Hello Guest, Welcome to Apnea Board !
As a guest, you are limited to certain areas of the board and there are some features you can't use.
To post a message, you must create a free account using a valid email address.

or Create an Account


New Posts   Today's Posts

What is A Nasal Pillow?
#11
(06-26-2012, 02:35 PM)BabyDoc Wrote: Well, guess what the DME said to the insurance company? According to Medicare, we are entitled to a SET of TWO pillows, a pillow for each nostril.

Tell them that if they won't give you two per month you'll switch to a different DME who interprets the rule correctly.

Quote:How ridiculous is this?

It's as ridiculous as saying you have only one working nostril and claiming you need to replace the pillow for that nostril twice a month to comply with Medicare regulations.
Sleepster
Apnea Board Moderator
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.
Post Reply Post Reply



Donate to Apnea Board  
#12
Well all is well, that ends well. Armed with all the codes that Zonk provided and the support from the rest of you, I called my Insurance company, who then called the DME. Apparently, EVERYONE at this particular location for this DME was misinterpreting the Medicare guidelines for the nasal pillows. Fortunately, there was no incorrect billing done. The insurance company was only getting billed for the 1 set of pillows by this DME office.

At another office for the same DME, they WERE providing 2 sets of pillows per month. The bottom line is: they will now be sending me 2 pillow pairs per month, or if I want, they can send a 3 month supply at a time (per Medicare guidelines), so I don't have to call every month.

Thanks to all of you here.
Post Reply Post Reply
#13
So what I don't understand is... You order two per month. They give you two per month. They bill your insurance. What insurance doesn't pay, they collect from you later. Just because insurance might only PAY for one a month, as they thought, doesn't mean you can't order more and pay out of pocket!

Edit: And by the way, I would have to define the "pillow" as the main body of the unit, not the individual nasal nozzle.
Post Reply Post Reply


Possibly Related Threads...
Thread Author Replies Views Last Post
  [Equipment] Very Difficult to be compliant my nasal pillow hurts the inside of my nose soo much WakemeupBeforeYouGoGo 33 12,307 Yesterday, 11:18 AM
Last Post: Fats Drywaller
  [CPAP] Leak in nasal pillow sherryl10 5 205 05-02-2018, 12:06 PM
Last Post: gwc2795
  Someone be so kind as to explain Gel nasal mask vs regular nasal mask gwc2795 12 544 04-27-2018, 05:53 AM
Last Post: gwc2795
  Pillow Recomendations jochumr 6 318 03-25-2018, 08:14 PM
Last Post: jochumr
  What (sleeping) pillow do you like and why? groggygirl 32 1,428 03-24-2018, 04:32 PM
Last Post: PaulKTF
  Pillow on a wedge pillow? Teddysjam 5 273 02-16-2018, 04:19 PM
Last Post: greatunclebill
  Pillow sizing off? paulag1955 14 575 02-06-2018, 04:41 PM
Last Post: sansnap

Forum Jump:

New Posts   Today's Posts




About Apnea Board

Apnea Board is an educational web site designed to empower Sleep Apnea patients.