The wireless modem is only used for reporting compliance data for insurance coverage. With my machine, it was uploaded to a PR server, and the insurance company verified that I was using it for the required time.
The MD is the only person that can determine if it was effective and medically necessary. In my case, I was asked to bring my machine in after abut 90 days of starting PAR therapy for a follow-up. The tech copied the data on the SD memory card and the MD determined that my symptoms had decreased sufficiently to declare that the treatment was medically necessary and effective.
Finally, I seriously doubt that a DME provider would adjust machine settings without direction from an MD. They are not trained to interpret results, nor are they allowed to prescribe treatment(s).
Just my two cents.
04-29-2014, 12:47 PM
(This post was last modified: 04-29-2014, 12:49 PM by ImaSurvivor.)
This is common practice to have the data sent to the DME by the transmitter. Otherwise they would require you removing the SD card and physically bringing it to them so they can check compliance for insurance purposes. I was happy to have this method rather than having to sneaker-net my SD card to them. My DME is 20 miles from where I live. Also, I was still in the compliance period while traveling with my machine. The information was sent to them and I didn't have to worry about it. They have to follow for 3 months for compliance purposes.
I was told they could make changes to the machine remotely as well. But have the impression it wouldn't be without discussion with me and moreso to assist me if I was not able to make the change myself.
04-29-2014, 12:58 PM
(This post was last modified: 04-29-2014, 01:05 PM by ImaSurvivor.)
Compliance means you have to prove you are using the machine minimum of 4 hours each night for a straight 30 day period. Most insurance companies give a 3 month period to get compliance in. When I began, I thought it was an average of 4 hours/night. Using mine the first week I had one night that was 10 minutes shy of 4 hours and another night 8 minutes shy of 4 hours. All other nights were well over and more than made up for those two nights that were shy by a total of 18 minutes. When the DME called me a week later as a followup to inquire how I was doing with it, they mentioned I was not compliant on two of the nights and that it had to be 30 straight days of compliance. They gave me 3 months to get that 30 straight days.
Once I met my compliance, they billed the insurance company to be paid. If I didn't meet compliance I probably would have had to return the machine or pay for it myself. My insurance company pays 100% for my CPAP equipment. Other insurance companies vary. Mine is 100%
I had my compliance done way before 3 months was up but the transmitter was on for the full 3 months before I had to return it to them.
thank you robysue for the visual... thank god i don't have one of those... i would have a major issue with it..
my new machine came with a data card and a mailer... the dme said that my insurance may request the card.
imrichard thank you for this thread...