I have a pretty forward thinking sleep doc, and a 100% DME Insurance policy which I am so grateful for when hearing other people's stories! My story went so smoothly and no thanks to me who didn't find this forum until after hosing up!
- Primary Care Doc sends me to Sleep Doc
- Sleep Doc does his exam and asks a lot of epworth questions. Orders in-home study.
- Home Study shows moderate apnea (even though I didnt sleep much)
- Doc sends orders for APAP to a DME that is In-Network for my Insurance
- They call me and schedule me to attend a class (where I and 5 others all receive a machine, do a mask fitting and choose a mask and receive instruction on cleaning) The DME gives everyone an S9 Autoset no matter what their Rx.
- 30 day check up with Sleep Doc - as required by Insurance
- 8 mo Sleep Doc Checkup - next will be in a year.
The part that kinda burns me is that the DME is charging the Insurance a monthly rental fee of $190 per mo. $35 of that is a monthly fee for the H5i humidifier... what a ripoff! However, the Insurance company allows it, so they do it
Not sure when the rental ends, I started this routine last November!
My 34 yr old son also has apnea... as soon as I began researching it I knew he did! I got him to get a referral to the same sleep clinic I used. He got a different MD, but similar forward thinking... She set him up for a home test after a first appt that must have gone much like mine, and he turned out to have very severe apnea with O2
desats below 70% and an AHI of 102. Deducting the time he was clearly awake (upright, and no events) puts it at 120. They didnt screw around with that one... Doc read his results late on a Saturday night, and by Tuesday his new DME (not the same as mine, different insurance) had the machine he requested with my help in his hands.
The home study with APAP instead of titration seems to be the latest trend, and Insurance companies are beginning to "prefer" it. The In-lab studies cost way more than the difference between CPAP and APAP. Son has medicaid - even they went for it. Canada probably will too, eventually. Its more cost effective!