE: Compliance
I effected something of a compromise. I'm a newbie.

I did the requisite 23 or so days at 4+ hours without changing the settings, except comfort items. So I passed the DME hurdle.

I didn't do a whole lot of messing with the settings until after my follow-up 30 days with the sleep center. I did one night at CPAP 8 and it didn't make a difference, so I just reverted to the scrip settings (5-15). I didn't want to ruffle any feathers at my appointment.

Since then (3 weeks), I've messed with the settings (starting at a low upper pressure) until I could manage leaks. I steadily increased the settings over a period of 10 days or so. With leaks now managed, I am back to my scrip setting for upper pressure, but had to move up the lower pressure so I could breathe (8-15).

That's where I am now. I am 100% compliant, leaks under control, and the patient from heaven. I am not messing with settings any more for the moment, because I need to convince the sleep center to get me on another kind of machine. I don't want them to come back at me with "you messed with the settings. Use the prescribed settings for a month, and we'll take another look."

So, I guess it depends on your mission. And it doesn't need to be an all or nothing proposition.
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#8
RE: Compliance
Thanks to everyone .  This is such a great forum.  Will make small changes until I see my sleep doctor.
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#9
RE: Compliance
(11-16-2017, 11:52 PM)SuperSleeper Wrote: Just a caveat - I would not publicize the fact that you're changing settings to either the DME or an insurance company. 

Even if it's not illegal, nor against any "agreement" that you (unknowingly) signed off on, or that it's not likely to affect your coverage, why give them ammo that can potentially be used against you?

If you have any doubts at all, it's probably best to allow the DME or sleep doctor to make the pressure changes... that would be the ultimate safe route to go.  But we here tend to be something of a group of mavericks who often throw caution to the wind in order to lower our AHI.   Grin

...

"Pressure changes you say?... What pressure changes?  We ain't got no stinkin' pressure changes...."   Whistle
I am in no way disagreeing with the statements, I am only using my personal experience as an educational information tool. Note that I am fortunate that all turned out OK as SS's advisement above quoted was exactly what I didn't do.

Scenario was a few months back when I was battling the trio of doc insurance and DME to get my required therapy and needing an ASV machine. I told a PA at the pulmonary office I changed settings to x to help feel better. Another time I told insurance customer service rep I change settings to help me get needed therapy. AND I've told 2 DME businesses that were renting out my CPAP devices that I change settings as I see fit.

All these have a response of "OK if it's helping then fine by us". Even so, it's a wise thing to apply the "less said the better you'll come though the situation" style action probably applies.

Dave Coffee
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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